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Randomized Controlled Trial
. 2012 Jul;60(4):263-6.
doi: 10.4103/0301-4738.98701.

Ranibizumab as an adjunct to laser for macular edema secondary to branch retinal vein occlusion

Rajvardhan Azad  1 , Kumar Vivek, Yograj Sharma, Parijat Chandra, Siddarth Sain, Anusha Venkataraman
Affiliations
Randomized Controlled Trial

Ranibizumab as an adjunct to laser for macular edema secondary to branch retinal vein occlusion

Rajvardhan Azad et al. Indian J Ophthalmol. 2012 Jul.

Abstract

Purpose: To compare the safety, efficacy, and dosing regimen of intravitreal ranibizumab as an adjunct to laser therapy for the treatment of macular edema secondary to branch retinal vein occlusion (BRVO).

Materials and methods: Thirty eyes of 30 patients of BRVO of at least 6 weeks duration were randomized into three groups: Group 1 received grid laser treatment alone, Group 2 received a single dose of intravitreal injection of ranibizumab (0.5 mg / 0.05 ml) followed by grid laser treatment on 7 th day following injection, while Group 3 received three loading doses of intravitreal ranibizumab at monthly interval (i.e. 0, 1, & 2 months) + standard laser treatment 7 days after the 1 st injection. Outcome measure noted at 6 months follow-up were the improvement in best-corrected visual acuity (BCVA) and central macular thickness (CMT).

Results: At 6 months follow-up, there was an average gain of 12 letters (P=0.05), 17.5 letters (P=0.05) and 19 letters (P=0.05) in groups 1, 2, and 3, respectively, with the decrease in CMT being 208.7 μm (P=0.05), 312.9 μm (P= 0.05) and 326.8 μm (P=0.05), respectively, in these groups. Gain in BCVA of more than 3 lines was noted in 1/10 patients in Group 1(10%) as compared to 3/10 (30%) and 4/10 (40%) patients in groups 2 and 3, respectively.

Conclusion: The gain in BCVA and reduction in CMT were better with combination therapy (single- and triple- dose regimen) compared to grid laser alone. Single dose of intravitreal ranibizumab with grid laser seems to be an effective therapy.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Comparison of visual outcomes between Group 1 (laser alone), Group 2 (single loading dose with laser), and Group 3 (triple loading dose with laser) over a period of 6 month
Figure 2
Figure 2
Changes in the mean OCT thickness in the three groups over 6 months following treatment
Figure 3
Figure 3
Changes in the fundus, FFA, and OCT in Group 1 at 1, 3, and 6 months follow- up
Figure 4
Figure 4
Changes in the fundus, FFA, and OCT in Group 2 at 1, 3, and 6 months follow- up
Figure 5
Figure 5
Changes in the fundus, FFA, and OCT in Group 3 at 1, 3, and 6 months follow- up
See this image and copyright information in PMC

References

    1. The Branch Vein Occlusion Study Group. Argon Laser photocoagulation for macular edema in Branch vein occlusion. Am J Ophthalmol. 1984;98:271–82. - PubMed
    1. Campochiaro PA, Heier JS, Feiner L, Gray S, Saroj N, Rundle CA, et al. BRAVO investigators.Ranibizumab for Macular Oedema following BRVO: Six month primary end point results of a phase 3 study. Ophthalmology. 2010;117:1102–12. - PubMed
    1. Campochiaro PA, Hafiz G, Shah SM, Vguyen QD, Ying H, Do DV, et al. Ranibizumab for macular oedema due to retinal vein occlusions; implications of VEGF as a critical stimulator. Mol Ther. 2008;16:791–9. - PubMed

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