Experience of applying a differentiated approach to the treatment of patients with ischemic branch retinal vein occlusion
There were analyzed 55 eyes of 55 patients aged from 52 to 86 years. The main criterion for the inclusion of patients in the study was the ischemic form of branch retinal vein occlusion (BRVO) confirmed by fluorescent angiography and optical coherence tomography angiography. The patients were divided into two groups according to the height of the edema of the retinal neuroepithelium in the macula: 1) with the height of edema > 450 jm; 2) with the height of edema < 450 jm. The first group underwent intravitreal administration (IVA) of anti-VEGF preparation Ranibizumab. After the decrease of the neuroepithelium edema to 450 jjm or lower, the laser coagulation of the retina was made. The second group underwent only the laser coagulation of the retina. In the first group, the best-corrected visual acuity (BCVA) increased to 0.32±0.05, the average thickness of the retina decreased by 34.7% - to 332±15.3 microns, the volume of neuroepithelium decreased by 16.4% - to 6.07±0.19 mm<sup>3</sup>. In the second group BCVA increased to 0.54±0.05, the average thickness of the retina decreased by 13.5% - to 329±15.6 microns, the volume of neuroepithelium decreased by 11.4% - to 5.95±0.26 mm<sup>3</sup>. Laser coagulation of the retina is effective in the treatment of ischemic form of BRVO, as it allows increasing BCVA and eliminate the edema of retina neuroepithelium. In the case of the neuroepithelium edema more than 450 microns, it is advisable to use a combined treatment: 1) IVA of anti-VEGF with the control of the edema; 2) laser coagulation in the ischemic zones.