Siamak Moradian, Hooshang Faghihi, Babak Sadeghi, Niloofar Piri, Hamid Ahmadieh, Masoud Soheilian, Mohammad Hossein Dehghan, Mohsen Azarmina, Mohammad Riazi Esfahani (Tehran, Iran)

Advantages:

To compare the visual and anatomical (central macular thickness; CMT) outcomes of intravitreal bevacizumab (IVB) injections relative to sham treatment in eyes with acute (less than three months in duration) branch retinal vein occlusion (BRVO).

Methods:

In a double-masked randomized clinical trial (RCT), patients with acute BRVO were randomly assigned to one of two treatment groups: IVB (two injections of 1.25 mg IVB 6 weeks apart) or sham treatment. Primary outcome measures included changes in best-corrected visual acuity (BCVA) and CMT in optical coherence tomography (OCT) during follow-up (FU) examinations. Any complications secondary to injections were considered secondary outcomes. FU results after 6 and 12 weeks are reported.

Effectiveness / Safety:

Eighty-one eyes (43 OD) of 81 patients (47 females) enrolled in the study. Forty-two patients were enrolled in the IVB group, and 39 patients were enrolled in the sham group. Visual acuity and CMT improved in the IVB group after week 6 (2 Snellen lines and 262 µm, respectively) and week 12 (3 Snellen lines and 287 µm, respectively). After week 6, visual improvements in the IVB group were significantly increased relative to that of the sham group. However, visual improvements at week 12 were not significantly different between the two groups (1.5 Snellen lines visual improvement in the sham group at week 12).

Take home message:

In acute BRVO, two IVB injections resulted in significant improvement of vision and CMT at 6 weeks relative to the sham group.