Combination of ranibizumab and laser photocoagulation in CRVO

Abstract

AbstractPurpose In a model of CRVO upregulation of VEGF was strongest in the ischemic areas. Therefore initiated a proof of concept study to evaluate the efficacy of intraocular ranibizumab injections combined with laser photocoagulation of the non perfused areas in patients with CRVO.Methods 22 patients with areas of non‐perfusion were randomized into two groups. In the treatment arm patients received the ranibizumab injections with additional selective laser photocoagulation. The controls were treated with ranibizumab only. All patients received an upload and were re‐injected in a PRN regimen. The results at month 6 were evaluated. The change in BCVA compared with baseline as well as the amount of ranibizumab injections and the percentage of patients progressing to neovascularization ( retina and/or anterior segment) were analyzed in the both arms.Results BCVA increased at month 6 compared with baseline in the treatment arm from 61.6±12.7 to 68.9±13.7 ETDRS letters and in the control arm from 59.25±10.9 to 64.1±16.5 letters. One control patient developed retinal neovascularisation and required panretinal aser photocoagulation. Due to the small number of patients the differences between experimental and control arm are not statistically significant. The sample size calculation showed, that 100 patients are required to achieve the statistical power of 90%.Conclusion The preliminary results of the study showed a positive effect of the additional selective laser photocoagulation in patients with CRVO. The laser treatment seems to lead to faster and substantial resolution of the macular edema. A multicenter trial is currently prepared to confirm the results of this proof of concept study.