Use of bevacizumab for macular edema secondary to branch retinal vein occlusion: a systematic review

This systematic review assesses the effectiveness of intravitreal bevacizumab (IVB) versus a comparison group in the treatment of branch retinal vein occlusion (BRVO)-associated macular edema, and explores its effects on visual acuity (VA) and central macular thickness (CMT). The authors searched the following databases: Medline (1950-October week 3, 2011), The Cochrane Library (Issue 10, 2011), EMBASE (up to 24 October 2011), and the TRIP Database (up to 24 October 2011), using no language or other limits. Trials that were included consisted of patients with BRVO-associated macular edema, those comparing a 1.25 mg IVB injection with a comparison group, those reporting both VA and CMT outcomes, and those having a minimum follow-up of 4 weeks. In the four trials comparing IVB with a comparison group, IVB was effective in improving VA and CMT values in the long-term (12 weeks) in patients with BRVO-associated macular edema. Furthermore, statistically significant improvements in VA in the short-term (4 weeks) could also be seen. Clinicians should use this review as an indicator that IVB is effective in improving VA and CMT values in the long-term in patients with BRVO-associated macular edema. It is important to note, however, that statistically significant improvements in VA in the short term could be seen. This review's main aim was to serve as an evidence base for potentially using other modalities, such as IVB, which seems to be reserved for certain cases.