A Prospective Study on Clinical Efficacy of Intravitreal Bevacizumab and Macular Grid Laser in Patients with Macular Edema Secondary to Branch Retinal Vein Occlusion

Background: Branch retinal vein occlusion (BRVO) is the second most common cause of retinal vascular abnormality after diabetic retinopathy. Persistent macular edema develops in 60% of eyes with BRVO. Untreated, only 14% of eyes with chronic macular edema will have a visual acuity (VA) of 20/40 or better. If not resolved spontaneously, treatment is necessary in the form of intravitreal injection of Anti-VEGF followed by Macular Grid Laser. Bevacizumab is the Anti-VEGF of choice in developing countries because of its prolonged action and cheap price, which helps in preventing neovascularisation and thus further haemorrhages. Laser helps in stopping the leakage and thus helps in treating the macular edema.

Aims and Objectives: The aim of the study is to evaluate the efficacy of intravitreal Bevacizumab and Macular grid laser in the management of macular edema secondary to Branch Retinal Vein Occlusion in patients attending the ophthalmology.

Materials and Methods: In this research study, 32 patients presenting with macular edema secondary to Branch Retinal Vein Occlusion to ophthalmology OPD were included after taking their consent and the study was carried out for a period of 2 years. Detailed history taking, Visual acuity, slit lamp examination, Fundus examination and OCT were done for all before treatment and also during every follow ups. FFA was done before treatment and after 3 months of laser. As treatment, all of them were given intravitreal injection of bevacizumab followed by macular grid laser.Patients were followed up on Day 1, Day 4, Day 7 and 4 weeks after intravitreal injection and 3 months after grid laser.

Results: In our study out of 32 patients, 17 were male (52%) and 15 were females (48%). The average age of the patient was 59 (range 40-70). The commonest co-morbidities in the patients were either Diabetes or Hypertension or both. The commonest type of BRVO was superotemporal BRVO. The average visual gain was statistically significant. The average decrease in Central Macular Thickness was 383 microns and this was statistically significant (p<0.05). There was no serious ocular or systemic complications following intravitreal injection of Bevacizumab in our study

Conclusion: In the management of macular edema secondary to Branch Retinal Vein Occlusion Intravitreal Bevacizumab injections in combination with subsequent macular grid treatment significantly improves vision and reduces macular edema.