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

Purpose: To 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. Methods: Seventy eyes of 70 patients with treatment naïve 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 12 months. Primary outcome measures included mean change in best corrected visual acuity (BCVA) and central foveal thickness (CFT) at month 12 compared to baseline. Results: At 12 months follow-up, the mean BCVA improved from 0.58 ± 0.13 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 µm (P < 0.0001) in the aflibercept group and from 488 ± 31 to 212 ± 29 µm (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.