BRVO treatments in 2014

Abstract

Until recently, laser photocoagulation was the standard of care for branch retinal vein occlusion (BRVO). The recent development of intravitreal pharmacotherapy has revolutionized the management of BRVO and has expanded our treatment options. Intravitreal anti‐VEGF agents (ranibizumab, bevacizumab, aflibercept) and a sustained‐release dexamethasone implant have been shown effective to treat BRVO‐related macular edema by randomized studies and/or case series, offering favorable anatomical and visual outcomes. Still, long‐term repeated injections may be needed and head‐to‐head comparisons of these treatment modalities have not been performed. As for treatment duration, new data suggest that half of the patients may be cured after 2 years from the onset of the disease, whereas the other half will probably need repeated injections for at least 4 years. A better control of the underlying systemic disease (mostly arterial hypertension) and the identification of the proper time to perform laser photocoagulation could further improve prognosis. Safety and efficacy profiles and updated indications of each treatment modality with representative examples will be discussed.