A PROSPECTIVE OBSERVATIONAL STUDY OF INTRAVITREAL AFLIBERCEPT IN RETINAL VEIN OCCLUSION WITH INITIALLY GOOD VISUAL ACUITY.

PURPOSE: To clarify the effect of intravitreal aflibercept injections in patients with branch retinal vein occlusion (BRVO) and central retinal vein occlusion (CRVO) presenting with best-corrected visual acuity (BCVA) better than 20/40.

METHODS: This prospective study included 61 eyes of 44 patients with BRVO and 17 patients with CRVO with untreated macular edema. Patients whose macular edema improved within 3 months through the natural course were excluded. Patients were administered intravitreal aflibercept injections following a treat-and-extend regimen in which treatment intervals were adjusted every 4 weeks based on BCVA and central retinal thickness stability. BCVA and central retinal thickness were measured before and up to 12 months. Retinal sensitivity measured by microperimetry and mean deviation values from the Humphrey 30-2 visual field analyzer were evaluated at baseline and 6 and 12 months.

RESULTS: Thirty-five patients with BRVO and 14 patients with CRVO completed the study. For patients with BRVO, the mean BCVA (logarithm of the minimum angle of resolution [logMAR]) significantly improved from 0.19 ± 0.12 (Snellen equivalent, 20/31) to 0.06 ± 0.16 (20/23) at 12 months ( P < 0.005), but not in patients with CRVO (from 0.15 ± 0.13 [20/28] to 0.07 ± 0.16 [20/24]). In addition, retinal sensitivity at 12 months improved significantly in both BRVO and CRVO ( P < 0.001, P < 0.05, respectively). Central retinal thickness showed a significant reduction in both groups ( P < 0.001). There was no significant change in MD values in either group.

CONCLUSION: Intravitreal aflibercept treatment using treat-and-extend regimen had a favorable visual prognosis for retinal vein occlusion-related macular edema with good initial BCVA, particularly in BRVO.