title: Comparison of anti-vascular endothelial growth factors, laser treatments and a combination of the both for treatment of central retinal vein occlusion.
abstract: OBJECTIVE
  To compare changes in visual acuity and macular edema in patients with central retinal vein occlusion (CRVO) treated with intravitreal injections of bevacizumab, macular grid photocoagulation combined with pan retinal photocoagulation (PRP), or both (bevacizumab+grid+PRP).
  
  
  METHODS
  Our study is a retrospective cohort clinical study that examined patients that suffered from ischemic CRVO with macular edema. Study inclusion criteria were ischemic CRVO with macula edema and the availability of complete medical records for at least 12mo after treatment. Excluded were patients with diabetes or any other retinal disease. We reviewed the medical records of patients treated in one ophthalmology department-comparing changes in visual acuity and macular edema in patients treated with intravitreal injections of bevacizumab vs those that were treated with macular grid photocoagulation and PRP or both. The main outcome measures were the differences in best corrected visual acuity (BCVA) and in macular thickness, as assessed by optical coherence tomography, between the enrollment and the final follow up visits.
  
  
  RESULTS
  Sixty-five patients met inclusion criteria. There were no statistically significant differences among the three groups in the mean changes in macular thickness as measured by ocular coherence tomography (131.5±41.2, 108.6±29.2, and 121.1±121.1, P=0.110), or in visual acuity (0.128±0.077, 0.088±0.057, and 0.095±0.065), for intravitreal injections, macular grid photocoagulation+PRP and a combination of the treatments, respectively, P=0.111. The proportions of patients with macular edema after treatment were: 26.1%, 28.6%, and 14.3%, respectively, P=0.499.
  
  
  CONCLUSIONS
  Similar benefit was observed for intravitreal injections, laser photocoagulation, or a combined regimen in the treatment of CRVO. A non-statistically significant trend for reduction in macular edema was observed following combined treatment.
authors.affiliation: Tzameret Medical Track, Hebrew University, Jerusalem 91120, Israel.
authors.forename: Yoav Y
authors.initials: YY
authors.lastname: Pikkel
authors.affiliation: Research Wing, Ziv Medical Center, Safed, Israel and Tel-Hai Academic College, Kiryat Shmona 12208, Israel.
authors.forename: Adi
authors.initials: A
authors.lastname: Sharabi-Nov
authors.affiliation: Department of Ophthalmology, Rambam Medical Center, Haifa 3525408, Israel; The B. Rappaport Faculty of Medicine, Israel Institute of Technology, Haifa 3525427, Israel.
authors.forename: Itzchak
authors.initials: I
authors.lastname: Beiran
authors.affiliation: Department of Ophthalmology, Ziv Medical Center, Safed 13100, Israel; Bar Ilan University, Faculty of Medicine, Safed 13101, Israel.
authors.forename: Joseph
authors.initials: J
authors.lastname: Pikkel
keywords: bevacizumab; grid laser photocoagulation; macular edema; optical coherence tomography; retinal vein occlusion