Comparative study of combined bevacizumab/targeted photocoagulation vs bevacizumab alone for macular oedema in ischaemic branch retinal vein occlusions

Purpose To investigate whether targeted retinal photocoagulation ( TRP ) of peripheral non‐perfused areas ( NPA s) could prevent the recurrence of macular oedema ( ME ) due to branch retinal vein occlusion ( BRVO ) after intravitreal bevacizumab injection ( IVB ). Methods Eyes received 1.25 mg IVB only ( IVB group) or combined with TRP ( IVB  +  TRP group) of NPA s, more than 5 disc areas identified by fluorescein angiography in the patients with ME secondary to BRVO . Best‐corrected visual acuity ( BCVA ) and central retinal thickness ( CRT ) determined by optical coherence tomography were measured every month for 6 months. Results Thirty‐eight patients were enrolled and randomized to IVB group ( n  = 19) and IVB  +  TRP group ( n  = 19). Both groups showed similar thinning in CRT at 1 week after IVB , IVB  +  TRP group maintained thinner retina at 2 (p = 0.0072) and 3 (p = 0.0086) months compared with IVB group in whom turned to thickened almost back to baseline at 3 months. The number of reinjections in IVB group (1.58 ± 0.69) was significantly greater (p = 0.0025) than that in IVB  +  TRP group (0.83 ± 0.62). BCVA significantly improved at 6 month in IVB  +  TRP group (p = 0.015), but not in IVB group. Conclusion TRP of NPA s reduced the amount of ME recurrence following IVB compared to IVB alone.