First Author: J.Kang JAPAN
Co Author(s): M. Hamada K. Inagaki Y. Minowa S. Oode K. Ohkoshi
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Retrospective interventional study
The aim of this study is to evaluate of visual gain and reduction of central macular thickness (CMT) after combined therapy of intravitreal anti-VEGF injection and subthreshold macular laser photocoagulation in macular edema secondary to BRVO.
We retrospectively reviewed the medical records of 30(15males, 15females) patients who underwent combined therapy of intravitreal anti-VEGF injection and subthreshold macular laser photocoagulation in macular edema secondary to BRVO. 10 patients showed ischaemic type. 20 patients showed non-ischaemic type. Eight (26%) patients was macular BRVO type. Best corrected visual acuity (LogMAR) and central macular thickness (CMT) recorded with spectral-domain optical coherence tomography were evaluated at baseline and 1, 3, 6, and 12 months after treatment onset. Laser was applied after 1~3 anti-VEGF injection to the area where edema was present before anti-VEGF up to the edge of foveal area. Pattern scanning scatter laser to ischaemic area was applied to ischaemic type of BRVO. Additional injection was applied when edema was recurred PASCAL steam yellow (Topcon), IQ577 (IRIDEX), Visulas trion vite (Zeiss) Lasers were used for the macular laser therapy and scatter laser. Laser energy was set as 50~60% of threshold energy for macular laser application
The mean number of anti-VEGF intravitreal injection on the combined therapy was 3.0±1.4回in 12months. The mean number of subthreshold macular laser photocoagulation was1.1 in 12months. BCVA (LogMAR) improved from 0.43±0.35 to 0.16±0.27 (P=0.00) at one year. The central macular thickness (CMT) decreased from 410.7±149.2 µm at baseline to 290.4±76.0µm (P=0.001) at one year. Only one patient presented a mild laser scar at macular area
Subthreshold macular photocoagulation combined with intravitreal anti-VEGF injection has a substantial effect on increasing visual acuity in macular edema secondary to BRVO and may decrease the number of anti-VEGF injection.