Current Treatments in Branch Retinal Vein Occlusions

Dr. Meltem Kılıç

Ankara Bilkent City Hospital, Department of Ophthalmology, Ankara, Türkiye

ABSTRACT

Retinal vein occlusion ranks second among the leading causes of vision loss, following diabetic retinopathy. Patients usually present to the ophthalmologist with acute, unilateral vision loss. Branch retinal vein occlusion (BRVO) develops due to a thrombus at the arteriovenous crossing points. Dilated retinal veins, intraretinal hemorrhages, and macular edema fundus findings observed in acute BRVO. In contrast, hard exudates, neo- vascularization, vitreous hemorrhage, and retinal detachment are seen in chronic BRVO. Optical coherence tomography and fundus fluorescein angiography are used for diagnosis and treatment follow-up. The goal of BRVO treatment is to manage its complications (macular edema, ischemia, and neovascularization). After managing risk factors and addressing the underlying chronic disease, treatment options may include anti- thrombotic therapy, laser photocoagulation, and medical and surgical treatments. Today, visual recovery in macular edema due to BRVO can be achieved with intravitreal injections of ranibizumab, bevacizumab, and aflibercept. In cases where progress is not made with anti-vascular endothelial growth factor (anti-VEGF) therapies, intravitreal steroids are also used in treatment. Faricimab and conbercept are current anti-VEGF agents included in treatment options. Unfortunately, complete recovery from BRVO is not possible; however, complications can be managed with close follow-up and treatment.

Keywords: Branch retinal vein occlusion; Anti-vascular endothelial growth factor; Aflibercept; Ranibizumab, bevacizumab

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