Ranibizumab for Macular Edema Secondary to Central and Branch Retinal Vein Occlusion in Patients Younger Than 50 Years of Age

Background. To determine the effectiveness of intravitreal ranibizumab (IVR) approach over 1-year follow-up in patients younger than 50 years old with central and branch retinal vein occlusion (RVO) complicated by macular edema (ME). Methods. Prospective, open-label case series. Patients initiating IVR injections from January 2015 to May 2017 were consecutively recruited. Each patient underwent monthly ophthalmic examination and structural OCT over 12 months. A single IVR injection was administered at baseline, followed by a PRN regimen. Outcome measures are best-corrected visual acuity (BCVA); central foveal thickness (CFT); number of IVR injections; subretinal fluid (SRF); epiretinal membrane; and outer retinal layer (ORL) status. Results. Thirty-eight patients (27 males) were included in the study. At follow-up, mean BCVA improved from 0.40±0.17 to 0.10±0.10 LogMAR in patients with central RVO and from 0.39±0.19 to 0.19±0.07 LogMAR in those with branch RVO, with 20 eyes gaining ≥3 ETDRS lines. In addition, mean CFT significantly decreased in both subgroups at the end of follow-up. All patients with SRF at baseline (9) disclosed complete resolution after 1 year. Likewise, ORL appeared reconstituted in most cases. At 12 months, 3.6±2.4 and 4.4±2.4 IVR injections were required for central and branch RVO, respectively, with only 5 eyes showing ME persistence. Conclusions. Our study indicates that IVR injections can be a valid therapeutic option in patients under 50 years of age with ME secondary to RVO.