Management of macular oedema due to retinal vein occlusion: An evidence‐based systematic review and meta‐analysis

Abstract

Background Central retinal vein occlusion and branch retinal vein occlusion are common causes of visual loss due to associated macular oedema. The aim of this review was to assess the effectiveness of interventions improving vision and treating macular oedema in central retinal vein occlusion and branch retinal vein occlusion. Methods Medical search engines and clinical trial registries were systematically searched. Randomised clinical trials with ≥90 eyes and real‐world outcome studies with ≥100 eyes each with ≥6 months follow‐up were included. Results There were 11 randomised controlled trials evaluating treatments for central retinal vein occlusion which met the inclusion criteria and 10 for branch retinal vein occlusion. There were 10 real world outcome studies of central retinal vein occlusion and 5 real world outcome studies of branch retinal vein occlusion. Meta‐analysis was performed on studies that met the defined inclusion criteria. Main outcomes were change in visual acuity at 6‐, 12‐, 24‐ and 36 months by treatment. Conclusions Intravitreal anti‐vascular endothelial derived growth factor is recommended as first line treatment over intravitreal corticosteroid due to its effectiveness and lower rate of ocular adverse events. Best outcomes are achieved when intravitreal treatment is started early. Macular laser may have an adjunctive role in branch retina vein occlusion but not central retinal vein occlusion.

Automated interpretation of retinal vein occlusion based on fundus fluorescein angiography images using deep learning: A retrospective, multi-center study

“…The ‘diagnosis’ and ‘macular involvement’ label will help in selecting an appropriate treatment plan. While visual acuity is indeed a primary criterion for treatment decisions, it is important to note that the overall management strategy must also consider the type of RVO and specific pathological changes such as macular edema, which is a leading cause of vision loss in these patients [ 35 ]. While systemic treatments for RVO are generally consistent, the ophthalmological strategies for managing CRVO differ significantly from those applied to BRVO [ 36 ], indicating the necessity of tailored ophthalmic interventions based on the diagnosis and detailed ocular findings.…”