Treatment of macular oedema due to branch retinal vein occlusion with laser induced arterial constriction. Twenty years results of retrospective interventional study

Abstract

AbstractPurpose To evaluate the final visual acuity (VA) in patients with Branch Retinal Vein Occlusion (BRVO) treated with either laser arteriolar constriction (ACo) or grid laser photocoagulation (GLP).Methods 265 BRVOs were treated with 3 different approaches: early ACo performed ≤ 9 weeks after onset of BRVO, late ACo performed > 9 weeks after onset and GLP. The groups were divided into 3 subgroups according to initial VA: ≤ 0.1; 0.16‐0.3; and ≥ 0.4. The data were analyzed using univariate and multivariate logistic regression and, Receiver Operating Characteristics analysis. Factors which could have influenced final VA such as age, sex, localization of occlusion (major temporal or macular BRVO) and the presence of retinal ischemia were taken into account. In the group of early and late ACo, patients with VA ≤ 0.5 and a ME persisting over three months, underwent additional macular GLP.Results Based on the proportion of 1 year VA ≤ 0.1 as a risk category, the results of early ACo (3.8%) were significantly better than either GLP (29.6%, p < 0.001) or late ACo (16.1%, p=0.006). In the subgroup of intermediate initial VA 0.16‐0.3, a significant difference was only found between the early ACo group and GLP (p=0.004). The effect of the treatments on the prevalence of final VA ≤ 0.1 was not significantly different for patients with an initial VA ≥ 0.4. In patients treated by ACo, residual chronic ME requiring additional GLP was present in 35% of early and 44% of late ACo cases.Conclusion ACo performed in the first 9 weeks after onset of BRVO significantly reduces the prevalence of a final VA ≤ 0.1 in patients with an initial VA < 0.3.