Original ArticleInterventions for Branch Retinal Vein Occlusion: An Evidence-Based Systematic Review
Section snippets
Sources and Methods of Literature Search
The authors conducted a comprehensive search to identify all relevant randomized clinical trials (RCTs) evaluating interventions for BRVO. Studies lacking a control group that used either a placebo or current best practice as the control method and studies with fewer than 3 months follow-up were excluded because outcomes from these studies may represent simply the natural history of the disease or fail to evaluate clinically significant longer-term outcome. English and non-English language
Laser Treatment
There were 5 RCTs that evaluated the use of laser photocoagulation to treat macular edema and neovascularization secondary to BRVO. Three RCTs investigated the efficacy of grid macular laser treatment for macular edema secondary to BRVO.1, 17, 18
The Branch Vein Occlusion Study (BVOS) Group1 evaluated whether grid macular laser photocoagulation improved VA in patients with VA of 20/40 or worse resulting from macular edema secondary to BRVO. This multicenter RCT assigned 139 patients to either
Clinical Recommendations
As this review shows, many of the studies examining interventions for BRVO had methodological limitations, including insufficient power resulting from small sample sizes, short follow-up periods, absence of a control group or an appropriate control group (absence of placebo or best practice intervention as the control group), and lack of distinction between clinical entities.
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Individualized Stabilization Criteria-Driven Ranibizumab versus Laser in Branch Retinal Vein Occlusion
2016, OphthalmologyCitation Excerpt :The BRIGHTER study evaluated the individualized stabilization criteria–driven PRN dosing regimen of ranibizumab 0.5 mg, mainly based on VA stabilization criteria, with or without laser versus laser alone in patients with visual impairment due to macular edema secondary to BRVO and with a longer disease duration. Laser treatment, the active comparator in this study, has previously been shown to stabilize VA in patients with BRVO, but improvements in VA are suggested to be delayed and of lower amplitude.10,11 In addition, in patients with diabetic retinopathy, the structural damage due to repeated treatment with laser alone has been shown to worsen over time because of an enlargement of coagulation scars.12
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Manuscript no. 2006-534.
The authors have no proprietary interests related to the article.
Funding was provided by the Science Technology and Innovation Grant, Victoria State Government, Melbourne, Australia, and Sylvia and Charles Viertel Clinical Investigator Award, Sylvia and Charles Viertel Charitable Foundation, Melbourne, Australia (TYW).