New data corroborates value of early intervention for BRVO

Findings from exploratory analyses of data collected in the BRIGHTER study support initiating anti-VEGF treatment for branch retinal vein occlusion (BRVO) early in order to optimise functional outcomes. “These data are not definite proof of the benefit of early treatment, because that would require a randomised study,” said Ramin Tadayoni MD, PhD, of Sorbonne Paris Cité, Paris, France, at the 16th EURETINA Congress in Copenhagen. “However, they come as supplementary information from a large study showing that treating BRVO patients with higher best corrected visual acuity (BCVA) and earlier leads to better results,” said Dr Tadayoni. BRIGHTER was a 24-month study randomising 455 patients to ranibizumab (Lucentis), ranibizumab plus laser, or laser with ranibizumab allowed after six months. Among patients receiving ranibizumab from baseline, patients with lower baseline BCVA had greater BCVA gains at 24 months than those with a higher baseline BCVA, but a lower final BCVA. Final BCVA also seemed lower in the group where ranibizumab was delayed for at least six months, particularly for those with higher baseline BCVA. Comparing patients after stratification by interval since BRVO showed the BCVA results were poorer for patients with a disease duration ≥12 months versus <12 months. Interestingly, the median time to gain ≥15 letters after initiating ranibizumab was significantly shorter for patients with a shorter duration of BRVO. “These data indicate that one should not give up early when treating patients with longer BRVO duration, because it may take a longer time to evaluate the treatment effect,” said Dr Tadayoni.