Barzilai University Medical Center

71 Research Day 2020 Barzilai University Medical Center 49 MINIMAL TREATMENT FOR RETINAL VEIN OCCLUSION: HOW LOW CAN YOU GO? Reuven Russell Pokroy, MD Department of Ophthalmology, Barzilai University Medical Center, Ashkelon Background Multiple controlled studies have demonstrated the efficacy of intravitreal anti-VEGF and steroid treatment for macular edema in retinal vein occlusion (RVO) with visual acuity (VA) of 6/12 or worse. Regarding eyes with VA of 6/10 or better, no published data compares intravitreal treatment with observation. Thus, treating physicians are faced with the dilemma of whether to extrapolate and treat from studies on eyes with worse VA or to take a conservative approach of “watch and wait”. Hypothesis A good clinical result can be obtained in certain eyes with RVO with none or minimal intravitreal injections. Objectives This study aims to describe the clinical course of RVO patients that received no or minimal ocular treatment. Results Eight branch RVO and 2 central RVO patients, with center-involved macular edema, at least 24 months follow-up and who received a maximum of two intravitreal injections, were retrospectively studied. Mean presenting central retinal thickness was 433 ± 155 um (range, 304-825). Two of the eight branch RVO patients received 2 bevacizumab injections each, 6 received no ocular treatment. Both central RVO patients received two injections each, one of these was dexamethasone implant and the rest were bevacizumab. Final central retinal thickness was 289 ± 41 um (range, 217-340). All 10 eyes attained a VA of 6/7.5 or better, 5 attained 6/6. Conclusions RVO with center-involving macular edema and good vision can be managed without ocular treatment or with minimal injections, on condition that the patient is closely monitored. Randomized trials are necessary to establish clear indications for treatment of macular edema due to RVO presenting with good VA.