title: Best practices for treatment of retinal vein occlusion.
abstract: OBJECTIVE
  Retinal vein occlusion (RVO) is a sight-threatening retinal vascular disorder associated with macular edema and neovascularization. Until recently, the standard of care for branch RVO-associated macular edema was grid laser photocoagulation and observation for central RVO-associated macular edema. Neovascularization was treated with scatter laser photocoagulation. The purpose of this article is to review recent findings that have changed our treatments of RVO.
  
  
  RESULTS
  The recent development of intravitreal pharmacotherapy has demonstrated benefit with anti-vascular endothelial growth factor (VEGF) agents and corticosteroids for the treatment of RVO-associated macular edema. The intravitreal use of FDA-approved ranibizumab (Lucentis) and a sustained release dexamethasone implant (Ozurdex), along with off-label bevacizumab (Avastin) and preservative-free triamcinolone, has significantly expanded our treatment options and replaced standard of care for treatment of RVO-associated macular edema. Whereas anti-VEGF agents can also induce rapid regression of neovascularization, scatter laser photocoagulation remains the standard of care to prevent neovascular complications.
  
  
  CONCLUSIONS
  Intravitreal pharmacotherapy has revolutionized our treatment of retinal vascular diseases, including RVO. Although these intravitreal agents are effective, our understanding of their specific indications and long-term roles is still evolving. Furthermore, until the underlying occlusive pathophysiology of RVO can be addressed, our treatments will be limited to temporizing therapies against a chronic disease.
authors.affiliation: Duke Eye Center, Duke University Medical Center, Durham, North Carolina 27710, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Hahn
authors.forename: Sharon
authors.initials: S
authors.lastname: Fekrat
mesh_terms: D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D000068258:Bevacizumab; D003907:Dexamethasone / Q000627:therapeutic use; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D008269:Macular Edema / Q000188:drug therapy* / Q000503:physiopathology; D000069579:Ranibizumab; D012170:Retinal Vein Occlusion / Q000188:drug therapy* / Q000503:physiopathology; D014221:Triamcinolone / Q000627:therapeutic use; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D005938:Glucocorticoids; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D014221:Triamcinolone; D000068258:Bevacizumab; D003907:Dexamethasone; D000069579:Ranibizumab