Abstract

SO.21.09

Macular edema secondary to retinal vein occlusions – Challenge of treatment

Tatjana Josifova1, Paul B. Henrich1, Ulrike Schneider1, Silke Peter2, Roland Peter2
1Augenklinik, Universitätsspital Basel, Basel, Switzerland, 2Augenarzt-Praxis, Luzern, Switzerland

Objective
The aim of this study is to show whether the treatment of the macular edema (ME) due to retinal vein occlusion, with combined Anti-VEGF and laserphotocoagulation therapy, versus monotherapy with Anti-VEGF drug, can provide us with better results.
Methods
The study included 86 eyes, out of which 38 received combined therapy (Group A), and 48 monotherapy (Group B).The patients were treated with intravitreal drug administration of 0,05 ml 1.25 mg Bevacizumab (Avastin). Focal laserphotocoagulation was performed two weeks after the intravitreal injection (IVI), in average 1,3 sessions, in accordance with the Fluorescein Angiography (FA) findings. Before performing the therapy visual acuity (VA), OCT and FA tests were done. The OCT findings together with visual acuity outcomes guided, the inclusion criteria for the repeated drug application, at least 6 weeks after the prior injection.  
Results
The ETDRS BCVA (best corrected visual acuity) in Group A ranged between 20/20 to 20/240 and in Group B between 20/20 to 20/320. In Group A the BCVA was achieved after repeated administration of 4,2 injections, compared to Group B with 6,3 injections. The central macular thickness in Group A decreased almost 65% and in Group B about 50 %. Visual acuity improved by 15 letters or more in 41.7% in Group A, as compared with 34.9% in Group B.
Conclusions
Both Groups A and B had shown increase of BCVA and decrease in central retinal thickness, although at the end of the follow-up period both groups had substantial residual macular thickness. Combined therapy of intravitreal drug administration and laserphotocoagulation provides us advantage over Bevacizumab alone.

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