Outcome of treat and monitor regimen of aflibercept and ranibizumab in macular edema secondary to non-ischemic branch retinal vein occlusion

PurposeTo compare the efficacy of a modified PRN treatment regimen (treat and monitor) of aflibercept and ranibizumab in macular edema secondary to non-ischemic branch retinal vein occlusion.MethodsSeventy eyes of 70 patients with treatment naive branch retinal vein occlusion were enrolled. All patients underwent a comprehensive ophthalmic examination, spectral-domain optical coherence tomography, and fluorescein angiography. Patients were randomized 1:1 to receive intravitreal aflibercept (34 eyes) and ranibizumab (36 eyes) with a treat and monitor treatment regimen with monthly follow-up for 12months. Primary outcome measures included mean change in best corrected visual acuity (BCVA) and central foveal thickness (CFT) at month 12 compared to baseline.ResultsAt 12months follow-up, the mean BCVA improved from 0.580.13 to 0.20 +/- 0.15 logMAR (P=0.0003) in the aflibercept group (mean injections 2.6 +/- 1.51) and from 0.52 +/- 0.11 to 0.21 +/- 0.1 logMAR (P=0.0002) in the ranibizumab group (mean injections 2.8 +/- 1.78). No statistical difference between the two groups in terms of the visual acuity gains in eyes with macular edema secondary to non-ischemic BRVO treated with either aflibercept or ranibizumab was observed. Mean CFT reduced from 498 +/- 46 to 204 +/- 23 mu m (P<0.0001) in the aflibercept group and from 488 +/- 31 to 212 +/- 29 mu m (P<0.0001) in the ranibizumab group.Conclusion Treat and monitor regimen is a real-life effective strategy in improving visual acuity after macular edema from branch vein occlusion and in reducing the number of injections.