Retinal vein occlusion-related macular edema: An updated review of current evidence and future directions.

Abstract

Macular edema is the leading cause of visual impairment in retinal vein occlusion (RVO). Management has evolved significantly with advances in retinal imaging and the recognition of vascular endothelial growth factor (VEGF) as a key pathogenic mediator. Anti-VEGF agents are now the mainstay of treatment, supported by robust evidence from randomized clinical trials and real-world studies. Intravitreal corticosteroids play a selective role in patients with suboptimal anti-VEGF responses or contraindications to anti-VEGFs, while the role of laser photocoagulation has become limited. Optical coherence tomography remains central to diagnosis, monitoring, and prognostication. Fluorescein angiography and optical coherence tomography have a role in assessing retinal perfusion, including the macula. Emerging therapies, including biosimilars and long-acting delivery systems, aim to increase accessibility and durability of treatment in RVO-related macular edema (RVO-ME). This review summarizes current evidence and future directions in the management of RVO-ME.