Initial Dose of Three Monthly Intravitreal Injections versus PRN Intravitreal Injections of Bevacizumab for Macular Edema Secondary to Branch Retinal Vein Occlusion

Purpose. To compare visual and anatomic outcomes of intravitreal bevacizumab injections administered as needed (PRN group) and initial treatment with 3 monthly injections followed by as-needed injections (3 monthly initial dose group) in patients with macular edema (ME) secondary to branch retinal vein occlusion (BRVO). Methods. This retrospective study included 69 and 26 patients in the PRN and 3 monthly initial dose groups, respectively. Best-corrected visual acuity (BCVA) and central retinal thickness (CRT) were compared between the 2 groups 6 months after initial injection. Results. At month 6, BCVA change from baseline was −0.27 ± 0.28 (mean ± standard deviation) logMAR in the PRN group and −0.28 ± 0.20 logMAR in the 3 monthly initial dose group. Mean CRT changes were −204 ± 168 in the PRN group and −161 ± 149 μm in the 3 monthly initial dose group at month 6. There were no statistically significant differences in BCVA or CRT changes between groups at any time point. The number of intravitreal injections over 6 months was significantly lower in the PRN group (1.8 ± 0.8 injections) than in the 3 monthly initial dose group (3.4 ± 0.5 injections; P < 0.001). Conclusions. Our results suggest that as-needed intravitreal bevacizumab injections are more tolerable for patients with ME secondary to BRVO.