title: Combination therapy with intravitreal bevacizumab and macular grid and scatter laser photocoagulation in patients with macular edema secondary to branch retinal vein occlusion.
abstract: OBJECTIVE
  To assess the efficacy of combined intravitreal bevacizumab (IVB) and macular grid and scatter laser photocoagulation in the treatment of macular edema secondary to branch retinal vein occlusion (BRVO) over a 12-month period.
  
  
  METHODS
  A prospective, interventional case series study was conducted in 20 patients. Patients were treated with 3 monthly IVB injections, followed by macular grid laser and scatter laser photocoagulation to nonperfused ischemic retina. Repeated IVB injections were performed on an as-needed basis when patients had recurrent macular edema.
  
  
  RESULTS
  The best-corrected visual acuity of 20/40 or better was achieved in 17 eyes (85%) and a vision gain of 3 lines or more was noted in 12/20 eyes (60%). Mean visual acuity improved from 0.68 logMAR at baseline to 0.28 logMAR at 3 months, 0.26 logMAR at 6 months, and 0.26 logMAR at 12 months (P<0.01). The mean central macular thickness (CMT) was 442 μm at baseline and decreased to 266, 264, 300, and 294 μm at 1, 3, 6, and 12 months' follow-up, respectively (P<0.01). A mild rebound CMT increase was noted at 6 months, which was reduced after bevacizumab reinjection. Ten patients (50%) required repeated IVB injections. Fifteen eyes (75%) have complete edema resolution on optical coherence tomography scan at the 12-month return visit. Overall, patients received an average of 4 injections during the 12-month period. No adverse ocular or systemic events were observed following injections.
  
  
  CONCLUSIONS
  Early IVB injections in combination with subsequent macular grid and scatter laser photocoagulation treatment significantly improved vision and reduced macular edema secondary to BRVO. Further studies are warranted to evaluate the long-term outcomes and safety.
authors.affiliation: 1 Department of Ophthalmology, Taipei Veterans General Hospital , Taipei, Taiwan, Republic of China .
authors.forename: Chang-Sue
authors.initials: CS
authors.lastname: Yang
authors.forename: Jorn-Hon
authors.initials: JH
authors.lastname: Liu
authors.forename: Yu-Chien
authors.initials: YC
authors.lastname: Chung
authors.forename: Yu-Bai
authors.initials: YB
authors.lastname: Chou
authors.forename: Kuo-Hsuan
authors.initials: KH
authors.lastname: Hung
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D000068258:Bevacizumab / Q000008:administration & dosage*; D003131:Combined Modality Therapy; D005260:Female; D005451:Fluorescein Angiography / Q000379:methods; D006801:Humans; D058449:Intravitreal Injections; D008028:Light Coagulation / Q000379:methods*; D008269:Macular Edema / Q000209:etiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012170:Retinal Vein Occlusion / Q000150:complications / Q000628:therapy*; D041623:Tomography, Optical Coherence / Q000379:methods; D042461:Vascular Endothelial Growth Factor A / Q000032:analysis; D014792:Visual Acuity / Q000187:drug effects
chemical_list: D020533:Angiogenesis Inhibitors; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab