Table 2.
Characteristics of included real-world studies of macular oedema secondary to branch retinal vein occlusion.
| Study | Country/region | Treatment arm | Treatment regimen | Patient status | Number of eyes | Age, mean (SD) | Female (%) | Study design | Follow-up (months) |
|---|---|---|---|---|---|---|---|---|---|
| Braimah et al. [49] | India and Lebanon | Bevacizumab 1.25 mg | Monthly injections until complete anatomical success then 2–3 monthly reviews. If recurrence monthly follow up until complete anatomical success. | Naive | 32 | 54.2 (9.1) | 46.9 | Retrospective, multi-centre | 12 |
| Ivanovksa Adjievska et al. [78] | North Macedonia | Bevacizumab 1.25 mg | Single injection then if patients had VA improvement and CRT decrease >30%, then PRN regimen. If VA improvement and CRT decrease <30%, two further IVB injections administered at 6 weeks intervals. | Naive | 55 | 58 (9.2) | 50.9 | Prospective, multi-centre | 12 |
| Kim et al.a [93] | South Korea | Bevacizumab 1.25 mg (low BCVA group) | Single injection then monthly PRN regimen. Patients with baseline BCVA < 20/200 were in this arm. | Naive | 11 | 63.1 (8.6) | 90.9 | Retrospective, – | 12 |
| Kim et al 2017 [93] | South Korea | Bevacizumab 1.25 mg (medium BCVA group) | Single injection then monthly PRN regimen. Patients with baseline BCVA ≥ 20/200 and ≤20/40 were in this arm. | Naive | 83 | 59.4 (10) | 68.7 | Retrospective, – | 12 |
| Kim et al.a [93] | South Korea | Bevacizumab 1.25 mg (highest BCVA group) | Single injection then monthly PRN regimen. Patients with baseline BCVA > 20/40 were in this arm. | Naive | 23 | 55.4 (8) | 47.8 | Retrospective, – | 12 |
| Son et al. [94] | South Korea | Bevacizumab 1.25 mg | Three 6 weekly injections then PRN regimen. | Unclear | 56 | 60.7 (10.2) | – | Retrospective, single-centre | 6 |
| Kornhauser et al. [52] | Israel | Bevacizumab 1.25 mg | One to three monthly loading injections then 1–3 monthly PRN regimen. | Unclear | 87 | 72.9 (10.4) | 58.6 | Retrospective, – | 24 |
| Wang et al. [53] | Taiwan | Bevacizumab 1.25 mg | Single injection then monthly PRN regimen. | Naive | 54 | 62.7 (5.5) | 55.6 | Retrospective, single-centre | 12 |
| Ito et al. [95] | Japan | Bevacizumab 1.25 mg (1 + PRN group) | Single injection with 2 months observation, followed by a monthly PRN regimen | Non-naive | 25 | 69.3 (7.8) | 64 | Prospective, single-centre | 12 |
| Ito et al. [95] | Japan | Bevacizumab 1.25 mg (3 + PRN group) | Three monthly injections then monthly PRN regimen. | Non-naive | 27 | 68 (10.7) | 44.5 | Prospective, single-centre | 12 |
| Kim et al. [96] | South Korea | Bevacizumab 1.25 mg | Single injection then monthly PRN regimen. | Naive | 44 | 61.8 (9.17) | 68.2 | Retrospective, single-centre | 12 |
| Tsagkataki et al. [58] | United Kingdom | Bevacizumab 1.25 mg | Three monthly injections then 2–6 monthly PRN regimen. | Non-Naive | 35 | 75a (IQR 65–81) | – | Retrospective, single-centre | 24 |
| Zhao et al. [97] | China | Bevacizumab 1.25 mg | Single injection then monthly PRN regimen. | Naive | 33 | 60.5 (9.1) | 51.5 | Retrospective, single-centre | 6 |
| Gokce et al. [98] | Turkey | Bevacizumab 1.25 mg | Single injection at baseline. Patients with a good response had 6 weekly PRN regimen; other patients had monthly follow up and PRN regimen. | Unclear | 36 | 58.8 (12.4) | 33 | Retrospective, – | 12 |
| Hikichi et al. [99] | Japan | Bevacizumab 1.25 mg | Single injection then 1–3 monthly PRN regimen. | Naive | 89 | 65 (11) | 46.1 | Retrospective, single-centre | 24 |
| Istek et al. [100] | Turkey | Bevacizumab 1.25 mg | Single injection then 2–4 monthly PRN regimen. | Naive | 32 | 57.2 (10.6) | 75 | Retrospective, single-centre | 12 |
| Ahn et al. [71] | South Korea | Bevacizumab 1.25 mg (1 + PRN group) | Single injection then PRN regimen. | Unclear | 69 | 61.9 (12.3) | 53.6 | Retrospective, single-centre | 6 |
| Ahn et al. [71] | South Korea | Bevacizumab 1.25 mg (3 + PRN group) | Three monthly injections then PRN regimen. | Unclear | 26 | 60 (8.4) | 50 | Retrospective, single-centre | 6 |
| Hanada et al.a [59] | Japan | Bevacizumab 1.25 mg | Single injection then 1–2 monthly PRN regimen | Unclear | 25 | 67 (10) | 48.6 | Retrospective, single-centre | 391 ± 147 days |
| Siegel et al. [46] | Israel | Bevacizumab 1.25 mg | Three monthly injection then 6 weekly PRN regimen. If rescue laser required, IVB paused but re-started if macular oedema persistent 2 months after laser. | Non-naive | 45 | 70.7 (8.5) | 40.00 | Retrospective, single-centre | 12 |
| Thapa et al. [62] | Nepal | Bevacizumab 1.25 mg | Single injection then 6–8 weekly injections until the macula is dry, then PRN regimen. | Naive | 63 | 58.2 (12.4) | 43 | Prospective, single-centre | 12 |
| Demir et al. [38] | Turkey | Bevacizumab 1.25 mg | Three monthly injections then monthly PRN regimen. | Unclear | 33 | 55.3 (9.6) | 64.5 | Retrospective, – | 12 |
| Hayashi et al. [57] | Japan | Bevacizumab 1.25 mg | Single injection then monthly PRN. All patients were eligible for grid laser, however all patients in this arm did not require it. | Naive | 25 | 68.3 (11) | 61.4 | Retrospective, single-centre | 6 |
| Jaissle et al. [101] | European | Bevacizumab 1.25 mg | Single injection then PRN regimen. | Non-naive | 205 | 69b | 51 | Retrospective, multi-centre | 48 ± 6 weeks |
| Byun et al. [56] | South Korea | Bevacizumab 1.25 mg | Single injection then PRN regimen with monthly follow up for 3 months, then 3 monthly follow up. | Non-naive | 47 | 63.3 (12) | 59.6 | Retrospective, single-centre | 12 |
| Kim et al.a [102] | South Korea | Bevacizumab 1.25 mg | Single injection. | Unclear | 22 | 56.9 (9.6) | 54.5 | Retrospective, – | 6 |
| Kondo et al. [103] | Japan | Bevacizumab 1.25 mg | Single injection then monthly PRN regimen. | Naive | 50 | 64.3 | 68 | Prospective, multi-centre | 12 |
| Wu et al. [61] | Pan-American | Bevacizumab 1.25 mg | Single injection then PRN regimen. | Naive | 38 | 65 | 47.4 | Retrospective, multi-centre | 24 |
| Papadia et al.a [51] | Switzerland | Bevacizumab 2 mg | Three months observation, then if oedema still present single injection and PRN regimen. | Unclear | 35 | 68.8 (10.3) | 35.29 | –, single-centre | 20.7 ± 9.4 |
| Lee et al. [41] | South Korea | Bevacizumab 2.5 mg | Single injection then PRN regimen. | Unclear | 95 | 58.4 (11.7) | 46.9 | Retrospective, single-centre | 10.6 ± 8.6 |
| Chen et al.a [104] | Taiwan | Bevacizumab 2.5 mg | Single injection. | Naive | 24 | 60.7 | 37.5 | Retrospective, single-centre | 6 |
| Hoeh et al. [39] | Germany | Bevacizumab 2.5 mg | Single injection then 6–8 weekly PRN regimen. | Naive | 34 | 66.5 (12.3) | 50 | – | 59 ± 25 weeks |
| Wu et al. [61] | Pan-American | Bevacizumab 2.5 mg | Single injection then PRN regimen. | Naive | 25 | 62 | 64 | Retrospective, multi-centre | 24 |
| Khan et al. [105] | United States | Bevacizumab (dose not specified) | Single injection then 4–8 weekly PRN regimen. | Naive | 70 | 68.3 (13) | 52.9 | Retrospective, single-centre | 12 |
| Lip et al. [106] | United Kingdom | Bevacizumab (dose not specified) | One to three monthly loading injections then 4– 8 weekly PRN regimen. | Non-naive | 100 | 71 (11.1) | 49 | Retrospective, single-centre | 12 |
| Rush et al. [63] | United States | Bevacizumab (dose not specified) | Three monthly injections with monthly injections until the macula is dry, then a TAE regimen. | Naive | 52 | 70.4 (12) | 55.8 | Retrospective, – | 12 |
| Houben et al. [107] | Belgium | Dexamethasone 0.7 mg | Single implant then PRN regimen. | Non-naive | 32 | 66.5 (12.9) | 56.2 | Retrospective, multi-centre | 48.7 ± 30.2 weeks |
| Ozkaya et al. [50] | Turkey | Dexamethasone 0.7 mg | Single implant then PRN regimen. | Naive | 41 | 63.1 (11.1) | 46.3 | Retrospective, single-centre | 24 |
| Winterhalter et al. [43] | Germany | Dexamethasone 0.7 mg | Single implant then PRN regimen. | Non-naive | 31 | c | c | Retrospective, single-centre | 6 |
| Yoon et al. [44] | South Korea | Dexamethasone 0.7 mg | Single implant then 4 monthly PRN regimen. | Unclear | 71 | 57.5 (9.2) | 46 | Prospective, multi-centre | 12 |
| Kim et al. [96] | South Korea | Dexamethasone 0.7 mg | Single injection then 6 monthly PRN regimen. | Naive | 28 | 64.1 (6.9) | 57.1 | Retrospective, single-centre | 12 |
| Bezatis et al. [108] | Germany | Dexamethasone 0.7 mg | Single implant then PRN regimen. Rescue anti-VEGF if required. | Unclear | 54 | 68.5 (10.3) | 57.4 | Retrospective, multi-centre | 6 |
| Buyru Özkurt et al. [42] | Turkey | Ranibizumab 0.5 mg | Single treatment then PRN regimen. | Unclear | 27 | 64.7 (13.9) | 33.3 | Retrospective, – | 12 |
| Chatziralli et al. [45] | Greece | Ranibizumab 0.5 mg | Three monthly injections then monthly PRN regimen for the first year, 3 monthly PRN regimen thereafter. | Naive | 29 | 66.7 (8.2) | 58.6 | Retrospective, – | 48 |
| Lalinská et al. [109] | Czech Republic | Ranibizumab 0.5 mg | Three monthly injections then PRN regimen. | Unclear | 54 | 65 | 50 | Retrospective, single-centre | 12 |
| Osaka et al. [110] | Japan | Ranibizumab 0.5 mg | Single injection then monthly PRN regimen | Naive | 32 | 68.1 (11.1) | 53.13 | Prospective, single-centre | 12 |
| Ozkaya et al. [50] | Turkey | Ranibizumab 0.5 mg | Three monthly injections then monthly PRN regimen. | Naive | 46 | 60.8 (8.7) | 30.4 | Retrospective, single-centre | 24 |
| Winterhalter et al. [43] | Germany | Ranibizumab 0.5 mg | Three monthly injections, then further sets of 3 monthly injections PRN if active disease. | Naive | 27 | c | c | Retrospective, single-centre | 6 |
| Son et al.a [94] | South Korea | Ranibizumab 0.5 mg | Three monthly injections then PRN regimen. | Unclear | 24 | 57 (11.6) | – | Retrospective, single-centre | 6 |
| Brynskov et al. [48] | Denmark | Ranibizumab 0.5 mg | Three monthly injections, then 1–3 monthly PRN regimen. | Unclear | 57 | 67 (13) | 46 | Prospective, – | 9–15 |
| Hasegawa et al. [111] | Japan | Ranibizumab (dose not specified) | Single injection then monthly PRN regimen. | Naive | 31 | 69.1 (9.8) | 54.8 | Retrospective, single-centre | 12 |
| Shiono et al. [64] | Japan | Ranibizumab (dose not specified) | Single injection then PRN regimen. | Naive | 27 | 62.8 (11.9) | 51.9 | Prospective, – | 12 |
| Khan et al.a [105] | United States | Ranibizumab (dose not specified) | Single injection then 4–8 weekly PRN regimen. | Naive | 14 | 65.8 (15.6) | 50 | Retrospective, single-centre | 12 |
| Miwa et al. [79] | Japan | Ranibizumab (1 + PRN group) | Single injection then PRN regimen. | Naive | 42 | 65.4 (9.3) | 52.4 | Prospective, multi-centre | 12 |
| Miwa et al. [79] | Japan | Ranibizumab (3 + PRN group) | Three monthly injections then PRN regimen. | Naive | 39 | 70.3 (10.2) | 56.4 | Prospective, multi-centre | 12 |
| Gokce et al. [98] | Turkey | Triamcinolone Acetonide 4 mg | Single injection at baseline. Patients with a good response had 12 weekly PRN regimen; other patients had monthly review and PRN regimen. | Unclear | 26 | 58.2 (9.8) | 31 | Retrospective, – | 12 |
| Lee et al. [41] | South Korea | Triamcinolone Acetonide 4 mg | Single treatment then PRN regimen. | Unclear | 31 | 57.3 (10.2) | 49.2 | Retrospective, single-centre | 34.6 ± 18.5 |
| Byun et al. [56] | South Korea | Triamcinolone Acetonide 4 mg | Single injection then PRN regimen with monthly follow up for 3 months, then 3 monthly follow up. | Non-naive | 87 | 62 (8.6) | 65.2 | Retrospective, single-centre | 12 |
| Chen et al. [104] | Taiwan | Triamcinolone Acetonide 4 mg | Single injection. | Naive | 25 | 60.8 | 40 | Retrospective, single-centre | 6 |
| Kim et al. [102] | South Korea | Triamcinolone Acetonide 4 mg | Single injection. | Unclear | 28 | 59.4 (11.6) | 60.7 | Retrospective, – | 6 |
| Braimah et al.a [49] | India and Lebanon | Ziv-Aflibercept 1.25 mg | Monthly injections until complete anatomical success then 2–3 monthly reviews. If recurrence monthly injections until complete anatomical success. | Naive | 17 | 58.8 (14.5) | 47.1 | Retrospective, multi-centre | 12 |
| Sun et al.a [65] | China | Conbercept 0.5 mg | Three monthly injections then monthly PRN regimen. | Non-naive | 30 | 56.3 (8.8) | 30 | Prospective, multi-centre | 9 |
| Wang et al.a [53] | Taiwan | Aflibercept 2 mg | Single injection then monthly PRN regimen. | Naive | 50 | 63.3 (6.9) | 48 | Retrospective, single-centre | 12 |
| Kola et al.a [40] | Turkey | Triamcinolone Acetonide 40 mg (posterior sub-tenon) | Single injection. | Naive | 41 | 63.5 (11) | 36.6 | – | 6 |
| Buyru Özkurt et al.a [42] | Turkey | Subthreshold macular laser | Single treatment then PRN regimen. A 577 nm yellow laser system was used with the subthreshold laser power in micropulse mode 50% of threshold and applied in confluent spots to the whole area of leakage as assessed by the FA including the foveal centre. | Unclear | 24 | 65.3 (11.8) | 41.7 | Retrospective, – | 12 |
| Inagaki et al.a [54] | Japan | Subthreshold macular laser | Treatment at baseline, eligible for re-treatment after 3 months observation. An 810-nm diode laser photocoagulation device at 60–90% of the just visible threshold energy level in micropulse mode was applied as confluent spots up to 500 µm from the centre of the fovea. | Non-naive | 32 | 66.9 (9.7) | 28.1 | Retrospective, single-centre | 12 |
| Lee et al.a [41] | South Korea | Triamcinolone Acetonide (intravitreal) 2 mg and Bevacizumab 1.25 mg | Single injection of combined IVTA and IVB, then PRN regimen. | Unclear | 25 | 57.9 (11.0) | 43.7 | Retrospective, single-centre | 11.5 ± 8.9 |
| Ozkaya et al.a [55] | Turkey | Bevacizumab 1.25 mg + Macular laser | Single injection then monthly PRN regimen. GLP performed after 1 month, then 4 monthly PRN regimen. Macular laser was performed over the focal leaks seen on the FA and on areas of diffuse retinal thickening with a 532 diode-pumped solid-state laser to create a soft whitening of the retina. Settings: spot diameter: 100 µm; exposure time: 0.1 s; and power 50–150 mW. | Naive | 47 | 64.6 (8.7) | 40.4 | Retrospective, – | 24 |
| Ozkaya et al.a [55] | Turkey | Triamcinolone Acetonide (intravitreal) 4 mg + macular laser |
Single injection then 4 monthly PRN regimen. GLP performed after 1 month, then 4 monthly PRN regimen. Macular laser was performed over the focal leaks seen on the FA and on areas of diffuse retinal thickening with a 532 diode-pumped solid-state laser to create a soft whitening of the retina. Settings: spot diameter: 100 µm; exposure time: 0.1 s; and power 50–150 mW. |
Naive | 52 | 62.8 (8.4) | 38.5 | Retrospective, – | 24 |
| Hayashi et al.a [57] | Japan | Bevacizumab 1.25 mg and macular laser |
Single injection then monthly PRN regimen. Rescue grid laser was given to all patients in this arm due to recurrence of oedema post-IVB re-treatment. No further injections given after GLP administered. Macular laser was performed using a yellow laser of 561 nm with 100-µm spot size, 0.1 s duration, and mild intensity in the area of macular oedema. The laser spots were aimed so as to avoid the foveal avascular zone. |
Naive | 52 | 66.9 (12) | – | Retrospective, single-centre | 6 |
| Chen et al.c [104] | Taiwan | Control | No treatment. | Naive | 34 | 59.4 | 41.2 | Retrospective, single-centre | 6 |
SD standard deviation, IQR inter-quartile range, IVB intravitreal bevacizumab, IVTA intravitreal triamcinolone acetonide.
aTreatment arm not included in meta-analyses as did not meet inclusion criteria (see “Results: Interventions”).
bMedian.
cData unavailable as collated with CRVO results.