Approved pharmacotherapy for macular edema secondary to branch retinal vein occlusion:A review of randomized controlled trials in dexamethasone implants,ranibizumab,and aflibercept

摘要

There are three approved pharmacotherapies for treating macular edema secondary to branch retinal vein occlusion(BRVO), including corticosteroids(dexamethasone implants) and anti-vascular endothelial growth factor(VEGF)(ranibizumab and aflibercept). They all show superior ability to improve vision and reduce macular thickness, comparing with sham injections or macular grid laser treatment. There is no severe ocular or systemic adverse reaction reported in studies associated with anti-VEGF for macular edema after BRVO. Intraocular pressure elevation and cataract aggravation should be addressed after intravitreal dexamethasone implants. Single intravitreal dexamethasone implant had effective duration as long as four to six months. Intravitreal anti-VEGF requires six monthly injections as loading doses, and then PRN regimen needed according to functional and anatomical changes. Ozurdex and ranibizumab reduce not only macular edema, but also the probability of retinal ischemia and neovascularization in patient s with BRVO. Prompt treatment with these agents can lead to a better outcome.