Assessment of efficacy and safety of intravitreal ranibizumab in patients with macular edema secondary to retinal vein occlusion

Abstract

The aim of the study was to assess the efficacy and safety of individualized repeated injection of intravitreal anti-VEGF ranibizumab for preserving or improving vision (BCVA) and central foveal thickness (CFT) in macular edema secondary to retinal vein occlusion (RVO).25 eyes of 25 patients with RVO were included. General and systemic examination was done. IOP measurement, slit lamp, fundus examination, BCVA assessment and OCT was done. CFT was measured to assess macular edema. Injection intravitreal ranibizumab (0.5mg/0.05ml) was given in the affected eye, every 6 weeks, till week 18, if CFT>250 µm. Total 3 injections were given in each patient. Final follow-up visit was at week 36.Hypertension (72%), DM (20%) and altered lipid profile (16%) were associated comorbidities. There was significant reduction in mean CFT from baseline visit (516.08±35.21) to week 18 visit (203.32±4.97) with P<0.0001. There was no significant statistical difference between week 18 CFT and week 36 CFT (P=0.44). There was significant reduction in mean CFT from baseline visit (516.08±35.21) to week 36(251.60±23.17) with P<0.0001.There was significant improvement in mean BCVA from baseline visit (0.87±0.03) to week 18 visit (0.27±0.03). There was no significant statistical difference between week 18 BCVA and week 36 BCVA (P=0.76). There was a significant reduction in mean BCVA from baseline visit (0.87±0.03) to week 36(0.35±0.05) with P<0.0001.At week 36 follow up visit, 4 patients had recurrence of macular edema. 2 had uncontrolled hypertension, 2 had combined uncontrolled hypertension and DM. 21(84%) patients had stable CFT and BCVA. No significant ocular or systemic side-effects were seen.Individualized repeated intravitreal injection of ranibizumab showed improvement in BCVA and CFT in patients with macular edema secondary to RVO. For long term maintenance, control of systemic comorbidities is essential.