Laser Applications in Branch Retinal Vein Occlusion and Macular Edema

2019 ◽  
pp. 112-119
Keyword(s):  
Macular Edema ◽  
Laser Therapy ◽  
Retinal Vein Occlusion ◽  
Branch Retinal Vein Occlusion ◽  
Treatment Options ◽  
Combined Treatment ◽  
Primary Treatment ◽  
Laser Applications ◽  
Vein Occlusion ◽  
Major Branch

Branch retinal vein occlusion (BRVO) includes occlusion of major branch retinal vein, macular branch vein, and peripheral branch vein. BRVO is the second most common retinal vascular disease after diabetic retinopathy. Macular edema is the leading cause of visual loss related to BRVO. Although there are many treatment options, effective treatment applications are limited. Laser therapy is one of these applications; that is used both in the development of neovascularization and in the presence of macular edema. Grid laser therapy doesn’t take place as much as the former in the primary treatment of macular edema; that still continues efficiency in combined treatment and selected cases.

Branch Retinal Vein Occlusion – Update on Treatment Options

2016 ◽  
Vol 10 (01) ◽  
pp. 25 ◽  
Author(s):  
Stephan Michels ◽  
Magdalena Anna Wirth ◽  
◽  
◽  
Keyword(s):  
Laser Therapy ◽  
Retinal Vein Occlusion ◽  
Branch Retinal Vein Occlusion ◽  
Treatment Options ◽  
Diagnostic Methods ◽  
Evidence Based ◽  
The Past ◽  
Recommended Treatment ◽  
Vein Occlusion ◽  
Wide Range

The advent of new pharmacotherapeutic options and diagnostic methods have led to a revolution in the management of branch retinal vein occlusion over the past few years. Despite the variety of treatment options, we are confronted with several questions: which drug should we use? Is switching between or combining treatment options beneficial? What is the recommended treatment regimen? When should we start treatment and for how long should we continue it? Should we still use retinal laser therapy? The wide range of possibilities and emerging treatment choices not only aids, but also challenges clinicians striving for evidence-based management.

scholarly journals Incomplete Treatment Response, Treatment Resistance, Pharmaceutical Changes and Combined Treatments in Branch Retinal Vein Occlusion and Macular Edema

2019 ◽  
pp. 108-111
Keyword(s):  
Macular Edema ◽  
Treatment Response ◽  
Retinal Vein Occlusion ◽  
Branch Retinal Vein Occlusion ◽  
Vision Loss ◽  
Combined Treatment ◽  
Treatment Resistance ◽  
Vein Occlusion ◽  
Anti Vegf ◽  
Incomplete Treatment

Branch retinal vein occlusion (BRVO) is the second most common retinal vascular disease after diabetic retinopathy. Vision loss varies depending on the affected area. The main causes of vision loss in BRVO are macular edema and macular ischemia. Anti-VEGF agents are preferred in the treatment of macular edema due to BRVO because of the increase in visual acuity. Although anti-VEGF therapy provides an early response, in some cases macular edema is resistant to the treatment. In this review, incomplete treatment response, treatment resistance, pharmaceutical changes, and combined treatment are mentioned in cases with BRVO and macular edema.

scholarly journals Non-Routine Therapies for the Treatment of Branched Retinal Vein Occlusion and Macular Edema

2019 ◽  
pp. 120-128
Keyword(s):  
Macular Edema ◽  
Laser Therapy ◽  
Retinal Vein Occlusion ◽  
Branch Retinal Vein Occlusion ◽  
Vitreous Hemorrhage ◽  
Treatment Modalities ◽  
Vascular Endothelial ◽  
Vein Occlusion ◽  
Emerging Therapies ◽  
Endothelial Growth Factors

Retinal vein occlusion is the second most common retinal vascular disorder after diabetic retinopathy and is considered to be an important cause of visual loss. There are several treatment modalities for branch retinal vein occlusion and specifically for its complications, such as macular edema, vitreous hemorrhage, retinal neovascularization, and retinal detachment. These treatment modalities are anti-aggregative therapy and fibrinolysis, isovolemic hemodilution, vitrectomy with or without sheathotomy, peripheral scatter and macular grid retinal laser therapy, non-steroid agents, intravitreal steroids ( triamcinolone, and dexamethasone implants), and intravitreal anti-vascular endothelial growth factors (anti-VEGFs) (bevacizumab, ranibizumab, aflibercept). In this review, the treatment modalities other than routinely performed anti-VEGF, steroid, and laser therapy in macular edema secondary to branch retinal vein occlusion and emerging therapies will be overviewed.

Early-scatter laser photocoagulation promotes the formation of collateral vessels in branch retinal vein occlusion

2019 ◽  
Vol 30 (2) ◽  
pp. 370-375
Author(s):  
Seoung Hyun An ◽  
Woo Jin Jeong
Keyword(s):  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Recurrence Rate ◽  
Branch Retinal Vein Occlusion ◽  
Laser Photocoagulation ◽  
Combined Treatment ◽  
Intravitreal Bevacizumab ◽  
Intravitreal Bevacizumab Injection ◽  
Vein Occlusion ◽  
Bevacizumab Injection

Purpose: To investigate the effect of early-scatter laser photocoagulation on the formation of collateral vessels in branch retinal vein occlusion. Methods: The medical records of 40 cases (40 patients) of branch retinal vein occlusion with macular edema were retrospectively reviewed. Of them, 23 patients were treated with intravitreal bevacizumab injection and 17 patients underwent intravitreal bevacizumab injection with additional laser treatment. Early-scatter laser photocoagulation was applied for capillary non-perfusion areas, regardless of retinal neovascularization. Collateral vessel presence, recurrence rate of macular edema, and number of intravitreal bevacizumab injections were compared between the groups. Results: During the follow-up period, collateral vessel formation was noted in 10/23 eyes (43.5%) in the intravitreal bevacizumab injection group and 15/17 eyes (88.2%) in the laser combined treatment group ( p = 0.004). The recurrence rate of macular edema was lower in the laser combined treatment group (29.4%) than in the intravitreal bevacizumab injection group (65.2%); this difference was statistically significant ( p = 0.025). The average numbers of intravitreal bevacizumab injections were 3.57 ± 3.23 in the intravitreal bevacizumab group and 2.14 ± 2.26 in the laser combined treatment group ( p = 0.044). Conclusion: Early-scatter laser photocoagulation promotes collateral vessel formation; the presence of collateral vessels seemed to affect the course of macular edema in branch retinal vein occlusion. Combined early-scatter laser photocoagulation treatment after intravitreal bevacizumab injection lowered the recurrence rate of macular edema and number of intravitreal bevacizumab injections in the cases of branch retinal vein occlusion.

scholarly journals Effects of Vitrectomy on Recurrent Macular Edema due to Branch Retinal Vein Occlusion after Intravitreal Injection of Bevacizumab

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Tatsuya Yunoki ◽  
Keiichi Mitarai ◽  
Shuichiro Yanagisawa ◽  
Tsuyoshi Kato ◽  
Nobuo Ishida ◽  
...  
Keyword(s):  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Branch Retinal Vein Occlusion ◽  
Pars Plana Vitrectomy ◽  
Retinal Thickness ◽  
Treatment Options ◽  
Central Macular Thickness ◽  
Vein Occlusion ◽  
Corrected Visual Acuity ◽  
Pars Plana

Purpose. To evaluate the effects of pars plana vitrectomy (PPV) on recurrent macular edema due to branch retinal vein occlusion (BRVO) after intravitreal injections of bevacizumab (IVB).Methods. This retrospective study included 22 eyes of 22 patients who underwent single or multiple IVB injections for macular edema due to BRVO and showed a recurrence of macular edema. All patients then underwent PPV and were followed up for more than 6 months after the surgery with examinations of best corrected visual acuity (BCVA) and optical coherence tomography (OCT). OCT parameters were central macular thickness (CMT) and average retinal thickness in a 1-mm-diameter circular region at the fovea (MRT).Results. Mean BCVA, CRT, and MRT were significantly improved from the baseline after PPV. Greater improvement of BCVA, CRT, and MRT was obtained after 1 month of IVB than after 6 months of PPV. No eyes showed worsening of macular edema after the surgery.Conclusion. PPV improved BCVA and recurrent macular edema due to BRVO, but PPV that was less effective than IVB had been in the same patients. PPV may be one of the treatment options for recurrent macular edema due to BRVO after IVB.

scholarly journals Visual acuity after intravitreal ranibizumab with and without laser therapy in the treatment of macular edema due to branch retinal vein occlusion: a 12-month retrospective analysis

2021 ◽  
Vol 14 (10) ◽  
pp. 1565-1570
Author(s):  
Reiko Umeya ◽  
◽  
Toshimitsu Kasuga ◽  
Keyword(s):  
Visual Acuity ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Macular Edema ◽  
Laser Therapy ◽  
Retinal Vein Occlusion ◽  
Branch Retinal Vein Occlusion ◽  
Intravitreal Ranibizumab ◽  
Interaction Terms ◽  
Vein Occlusion

AIM: To identify factors contributing to visual improvement after treatment of macular edema (ME) secondary to branch retinal vein occlusion (BRVO), and to assess the interaction between laser therapy and intravitreal ranibizumab (IVR). METHODS: We retrospectively reviewed the medical records of patients who had been treated for BRVO-related ME at our hospital. Records were traceable for at least 12mo, and evaluated factors included age, sex, medical history, smoking history, treatment methods, foveal hemorrhage, and change in visual acuity. Treatments included laser therapy, IVR, sub-Tenon’s capsule injection of triamcinolone (STTA), a combination, or no intervention. Multivariate logistic regression analysis and interaction terms were used to assess the clinical efficacy of the treatments, and odds ratios (OR) and 95% confidence intervals (CI) were calculated. RESULTS: Seventy-three patients (34 men, 39 women; 73 eyes) with a mean age of 69.4±12.1y were included. Patients who underwent IVR monotherapy, laser monotherapy, and STTA+laser had significantly higher best corrected visual acuity at 12mo compared to baseline (P<0.001, <0.001, and 0.019, respectively). Logistic regression analysis without interaction terms found that IVR was a significant visual acuity recovery factor (adjusted OR: 3.89, 95%CI: 1.25-12.1, P=0.019). Adjusted OR using an interaction model by logistic regression was 16.6 (95%CI: 2.54-108.47, P=0.003) with IVR treatment, and 8.25 (95%CI: 1.34-50.57, P=0.023) with laser treatment. No interaction was observed (adjusted OR: 0.07, 95%CI: 0.01-0.75, P=0.029). CONCLUSION: IVR contributes to improvements in visual acuity at 12mo in ME secondary to BRVO. No interaction is observed between laser therapy and IVR treatments.

scholarly journals Cystotomy with or without fibrinogen clot removal for refractory cystoid macular edema secondary to branch retinal vein occlusion

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hiroko Yamada ◽  
Hisanori Imai ◽  
Akira Tetsumoto ◽  
Mayuka Hayashida ◽  
Keiko Otsuka ◽  
...  
Keyword(s):  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Cystoid Macular Edema ◽  
Branch Retinal Vein Occlusion ◽  
Treatment Options ◽  
Treatment Resistant ◽  
Vein Occlusion ◽  
Clot Removal ◽  
Long Term Effect ◽  
Retrospective Clinical Study

AbstractTo demonstrate the long-term effect of cystotomy with or without fibrinogen clot removal for treatment-resistant cystoid macular edema (CME) secondary to branch retinal vein occlusion (BRVO). Retrospective clinical study. We retrospectively analyzed medical records of 22 eyes of 22 patients with treatment-resistant CME secondary to BRVO with 12 months observation after cystotomy with or without fibrinogen clot removal. Patients included 11 women and 11 men. The mean ± SD age was 72.7 ± 10.2 years. LogMAR-converted best corrected visual acuity (BCVA) was statistically better at 12 months after surgery (0.30 ± 0.30) than preoperative BCVA (0.39 ± 0.27) (p = 0.01). The central sensitivity of microperimetry (dB) was maintained during follow-up (preoperative sensitivity: 25.4 ± 4.1, postoperative sensitivity at 12 months after the surgery: 25.9 ± 4.2, p = 0.69). Twelve months after surgery, there was a significant improvement in the central retinal thickness (CRT) on optical coherence tomography (OCT) (303.7 ± 80.1) (μm) compared with the preoperative CRT (524.2 ± 114.8) (p < 0.01). In 12 months, CME recurred in 3 of 22 eyes. The preoperative reflectivity in cystoid cavity on OCT was significantly higher in patients with fibrinogen clot removal (n = 5) than in patients without fibrinogen clot removal (n = 17) (p < 0.01). For treatment-resistant CME secondary to BRVO, Cystotomy with or without fibrinogen clot removal may be one of the treatment options.

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