Grid photocoagulation combined with intravitreal bevacizumab for recurrent macular edema associated with retinal vein occlusion

Abstract

Ken Ogino, Akitaka Tsujikawa, Tomoaki Murakami, Yuki Muraoka, Yumiko Kurashige, Nagahisa YoshimuraDepartment of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, JapanPurpose: To report the efficacy of grid photocoagulation combined with intravitreal bevacizumab (IVB) for macular edema recurring after previous IVBs associated with retinal vein occlusion (RVO).Methods: This retrospective study consisted of 19 eyes with branch retinal vein occlusion (BRVO) and nine eyes with central retinal vein occlusion (CRVO), which were treated with grid photocoagulation combined with IVB for recurrent macular edema after previous IVBs. The mean duration of total follow-up was 29.3 ± 5.8 months.Results: After this combination therapy, foveal thickness was reduced, significant with slight improvement in visual acuity (VA). At 1 month after treatment, although 25 of the 28 eyes showed complete resolution of the cystoid space, the macular edema recurred to some extent in 19 eyes. Compared with initial values, final foveal thickness was reduced significantly in both BRVO and CRVO groups (P < 0.001), but improvement in VA was significant only for eyes with BRVO (P = 0.012). The total number of IVB was 2.8 ± 0.7 for eyes with either BRVO or CRVO.Conclusion: Grid photocoagulation combined with IVB has a substantial effect on reducing recurrent macular edema associated with RVO, but the effect on visual acuity is limited.Keywords: bevacizumab, grid laser photocoagulation, macular edema, optical coherence tomography, retinal vein occlusion