title: Interventions for branch retinal vein occlusion: an evidence-based systematic review.
abstract: OBJECTIVE
  To assess the evidence on interventions to improve visual acuity (VA) and to treat macular edema and/or neovascularization secondary to branch retinal vein occlusion (BRVO).
  
  
  CONCLUSIONS
  Branch retinal vein occlusion is the second most common retinal vascular disease.
  
  
  METHODS
  English and non-English articles were retrieved using a keyword search of Medline (1966 onwards), Embase, the Cochrane Collaboration, the National Institute of Health Clinical Trials Database, and the Association for Research in Vision and Ophthalmology Annual Meeting Abstract Database (2003-2005). This was supplemented by hand searching references of review articles. Two investigators independently identified all randomized clinical trials (RCTs) with more than 3 months' follow-up.
  
  
  RESULTS
  From 4332 citations retrieved, 12 RCTs were identified. There were 5 RCTs on laser photocoagulation. Grid macular laser photocoagulation was effective in improving VA in 1 large multicenter RCT, the Branch Vein Occlusion Study (BVOS), but 2 smaller RCTs found no significant difference. The BVOS showed that scatter retinal laser photocoagulation was effective in preventing neovascularization and vitreous hemorrhage in patients with neovascularization, but a subsequent RCT found no significant effect. Randomized clinical trials evaluating intravitreal steroids (n = 2), hemodilution (n = 3), ticlopidine (n = 1), and troxerutin (n = 1) showed limited or no benefit.
  
  
  CONCLUSIONS
  There is limited level I evidence for any interventions for BRVO. The BVOS showed that macular grid laser photocoagulation is an effective treatment for macular edema and improves vision in eyes with VA of 20/40 to 20/200, and that scatter laser photocoagulation can effectively treat neovascularization. The effectiveness of many new treatments is unsupported by current evidence.
authors.affiliation: Centre for Eye Research Australia, University of Melbourne, Melbourne, VIC, Australia.
authors.forename: Rachel L
authors.initials: RL
authors.lastname: McIntosh
authors.forename: Quresh
authors.initials: Q
authors.lastname: Mohamed
authors.forename: Seang Mei
authors.initials: SM
authors.lastname: Saw
authors.forename: Tien Yin
authors.initials: TY
authors.lastname: Wong
mesh_terms: D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D019317:Evidence-Based Medicine; D005938:Glucocorticoids / Q000627:therapeutic use; D006438:Hemodilution / Q000379:methods; D006801:Humans; D017075:Laser Coagulation / Q000379:methods; D008269:Macular Edema / Q000517:prevention & control; D013508:Ophthalmologic Surgical Procedures; D016032:Randomized Controlled Trials as Topic; D015861:Retinal Neovascularization / Q000517:prevention & control; D012170:Retinal Vein Occlusion / Q000628:therapy*; D014792:Visual Acuity; D014821:Vitrectomy; D014823:Vitreous Hemorrhage / Q000517:prevention & control
chemical_list: D020533:Angiogenesis Inhibitors; D005938:Glucocorticoids