Adjunctive topical bromfenac and the 3-year bevacizumab injection burden in macular edema secondary to branch retinal vein occlusion.

PURPOSE: Anti-vascular endothelial growth factor therapy for macular edema secondary to branch retinal vein occlusion (BRVO) imposes a substantial long-term injection burden. We evaluated whether eyes prescribed adjunctive topical bromfenac required fewer intravitreal bevacizumab injections over 3 years than those receiving bevacizumab monotherapy.

METHODS

This retrospective, nonconcurrent historical-control cohort study included 62 treatment-naïve eyes followed for 36 months under the same optical coherence tomography (OCT)-guided pro re nata protocol. Twenty-nine eyes received intravitreal bevacizumab alone during 2016-2019, whereas 33 received bevacizumab with adjunctive topical bromfenac during 2023-2026.

RESULTS

The adjunctive bromfenac group received fewer injections over 36 months than the bevacizumab monotherapy group (5.8 ± 2.5 vs. 8.9 ± 3.7; p < 0.001) and the association persisted after adjustment for baseline visual acuity, macular thickness, OCT biomarkers, and nonperfusion area (Poisson adjusted rate ratio 0.62; 95% confidence interval 0.50-0.77; p < 0.001). Best-corrected visual acuity and central macular thickness at 36 months did not differ significantly between the two groups.

CONCLUSION

Adjunctive topical bromfenac was associated with fewer bevacizumab injections over 36 months in BRVO-associated macular edema.