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After C.R.V.O.

358 cases of edema exceeding 300 microns following CRVO were submitted by 51 retina specialists. 111 were treated by anti-VEGF and 80 by vitrectomy and ILM peeling but other treatments were also chosen. The initial VA were not comparable. We can notice that eyes treated by Ozurdex have a much higher initial VA and eyes treated by triamcinolone have a much lower one. However the standard deviations (the dispersion of the data) are similar.

More than one third of the cases were treated by different combinations of treatments but none of these treatments has a large enough population to justify a separate analysis.

When focusing now on each individual major pure treatment, ie excluding combined treatments, we can note that:– Triamcinolone does not result in improvement,– Ozurdex, with a mean number of 2 injections seems to be comparable to antiVEGF, after 8 injections, but the number of cases and the follow-up with Ozurdex are not sufficient– ILM peeling seems to be the most effective treatment, giving to the patient a final vision 2 to 3 times higher than with the other treatments.

After B.R.V.O.

380 cases of edema following BRVO exceeding 300 microns have been submitted by 53 retina specialists. The initial VA was, here again, higher for eyes treated by Ozurdex. In contrast, the population treated by ILM peeling had a lower initial VA.

In this pathology we see that combined treatments are chosen more frequently, but here again without a large enough single population to justify a separate analysis.

When focusing now on each individual major pure treatment, we can see that Ozurdex is not very exciting as its effect decreases with the time. The improvement obtained by anti-VEGF seems better even if the curve seems to decrease after some injections. Here again, the most interesting rising curve is the ILM peeling one with a final vision twice as high as the one obtained by the anti-VEGF.

More interesting will be to combine CRVO and BRVO in order to obtain larger populations for the statistical analysis.

ME Following B.R.V.O.

ME Following B.R.V.O.

When considering all the treatments, the improvement obtained for these ME following RVO is close to the average one, just a little bit higher.

The improvement results confirm that Ozurdex, as well as Triamcinolone are not very good options. Anti-VEGF seems to improve the vision with an apparent stability. ILM peeling not only provides a twice as much higher improvement but also with a rising curve.

4 combinations of treatment have a large enough population to justify an analysis.

The addition of Triamcinolone to anti-VEGF considerably decreases the anti-VEGF efficacy.

As well as its addition to ILM peeling.

The addition of grid laser to anti-VEGF decreases the anti-VEGF efficacy and, here again, the addition of Triamcinolone to both combined treatments lowers the final result.

The number of cases improving 3 or more lines is much higher after ILM peeling than after anti-VEGF. This is statistically significant. Same thing applies to cases obtaining 6 lines or better. However, this classical way of presentation is not very meaningful since the improvement is dependent on the pre-treatment VA.

Much more accurate could be this way of presentation where the improvements can be compared taking into consideration the initial VA.according to that we can declare that the gold medal has to be awarded to PPV + ILM with a medium improvement twice as high as the one obtained by the anti-VEGF which achieves the silver medal.

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