Comparison of Therapeutic Effects Between Intravitreal Injection of Bevacizumab With Intravitreal Injection of Bevacizumab and Targeted Laser Photocoagulation of Non Perfused Areas of Retina in Patients With Acute Retinal Vein Occlusion

Study Overview
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Brief Summary
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Patients with new onset retinal vein occlusion in less than 3 month whom has visual acuity less than 20/40 and central macular thickness more than 250micrometer and non perfused areas of retina more than 10 DD are included in over study and devided into 2 groups randomizely, Group A under gone 3 intravitreal injection of bevacizumab monthly and examine monthly for Visual acuity and central macular thickness, if in month four or more the CMT is more than 250 micrometer and the visual acuity is less than 8/10 the injection is repeated and follow up in this manner is continued until 9 months. Group B is as the same of group A but patients in this group undergone laser photocoagulation of retinal non perfused areas based on FAG wide field imaging . After 9 month follow up the outcomes such as Vusal acuity, Central macular thickness, intraocular pressure, neovascular formation are compared,

Official Title
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Comparison of Therapeutic Effects Between Intravitreal Injection of Bevacizumab With Intravitreal Injection of Bevacizumab and Targeted Laser Photocoagulation of Non Perfused Areas of Retina in Patients With Acute Retinal Vein Occlusion

Conditions
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Retinal Vein Occlusion With Macular Edema

Intervention / Treatment
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* Drug: intravitreal injection of bevacizumab
* Radiation: intravitreal injection of bevacizumab+ targeted laser


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Center-involved macular edema secondary to RVO on clinical exam Symptoms less than 3 months BCVA= 20/40 or worse Mean center point thickness >250 μm Media clarity, pupillary dilation, and subject cooperation sufficient for adequate fundus photographs One eye per participant is enrolled in the trial Exclusion Criteria: Macular edema due to a cause other than CRVO An ocular condition such that visual acuity would not improve from resolution of the edema (eg, foveal atrophy) Substantial cataract estimated to have reduced visual acuity by >3 lines Prior treatment with intravitreal or peribulbar steroid injection History of macular photocoagulation or PRP Prior pars plana vitrectomy Hx of Intraocular surgery (including cataract extraction) uveitis, NVG, exudative AMD, diabetic retinopathy, any malignancy, optic neuropathy, amblyopia vitreomacular traction or epiretinal membrane *uncontrolled glaucoma ( > 30mmHg with anti-glaucoma medications)

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: intravitreal injection of bevacizumab<br> | Drug: intravitreal injection of bevacizumab<br>* under gone 3 intravitreal injection of bevacizumab monthly and examine monthly for Visual acuity and central macular thickness, if in month four or more the CMT is more than 250 micrometer and the visual acuity is less than 8/10 the injection is repeatet and follow up in this manner is continued until 9 months.<br>|
| Active Comparator: intravitreal injection of bevacizumab+ targeted laser<br>Intervention intravitreal bevacizumab injection + targeted laser photocoagulation of retinal non perfused areas | Radiation: intravitreal injection of bevacizumab+ targeted laser<br>* patients in this group undergone laser photocoagulation of retinal non perfused areas based on FAG wide field imaging . After 9 month follow up the outcomes such as Vusal acuity, Central macular thickness, intraocular pressure, neovascular formation are compared<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Visual acuity | Snellen chart | Every month | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| macular thickness | OCT | every month |