Intravitreal Ranibizumab Injection In Patients Research Articles

Subfoveal choroidal thickness before and after intravitreal Ranibizumab injection in patients with choroidal neovascularization

Background: Ranibizumab is anti-vascular endothelial growth factor (anti-VEGF) agent made for intraocular use, like smaller antibody fragment that can penetrate retina. Intravitreal ranibizumab therapy has been accepted as a predominant treatment for CNV in recent years.

Anti-VEGF Therapy Reduces Inflammation in Diabetic Macular Edema

Purpose: Correlations among the aqueous flare value (an indicator of inflammation), several functional-morphologic parameters, and aqueous humor levels of multiple cytokines or inflammatory factors were investigated in patients with diabetic macular edema (DME) receiving intravitreal rani­bizumab injection (IRI). Methods: Aqueous humor levels of 12 cytokines, growth factors, or inflammatory factors were measured in 46 DME patients who received IRI. Vascular endothelial growth factor (VEGF), soluble VEGF receptor (sVEGFR), and the other cytokines/inflammatory factors were measured by the suspension array method. In addition, aqueous flare values were measured with a laser flare meter, and central macular thickness (CMT) was examined by optical coherence tomography. Results: At 1 month after IRI therapy, the aqueous flare value showed a significant decrease compared with before treatment (baseline). Significant correlations were noted between the aqueous flare value and the aqueous humor levels of 6 factors/cytokines, including sVEGFR-1, placental growth factor, monocyte chemoattractant protein 1, soluble intercellular adhesion molecule-1, interleukin (IL)-6, and interferon-inducible 10-kDa protein (IP-10). There was also a significant correlation between the change in aqueous flare value and improvement in CMT 1 month after IRI. Conclusions: These findings suggest that IRI reduces subclinical inflammation and that the aqueous flare value is influenced by inflammatory factors/cytokines. In addition, the change in the aqueous flare value may be an indicator of the response of CMT to IRI in patients with DME.

Evaluating the Effect of Intravitreal Ranibizumab on Retrobulbar Hemodynamics by Color Doppler Ultrasonography in Neovascular AMD.

To evaluate changes in retrobulbar blood flow by using color Doppler ultrasonography (CDUS) after intravitreal ranibizumab injection in patients with neovascular age-related macular degeneration (AMD). Eighteen patients who had undergone intravitreal ranibizumab (0.05 mg/0.05 mL) injection due to choroidal neovascular membrane (CNVM) were included in the study. Contralateral eyes of the patients were also analyzed. Peak systolic velocity (PSV), end diastolic velocity (EDV), pulsatility index (PI), and resistivity index (RI) were measured from the ophthalmic artery (OA), central retinal artery (CRA), lateral posterior ciliary artery (LPCA), and medial posterior ciliary artery (MPCA) for all patients pre-injection, and at 1 day, 1 week, and 1 month after ranibizumab injection. The mean age of the 18 patients included in the study was 66.94 years (± 8.3 years). Of these 18 patients, eight were female and 10 were male. After Bonferroni's correction for multiple comparisons was carried out, there were significant differences only in some values of LPCA; these included the decrease in EDV and an increase in PI values of LPCA between the pre-injection and post-injection of the first month measurements in uninjected eyes (P = .002, P = .002), and a decrease in PI value of LPCA between post-injection first day and first week measurements in injected eyes (P = .004). There were no statistically significant differences in other parameters. Ocular blood flow velocities may change after intravitreal ranibizumab injection in patients with CNVM. [Ophthalmic Surg Lasers Imaging Retina. 2019;50:437-443.].

Comparison of one and three initial monthly intravitreal ranibizumab injection in patients with macular edema secondary to branch retinal vein occlusion.

To compare three initial monthly intravitreal ranibizumab (IVR) injections followed by pro re nata (PRN) dosing with one initial monthly IVR injections followed by PRN dosing for macular edema (ME) secondary to branch retinal vein occlusion (BRVO). Forty-two eyes of 42 patients who had IVR injections for BRVO were retrospectively studied. Eighteen eyes received 1 initial IVR injection (1+PRN group) and 24 eyes received 3 monthly IVR injections (3+PRN). At 1, 3, 6 and 12mo; spectral-domain optical coherence tomography (SD-OCT) was performed. Central macular thickness (CMT), the integrity of the external limiting membrane (ELM), the presence of subretinal fluid, cyst size, the presence of inner segment/outer segment (IS/OS) defect were determined. At baseline the mean CMT was 521.3±153.2 µm in the 3+PRN group while it was 438.1±162.4 µm in 1+PRN group. At the final visit, mean CMT was 278.3±87.8 µm in the 3+PRN group and 285.2±74.2 µm in the 1+PRN group (P=0.079). The changes in CMT over the entire study period were also comparable in both groups (243±160 µm in the 3+PRN group, and 152.9±175.3 µm in the 1+PRN group; P=0.090). At baseline, best-corrected visual acuity (BCVA) was 0.92±0.60 logarithm of the minimal angle of resolution (logMAR) in the 3+PRN group, while it was 0.72±0.46 logMAR in the 1+PRN group. Final BCVA was 0.42±0.55 logMAR in the 3+PRN group and 0.38±0.50 logMAR in the 1+PRN group (P=0.979). Additionally, the BCVA changes from baseline to final visit were not significantly different (-0.50±0.45 logMAR in the 3+PRN group, and -0.33±0.39 logMAR in the 1+PRN group; P=0.255). No significant differences in the anatomical or functional results are found between 3+PRN and 1+PRN regimens in the patients receiving ranibizumab for ME secondary to BRVO. Intact IS/OS and baseline BCVA are good predictor of the visual gain, while baseline CMT is a good predictor of the anatomical gain.

Anti-VEGF treatment and peripheral retinal nonperfusion in patients with central retinal vein occlusion.

PurposeTo evaluate the association between the size of peripheral retinal nonperfusion and the number of intravitreal ranibizumab injections in patients with treatment-naïve central retinal vein occlusion (CRVO).MethodsFifty-four patients with treatment-naïve CRVO and macular edema were included. Each patient underwent a full ophthalmologic examination including optical coherence tomography imaging and ultrawide-field fluorescein angiography. Monthly intravitreal ranibizumab injections were applied according to the recommendations of the German Ophthalmologic Society. Two ophthalmologists quantified the areas of peripheral retinal nonperfusion (group 1= less than five disc areas, group 2= more than five disc areas). Correlation analyses between the size of nonperfusion with best-corrected visual acuity, central subfield thickness, and the number of intravitreal injections were performed.ResultsBest-corrected visual acuity improved significantly after intravitreal injections (P<0.001, both groups). Final central subfield thickness after treatment did not significantly differ between both groups (P=0.92, P=0.96, respectively). Mean number of injections in group 1 and group 2 was 4.12±2.73 and 9.32±3.84, respectively (P<0.001). There was a significant positive correlation between areas of nonperfusion and the number of injections in each group. (R=0.97, P<0.001; R=0.94, P<0.001, respectively).ConclusionPeripheral retinal nonperfusion in patients with CRVO correlates significantly with the number of needed intravitreal ranibizumab injections. Ultrawide-field fluorescein angiography is a useful tool for detection of peripheral retinal ischemia, which may have direct implications in the diagnosis, follow-up, and treatment of these patients.

Peripheral retinal non-perfusion and treatment response in branch retinal vein occlusion.

To evaluate the association between the size of peripheral retinal non-perfusion and the number of intravitreal ranibizumab injections in patients with treatment-naive branch retinal vein occlusion (BRVO) and macular edema. A total of 53 patients with treatment-naive BRVO and macular edema were included. Each patient underwent a full ophthalmologic examination including optical coherence tomography (OCT) imaging and ultra wide-field fluorescein angiography (UWFA). Monthly intravitreal ranibizumab injections were applied according to the recommendations of the German Ophthalmological Society. Two independent, masked graders quantified the areas of peripheral retinal non-perfusion. Intravitreal injections improved best-corrected visual acuity (BCVA) significantly from 22.23±16.33 Early Treatment of Diabetic Retinopathy Study (ETDRS) letters to 36.23±15.19 letters (P<0.001), and mean central subfield thickness significantly reduced from 387±115 µm to 321±115 µm (P=0.01). Mean number of intravitreal ranibizumab injections was 3.61±1.56. The size of retinal non-perfusion correlated significantly with the number of intravitreal ranibizumab injections (R=0.724, P<0.001). Peripheral retinal non-perfusion in patients with BRVO associates significantly with intravitreal ranibizumab injections in patients with BRVO and macular edema.

Evaluation of the effect of intravitreal ranibizumab injections in patients with neovascular age related macular degeneration on retinal nerve fiber layer thickness using optical coherence tomography.

PurposeTo evaluate the effect of repeated intravitreal ranibizumab injections for neovascular age related macular degeneration (nAMD) on the retinal nerve fiber layer (RNFL) thickness using optical coherence tomography.DesignA prospective observational cohort study of patients with nAMD.MethodsThirty eyes of 30 patients with nAMD were selected. All patients received three ranibizumab injections and underwent scans using the fast RNFL thickness protocol (Stratus optical coherence tomography) before starting the first injection and 1 month after the third injection. The RNFL thickness measurements prior to the injections and after the third injection were used for the analysis. We also evaluated the effect of the lens status as well as the type of choroidal neovascular membrane on RNFL thickness measurements pre- and post-injection. Pre- and post-injection average and individual quadrant RNFL thickness were measured and statistically analyzed.ResultsThe mean (± standard deviation) pre-injection RNFL thickness was 90.8±18. The mean (± standard deviation) post-injection RNFL thickness was 91.03±15. The pre- and post-injection values of the mean RNFL thickness were not statistically significant. Likewise, the pre- and post-injection values for RNFL thickness in the different quadrants were not statistically significant. There was no statistical significance for the lens status or the type of choroidal neovascular membrane on the RNFL thickness.ConclusionRepeated ranibizumab injections in nAMD appear to have no harmful effect on the RNFL thickness in the short term, in spite of the proven neurotrophic effect of vascular endothelial growth factor. Nevertheless, the safety profile of ranibizumab injections in nAMD needs to be further evaluated in a large multicenter trial with special emphasis on the long-term effects on the retina and optic nerve.

Ranibizumab inhibits nuclear cataractogenesis: An optical measurement error or unexpected pharmacological effect?

Gonderilme tarihi: 17.08.2014 Kabul tarihi: 22.10.2014 Abstract Purpose:The aim of the study is to evaluate lens nuclear optic densitometry alterations following intravitreal ranibizumab injections in patients with age related macular degeneration (AMD). Materials and methods:Twenty-two eyes of 22 patients with wet type AMD were included in this retrospective case series. All the eyes received intravitreal ranibizumab injections as needed. The lens nucleus densitometry examinations were taken with the Scheimpflug anterior segment imaging system. The measurements were taken before the injections and at the last visit. Results: The mean age of the patients was 68.0 ± 8.7 years and the mean follow up time after the first injection was 7.8 ± 3.7 months. An average of 2.3 ± 1.0 injections was performed. For all lens densitometry measurement techniques, the pre-injection values were statistically significantly higher than the postinjection values, indicating decreased nuclear opacity after the injections (p<0.05). Conclusion: Our results show that intravitreal ranibizumab injection may have an inhibitory effect on nuclear cataract formation.

Combined photodynamic therapy and intravitreal ranibizumab injection for polypoidal choroidal vasculopathy

Objective To observe the efficacy and safety of combined photodynamic therapy (PDT)with intravitreal ranibizumab injection in patients with polypoidal choroidal vasculopathy (PCV).Methots Twenty-four PCV patients (24 eyes) were enrolled in this retrospective case study.All patients were assessed by the examinations of Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity chart,color fundus photography,fundus fluorescein angiography (FFA),indocyanine green angiography (ICGA) and optic coherence tomography (OCT).The mean visual acuity was (33.41± 19.43) letters; the mean macular retinal thickness was (343.63 ± 88.60) μm.Patients received PDT first,and intravitreal injected ranibizumab 0.5 mg (0.05 ml) 72 hours later.Treatments were repeated as a single intravitreal injection of ranibizumab combined with or without PDT if the monthly follow-up indicated that it was necessary.The average follow-up period was 13.1 months.The average treatment times were analyzed for each eye.Systemic and ocular adverse events were observed.Visual acuity,macular retinal thickness and leakage of PCV before and after the treatment were analyzed.Results Intravitreal ranibizumab injections was repeated (2.8± 1.6) times per eye on average,and intravitreal injection of ranibizumab combined with PDT was repeated (0.4±0.5) times per eye on average.No systemic and ocular adverse effects were found during and after combined therapy.In the last follow-up,the mean visual acuity of ETDRS was (44.21±17.24)letters,improved by 10.8 letters (t=-4.77,P＜0.01).Visual acuity was improved in 11 eyes (45.8％) and stable in 13 eyes (54.2％).FFA and ICGA showed complete closed PCV in 17 eyes (70.8％),partial closed PCV in 7 eyes (29.2％).OCT image showed that the retinal edema was disappeared in 19 eyes (79.2％) and alleviated in 5 eyes (20.8％).The mean macular retinal thickness was (171.33±38.06) μm,which was 172.30 μm less than that of pre-treatment values (t =11.96,P＜ 0.05).Conclusion Photodynamic therapy combined with intravitreal ranibizumab injections for PCV is safe and effective,with visual acuity improvement,reduction of retinal edema and PCV leakage. Key words: Choroid diseases/therapy; Photochemotherapy; Antibodies, monoclonal

Vascular endothelial growth factor suppression times in patients with diabetic macular oedema treated with ranibizumab

BackgroundTo measure vascular endothelial growth factor (VEGF) levels in aqueous humour from patients with diabetic macular oedema (DME) treated with ranibizumab and to determine how long VEGF was suppressed.MethodsIn this...

A randomised controlled trial of ranibizumab with and without ketorolac eyedrops for exudative age-related macular degeneration

AimsTo evaluate whether ketorolac eyedrops and ranibizumab intravitreal injections would provide additional benefit over ranibizumab alone in the treatment of choroidal neovascularisation (CNV).MethodsThis was a pilot study of eyes with...

Evaluation of retrobulbar blood flow by color doppler ultrasonography after intravitreal ranibizumab injection in patients with neovascular age‐related macular degeneration

This study aimed to evaluate the changes in retrobulbar blood flow by using color Doppler sonography in patients who had undergone intravitreal ranibizumab injection for neovascular age-related macular degeneration (AMD). The study comprised 37 AMD patients who had undergone intravitreal 0.5 mg ranibizumab injection. The ophthalmic artery, central retinal artery, and short lateral posterior ciliary artery of both eyes of patients were evaluated by color Doppler sonography. Peak systolic velocity, end-diastolic velocity, and resistance index were calculated before injection, and after injection on day 7 and day 30. The pre- and postinjection values were compared using Wilcoxon signed rank test. In a comparison with the preinjection values of peak systolic velocity, end-diastolic velocity, and resistance index, the postinjection values at both day 7 and day 30 showed no statistically significant difference in ophthalmic artery, lateral posterior ciliary artery, and central retinal artery (p > 0.05). Similarly, for the same parameters, pre- and postinjection values in the uninjected fellow eye showed no statistically significant difference (P > 0.05). Intravitreal ranibizumab injection for neovascular AMD does not cause a significant change in the retrobulbar blood flow in either the injected eye or the fellow eye.

Intravitreal Ranibizumab for Pigment Epithelium Detachment With Subfoveal Occult Choroidal Neovascularization: A Prospective 24-Month Case Series

To assess the effects of intravitreal ranibizumab injection in patients affected by pigment epithelial detachment associated with occult subfoveal choroidal neovascularization. Prospective, interventional case series. Forty eyes of 40 patients were considered for the purpose of the study. Consecutive patients were recruited for a 24-month study. All patients underwent a complete ophthalmic examination, including best-corrected visual acuity on Early Treatment Diabetic Retinopathy Study (ETDRS) charts. After a 3-monthly loading phase, further intravitreal ranibizumab injections were administered on the basis of detection of any type of fluid on optical coherence tomography. Changes in mean best-corrected visual acuity at 12 and 24months and the proportion of eyes losing fewer than 15 letters (corresponding to 3 ETDRS lines) from baseline visual acuity. Changes in central macular thickness on optical coherence tomography and variation in mean area of the entire lesion. Forty patients were included. Mean best-corrected visual acuity decreased from 20/66 (58 ETDRS letters) to 20/83 (53 letters) at 12months and 20/112 (489 ETDRS letters) at 24months (P= .003). Eighty percent and 67.5% of eyes lost fewer than 3 lines at 12 and 24months, respectively. Mean central macular thickness passed from 545μm to 428μm at 12months and 426μm at 24months. Mean lesion area changed from 6826μm(2) to 6312μm(2) at 12months and 6010μm(2) at 24months. The treatment of pigment epithelial detachment associated with occult subfoveal choroidal neovascularization with intravitreal ranibizumab injection after a 3-monthly loading phase and pro re nata strategy can lead to partial results over a 24-month follow-up. Further investigations are warranted to establish the best therapeutic approach to this disease.

Retinal Venular Caliber Predicts Visual Outcome after Intravitreal Ranibizumab Injection Treatments for Neovascular AMD

To examine whether baseline retinal vascular caliber predicts visual response to intravitreal ranibizumab injections in patients with neovascular age-related macular degeneration (AMD). In this prospective cohort study, patients with neovascular AMD received three monthly intravitreal injections of ranibizumab, followed by as needed dosing up to 1 year. Retinal vascular caliber was measured from digital fundus photographs at baseline and summarized as central retinal artery equivalent (CRAE) and venular equivalent (CRVE), representing average caliber of arterioles and venules, respectively. Visual outcome at 12 months was assessed and the relation to baseline retinal vascular caliber was determined. A total of 88 eyes were analyzed at baseline. After accounting for age, sex, size of choroidal neovascularization, and number of injections, patients who deteriorated in visual acuity at 12 months had significantly larger baseline CRVE, 243.10 μm (95% confidence interval [CI], 227.01-259.19), compared with those who were stable, 214.30 μm (95% CI, 205.79-222.81) and those who improved, 215.26 μm (95% CI, 204.69-225.84; P = 0.007). Baseline CRAE did not differ significantly from eyes whose vision deteriorated, 150.12 μm (95% CI, 140.67-159.57), compared with those remaining stable, 143.64 μm (95% CI, 138.64-148.63), or gaining vision 142.92 μm (95% CI, 136.71-149.13; P = 0.69). In eyes with neovascular AMD treated with intravitreal ranibizumab, larger baseline retinal venular caliber was significantly associated with a poorer response to treatment, possibly reflecting increased disease severity.

Retinal ganglion cell function after repeated intravitreal injections of ranibizumab in patients with age-related macular degeneration

BackgroundThe purpose of this study was to evaluate the safety of intravitreal ranibizumab injection in patients with age-related macular degeneration.Materials and methodsWe examined retinal ganglion cell function using the photopic negative response of the electroretinogram (ERG) in patients with age-related macular degeneration (AMD) treated with intravitreal injections of ranibizumab. We studied 32 eyes of 32 patients with AMD and aged 50–84 years with a mean of 71 years. An intravitreal ranibizumab injection was given three times at monthly intervals. Additional injections were given according to an optical coherence tomography-guided variable dosing regimen. ERG recordings were made before treatment (baseline) and at 3, 6, 9, and 12 months postoperatively. Full-field cone ERGs were elicited by red stimuli on a blue background. The focal macular ERGs were elicited by a 15 degree white stimulus spot centered on the macular region. We measured the amplitudes of the a and b waves, oscillatory potentials, and the photopic negative response of the full-field cone and focal macular ERGs.ResultsVisual acuity was significantly better than the baseline acuity, and macular thickness was significantly reduced after the intravitreal injections of ranibizumab. The amplitudes and implicit times of each wave of the full-field cone ERGs were not significantly changed after intravitreal ranibizumab injections. However, the amplitudes of each wave of the focal macular ERGs were increased after the injections. The implicit times of the a and b waves of the focal macular ERGs were significantly shortened after intravitreal injections of ranibizumab. The ratio of the full-field and focal photopic negative response/b-wave amplitude was not significantly changed after the injections.ConclusionThe amplitudes of the focal macular ERGs, including the photopic negative response improved after repeated intravitreal ranibizumab injections, accompanied by a recovery of visual acuity and macular structure. The results of the full-field cone ERGs indicate that retinal ganglion cell function was not altered by repeated intravitreal ranibizumab injection.

Retinal venular calibre dilatation after intravitreal ranibizumab treatment for neovascular age‐related macular degeneration

To describe the changes in retinal vascular calibre in response to intravitreal ranibizumab injections in patients with neovascular age-related macular degeneration. Prospective interventional case series. Treatment naïve patients with neovascular age-related macular degeneration were recruited over a 1-year period. Each patient received three monthly intravitreal injections according to a 'loading dose'. Retinal arteriolar and venular calibre was measured from digital fundus photographs and summarized as central retinal artery equivalent and central retinal vein equivalent at baseline and 3 months. Central retinal artery equivalent and central retinal vein equivalent changes from baseline to 3 months. Seventy-four eyes of 71 patients had good quality images for grading vessel calibre at baseline and at 3 months in treated (study) eyes and 51 eyes of 51 patients had good quality images in fellow (control) eyes. Over 3 months, in study eyes treated with ranibizumab, there was a significant increase in central retinal vein equivalent over baseline (+6.20 µm, P = 0.005), but no significant change in central retinal artery equivalent (+0.86 µm, P = 0.55). In control eyes, there was no change in central retinal vein equivalent (-0.82 µm, P = 0.70) or central retinal artery equivalent (0.34 µm, P = 0.75). Intravitreal ranibizumab has a significant vasodilational effect on retinal venular calibre in eyes treated for neovascular age-related macular degeneration. The reason for this change is unclear, but may relate to changes in blood flow or inflammatory changes within the retina.

Early visual impacts of optical coherence tomographic parameters in patients with age-related macular degeneration following the first versus repeated ranibizumab injection

The aim of this study is to evaluate the early visual impacts of various optical coherence tomographic (OCT) parameters after the first versus repeated intravitreal ranibizumab injection in patients with exudative age-related macular degeneration (AMD). A retrospective comparative case series study was conducted on 20 eyes of 18 consecutive patients who received intravitreal ranibizumab injection for exudative AMD either for the first time (group 1; n = 8) with no prior anti-vascular endothelial growth factor (anti-VEGF) injection in the same or fellow eye, or for repeated times during the course of monthly injected ranibizumab (group 2; n = 12 eyes). The following baseline and 1month post-injection data was collected for both groups and compared: best-corrected visual acuity (BCVA), qualitative and quantitative OCT parameters including: foveal thickness, foveal volume (central 1-mm circle), retinal volume at 3- and 5-mm central circles, retinal pigment epithelium (RPE) elevation, type of fluid collections, and type of AMD lesion. The size of the fluid and fibrovascular lesion (FVL) areas were measured using manual delineation and automatic calculation of the device. We made correlations between the post-injection visual acuity (VA) and each of post-injection OCT parameters in both groups and these were the main outcome measures. In group 1, there was a strong correlation between post-injection logarithm of minimum angle of resolution (logMAR) BCVA and each of the following: FVL size, foveal thickness, retinal volume at 3- and 5-mm central circles, RPE elevation, the size of the fluid area, and age of the patient (r > 0.70, p < 0.05), whereas in group 2; logMAR BCVA was strongly correlated only with foveal volume (r = 0.74, p = 0.01). Multivariate analysis showed that post-injection FVL size (r (2) = 0.69) and foveal volume (r (2) = 0.55) were the most important factors for VA 1month following the initial and repeated ranibizumab injection, respectively. The size of FVL and foveal volume showed a significant correlation with VA in AMD patients shortly after the first and repeated ranibizumab injection, respectively. Further studies with larger sample sizes are needed in order to support these results.

Changes in visual acuity after intravitreal ranibizumab injections in patients with ischemic and non‐ischemic central retinal vein occlusion

Abstract Purpose To evaluate changes in visual acuity after intravitreal injection of ranibizumab (0.5 mg) in patients with ischemic and non‐ischemic central retinal vein occlusion (CRVO). Methods In a retrospective study, 25 consecutive patients (25 eyes) where included, 15 eyes with ischemic CRVO and 10 eyes with non‐ischemic CRVO. Ophthalmic examination included decimal best corrected visual acuity (BCVA) and OCT at presentation and follow‐up visits. Changes on BCVA after treatment, in a period of follow up from 3 to 24 months, were evaluated. SPSS18 was used for statistical analysis. Results In ischemic CRVO group, patients’ mean age was 70.53 years. BCVA at presentation was 0.025 +/‐ 0.034 (mean +/‐SD), and BCVA at the last follow up was 0.072 +/‐ 0.13. The number of intravitreal injections performed was 3.07 +/‐ 2.12. In non‐ischemic CRVO group patients΄mean age was 69.60 years. BCVA at presentation was 0.33 +/‐ 0.22, and BCVA at the last follow up was 0.60 +/‐ 0.24. The number of intravitreal injections performed was 2.7+/‐ 1.2. In ischemic CRVO group there was no statistically significant improvement in visual acuity (0.046 +/‐ 0.13, paired t‐test p=0,186), whereas in non‐ischemic CRVO group the BCVA after treatment improved significantly (0.27 +/‐ 0.23 paired t‐test p=0,006). Conclusion Intravitreal ranibizumab injections in patients with CRVO may result in a significant improvement of BCVA in patients with non‐ischemic CRVO. Future prospective studies and a larger number of patients are needed to verify these results.