New Developments in the Classification, Pathogenesis, Risk Factors, Natural History, and Treatment of Branch Retinal Vein Occlusion

Table 1

Clinical trials evaluating intravitreal anti-VEGF agent for macular edema due to BRVO.

Study	Author/year	Method	Duration	Subjects	Mean BCVA change	Mean CMT change (μm)	Mean number; of injections
BERVOLT	Kornhauser et al. 2016	Bevacizumab 0.05 ml	24 months	87	+0.25 (LogMAR)	−193.9	7.6
BRIGHTER	Tdayoni et al. 2016	Ranibizumab 0.5 mg	24 months	183	+14.8 (ETDRS)	223.3	4.8
				180	+14.8	−240.1	4.5
		Laser alone (3 + PRN)		92	+6.0 (6 months)	−89 (6 months)	N/A
VIBRANT	Clark et al. 2016	Aflibercept 2.0 mg	52 weeks	91	+17.1 (ETDRS)	−283.9	9.0
		(6 + 1 per 2 months); Grid laser		92	+12.2	−249.3	N/A
RELATE	Campochiaro et al. 2015	Ranibizumab 2.0 mg	144 weeks	20	+14.6 (ETDRS)	−292.1	6
		Ranibizumab 0.5 mg		22	+12.1	−203.3	6
		Second randomization after 24 weeks:
		Ranibizumab		16	+3.1	+36.6	14.9
		Ranibizumab + laser (6 + PRN)		17	−2.6 (from week 24 to week 144)	−3.2	15.6
MARVEL	Raja et al. 2015	Ranibizumab 0.5 mg	6 months	37	+18.1 (ETDRS)	−177.1	3.2
		Bevacizumab 1.25 mg (PRN)		38	+15.6	−201.7	3.0
RABAMES	Pielen et al. [94]	Ranibizumab 0.5 mg	6 months	10	+17 (ETDRS)	+142.4	3
				10	+6	+171.7	3
		Laser only (monthly)		10	+2	−37.6	N/A
COMRADE-B	Hattenbach et al.	Ranibizumab 0.5 mg (3 + PRN)	6 months	126	+14.15 (ETDRS)	−275	4.7
		Dexamethasone 0.7 mg		118	+9.66	−130	1
BRAVO	Brown et al. [95]	Ranibizumab 0.3 mg	12 months	134	+16.4 (ETDRS)	−313.6	8.3
		Ranibizumab 0.5 mg		131	+18.3	−347.4	8.4
		Sham/ranibizumab 0.5 mg (6 + PRN)		132	+12.1	−273.7	5.7
HORIZON (12-month; open-label extension; of BRAVO trial)	Heier et al. [96]	Ranibizumab 0.3/0.5 mg	12 months	103	+0.9 (ETDRS)	+3.7	2.4
		Ranibizumab 0.5/0.5 mg		104	−2.3	+6.3	2.1
		Sham/ranibizumab 0.5 mg (PRN)		97	−0.7	+35.3	2
RETAIN (Prospective; follow-up of a subset; of patients from; HORIZON study)	Campochiaro et al. 2014	Ranibizumab 0.5 mg (PRN)	49 months	34	2 years:	2 years: −7.2	2 years: 2.6
					−0.4 (ETDRS)
					3 years: +2.6	3 years: −42.5	3 years: 2.1
					4 years: +0.5	4 years: −26.2	4 years: 2.0
					(Compared with year 1)
SHORE	Campochiaro et al. 2014	Ranibizumab 0.5 mg PRN	15 months	50	+21 (ETDRS)	−247.8	3.8
		Ranibizumab 0.5 mg; (7 + PRN)		48	+18.7	−289.9	7.6
COMO	Francesco et al.	Ranibizumab 0.5 mg (6 + PRN)	12 months	~200	N/A	N/A	N/A
		Dexamethasone 0.7 mg		~200	N/A	N/A	N/A

Note: only BRVO patients are analyzed in this table. Outcomes are not directly comparable because study design and populations varied from each other. The COMO trial is still undergoing; therefore, there are no results available at this time. BRVO: branch retinal vein occlusion; VEGF: vascular endothelial growth factor; BCVA: best-corrected visual acuity; CMT: central macular thickness; ETDRS: early treatment diabetic retinopathy study; LogMAR: logarithm of the minimum angle of resolution; BERVOLT: bevacizumab for RVO long-term follow-up; BRIGHTER: individualized stabilization criteria-driven ranibizumab versus laser in branch retinal vein occlusion; VIBRANT: intravitreal aflibercept for macular edema following branch retinal vein occlusion; RELATE: scatter photocoagulation does not reduce macular edema or treatment burden in patients with retinal vein occlusion; MARVEL: a randomized, double-masked, controlled study of the efficacy and safety of intravitreal bevacizumab versus ranibizumab in the treatment of macular edema due to branch retinal vein occlusion; RABAMES: ranibizumab for branch retinal vein occlusion associated macular edema study; BRAVO: the ranibizumab for the treatment of macular edema following branch retinal vein occlusion; HORIZON: ranibizumab for macular edema due to retinal vein occlusions; RETAIN: long-term outcomes in patients with retinal vein occlusion treated with ranibizumab; SHORE: study evaluating dosing regimens for treatment with intravitreal ranibizumab injections in subjects with macular edema following retinal vein occlusion; COMO: comparison of intravitreal dexamethasone implant and ranibizumab for macular edema in BRVO.