Evaluation of the efficacy and safety of navigational combined laser treatment in combination with antiangiogenic therapy in macular edema due to the branch retinal vein occlusion

Abstract

Purpose. To study methods of using antiangiogenic therapy in combination with combined navigational laser treatment in patients with MO due to BRVO. Material and methods. The study included 99 patients with ME due to BRVO, the main group (n=54) consisted of patients treated using the combined technique, the control group – patients treated with ranibizumab monotherapy (n=45). The combined method for the treatment of ME due to BRVO included the initial intravitreal injection of ranibizumab. 2 weeks after the injection, the patients carry out OCT, in the presence of central retinal thickness (CRT) more than 350 μm, 1 month after injection, one or more injections of ranibizumab were performed until the CRT reached 350 μm or less, when the «target» level was reached, combined navigation laser treatment was performed. Results. 1 month after the combined laser treatment, the best corrected visual acuity (BCVA) was 0.67±0.14 (on average), the CRT, on the average for the group, was 311.9 114.5 μm, the central retinal sensitivity was 22.3±1.6 dB. After 3 months, BCVA was 0.71±0.14, CRT was 289.9±110.5 μm, central retinal sensitivity was 22.8±1.6 dB. After 6 months, BCVA was 0.74±0.14, CRT was 236.5±107.6 μm, central retinal sensitivity was 23.1±1.5 dB. At follow-up period of 1 year in the main group was required on average, 3.47±1.58 injections of ranibizumab for stabilization, in the control group, on average, 4.36±1.58 injections were required, the average indicators of BCVA and CRT significantly did not differ. Conclusion. Navigational combined laser treatment in combination with antiangiogenic therapy has shown its effectiveness and safety in the treatment of macular edema due to the branch retinal vein occlusion. The effectiveness of the combined laser technology is expressed in positive dynamics in all functional and morphometric parameters. The safety of the proposed technology is expressed in the absence of clinically significant intra- and postoperative complications. Key words: navigation laser technology, micropulse mode, retinal vein occlusion, macular edema, antiangiogenic therapy