Systemic anticoagulant in management of central retinal vein occlusion

Abstract

Background Central retinal vein occlusion (CRVO) is one of the commonest retinal vascular diseases. Objective The aim was to compare between intravitreal injection of antivascular endothelial growth factors and combined intravitreal injection of antivasular endothelial growth factors with systemic anticoagulant drugs in treatment of CRVO. Patients and methods This study included 30 patients with CRVO who were divided into two groups. The first group was treated by intravitreal injection? of anti-Vascular endothelial growth factor (VEGF) (Ranibizumab) using three injections, 1 month apart. The second group was treated the same protocol of injection of the first group and systemic anticoagulant drugs, low-molecular-weight heparin. Optical coherence tomography was used to evaluate central macular thickness (CMT) at baseline and after treatment. Best-corrected visual acuity (BCVA) was documented before and after treatment. Results This study included 30 patients with CRVO. The first group treated by anti-VEGF (Ranibizumab) injection only improved in CMT from 702.9 ± 191.6 mm to 448.9 ± 178.0 mm (P = 0.001). BCVA also improved from 0.05 ± 0.01 to 0.11 ± 0.06 (P = 0.006). The second group treated by anti-VEGF (Ranibizumab) injection and systemic anticoagulant also improved in CMT from 814.4 ± 200.9 mm to 397.5 ± 166 mm (P = 0.001) and improved in BCVA from 0.06 ± 0.04 (range: 0.05–1.0) to 0.01 ± 0.11 (P = 0.002). Conclusion Systemic anticoagulant appears to be useful in the management of retinal vein occlusion regarding improvement in CMT and BCVA, but there is no difference regarding improvement between it and intravitreal injection of anti-VEGF (Ranibizumab).