gms | German Medical Science

Purpose: Comparing the benefits of treatment of patients with macular edema following a branch retinal vein occlusion by a focal laser in eyes already received intravitreal bevacizumab, with others that received bevacizumab alone.

Design: prospective, randomized single center study.

Methods: 34 patients were enrolled with a chronic non-ischemic macular edema following branch retinal vein occlusion (duration >8 weeks). In group I (n=17), intravitreal bevacizumab injection with focal laser photocoagulation was combined with GRID, in group II (n=17) was only injected with bevacizumab. There have been 3 injections at intervals of 4 weeks. The laser focal GRID in Group I was 2 weeks after the first injection. Reinjection performed with persistent or recurrent macular edema. In group I, a new laser treatment was possible. The primary outcome was the change in best-corrected visual acuity after 14 weeks.

Results: The visual acuity before intervention was 0.55 logMAR (SD±0.27) in Group I and 0.49 logMAR (SD±0.25) in Group II during the observation period, visual acuity increased significantly in both groups. After 14 weeks, visual acuity was 0.28 in group I (line difference 2.8, SD±0.22 p<0.01) in group II and 0.19 (SD±0.19, 3 lines of difference, p<0.01). The group difference was 0.3 lines (95% CI -0.96 to 1.6, p>0.05). In group I, 8 patients had a significant increase of visual acuity (≥3 lines), in group II, there were 10 patients.

Conclusions: The treatment of macular edema following a retinal vein occlusion with 3 injections of bevacizumab results in a significant visual acuity improvement. The additional focal GRID Laser photocoagulation beyond the observation period of 14 weeks did not lead to any further improvement. In conclusion, longer follow-ups are planned in order to assess an additive effect of focal laser photocoagulation.