Comparison of the Safety and Efficacy of Intravitreal Ranibizumab with or without Laser Photocoagulation Versus Dexamethasone Intravitreal Implant with or without Laser Photocoagulation for Macular Edema Secondary to Branch Retinal Vein Occlusion.

BACKGROUND: There is an ambiguity regarding the therapy of choice for patients with macular edema following branch retinal vein occlusion (BRVO). AIM: The purpose of the study was to compare the efficacy and safety of ranibizumab (3 injections 0.5 mg) versus ranibizumab (1 injection 0.5 mg) with laser photocoagulation (LP) versus dexamethamethasone intravitreal (IVT) implant (0.7 mg) with or without LP in patients with macular edema following BRVO. MATERIALS AND METHODS: 60 eyes of 60 patients were divided into 4 groups. Group 1 received IVT ranibizumab (3 injections 0.5 mg), Group 2 received IVT ranibizumab (1 injection 0.5 mg) + LP, Group 3 received dexamethasone IVT implant (0.7 mg), and Group 4 received dexamethasone IVT implant (0.7 mg) + LP. The endpoints were the difference in mean changes in best corrected visual acuity (BCVA), central macular thickness (CMT), and inter-group differences in contrast sensitivity (CS), retinal sensitivity (RS), and intraocular pressure (IOP). RESULTS: BCVA gains in Group 1 (18.00±8.51) patients were significantly (p < 0.05) higher than patients in Groups 2 (10.00±10.26), 3 (9.50±9.60), and 4 (10.50±10.97), after 6 months of therapy. No significant inter-group variation was found in the CMT, CS, and RS. CONCLUSIONS: Ranibizumab (3 injections 0.5 mg) showed significantly higher BCVA gains at 6 months post-therapy. Improvements in the BCVA, CMT, CS, and RS were comparable initially in all the therapies.