研究目的
The objective of the study was the investigation of the effects of intravitreal bevacizumab (BEV) with or without additional macular grid laser photocoagulation (GRID) for macular edema (ME) secondary to branch retinal vein occlusion (BRVO).
研究成果
Our data demonstrate a beneficial effect of bevacizumab in macular edema in eyes with branch retinal vein occlusion. A loading phase of three injections led to a significant improvement in vision in both groups, which persisted at week 38. Additional GRID laser treatment exhibited no beneficial functional or anatomical effect during the study, nor did it reduce the number of injections. The FAZ area increased significantly in both groups, but overall retinal ischemia did not. Further studies investigating more numerous eyes with long follow-up are needed to confirm our data.
研究不足
The main limitation of this study is its small patient cohort. Also, longer periods between controls/injections during the follow-up may hinder the interpretation of the results. In order to be able to detect the effect of laser we decided to plan longer intervals after the initial three injections. Another critical point is the use of images obtained by time-domain OCT.
1:Experimental Design and Method Selection:
Prospective, randomized, monocentric clinical trial comparing two treatment groups: intravitreal bevacizumab alone (BEV) and bevacizumab combined with macular grid laser photocoagulation (BEV + GRID). The study followed a pro re nata (PRN) regimen after initial loading doses.
2:Sample Selection and Data Sources:
Thirty-two treatment-na?ve patients with macular edema due to non-ischemic branch retinal vein occlusion were included. Exclusion criteria included macular ischemia > 1 mm2, other ocular diseases, prior treatments, and recent cardiovascular events.
3:List of Experimental Equipment and Materials:
Intravitreal bevacizumab (Avastin?,
4:25 mg/05 ml), laser photocoagulation system (spot size 100–200 μm, energy 100–300 mW, exposure time 100 msec, Volk Goldmann 3-mirror lens), optical coherence tomography (Stratus?, Zeiss), fluorescein angiography camera (Zeiss Fundus camera FF450 +IR), ETDRS visual acuity charts, ImageJ software for image analysis, SAS? 2 for statistical analysis. Experimental Procedures and Operational Workflow:
All patients received three monthly bevacizumab injections initially. In the BEV + GRID group, grid laser was applied 2 weeks after the first injection, with optional re-treatment. Follow-up visits at weeks 4, 8, 14, 26, and 38 included BCVA assessment, OCT, and FA at baseline and week
5:Additional bevacizumab injections were given if re-treatment criteria (persistent or recurring macular edema) were met. Data Analysis Methods:
Statistical analyses used ANOVA for BCVA and CRT changes, paired and unpaired t-tests for FAZ changes, with normality assessed by Wilk-Shapiro test. Interobserver repeatability was evaluated using interclass correlation. Significance level was set at alpha=0.05.
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