and at 12-month follow-up visits. CONCLUSION:: In addition toanatomical restoration and increased visual acuity, intravitreal ranibizumab alsoimproved the central macular function in patients with acute macular edemaafter branch retinal vein occlusion.CONCLUSAO:: Alem da restauracao anatomica e maior acuidadevisual ranibizumab intravitreo tambem melhorou a funcao macular central empacientes com edema macular aguda apos a oclusao de ramo da veia retiniana.Readingspeed improvements in retinal vein occlusion after ranibizumab treatment.Suner, I.J.;Bressler, N.M.; Varma, R.; Lee, P.; Dolan, C.M.; Ward, J.; Colman, S.; Rubio,R.G.JAMA Ophthalmology Vol. 131 Nr. 7 Pagina: 851 - 6 Data da publicacao:01/07/2013Resumo:IMPORTANCE Treatment ofmacular edema secondary to retinal vein occlusion with ranibizumab has beenshown to improve visual acuity compared with macular laser or observation. Itis important to determine whether these visual acuity improvements translateinto measurable improvements in visual function. OBJECTIVE To examine thebenefit of ranibizumab (Lucentis) on measured reading speed, a directperformance assessment, through 6 months in eyes of patients with macular edemaafter retinal vein occlusion (RVO). DESIGN Two multicenter, double-masked,phase 3 trials in which participants with macular edema after branch RVO orcentral RVO were randomized 1:1:1 to monthly sham, ranibizumab, 0.3 mg, orranibizumab, 0.5 mg, for 6 months. SETTING Community- and academic-basedophthalmology practices specializing in retinal diseases. PARTICIPANTS Sevenhundred eighty-nine eyes of 789 participants who were at least aged 18 years withmacular edema secondary to retinal vein occlusion in the branch vein occlusion(BRAVO) and central vein occlusion (CRUISE) trials. INTERVENTIONS Eyes wererandomized 1:1:1 to 1 of 3 groups for monthly injections for 6 months: sham(132 in BRAVO and 130 in CRUISE), intravitreal ranibizumab, 0.3 mg (134 inBRAVO and 132 in CRUISE), and intravitreal ranibizumab, 0.5 mg (131 in BRAVOand 130 in CRUISE). Patients were able to receive macular laser after 3 monthsif they met prespecified criteria. MAIN OUTCOMES AND MEASURES Reading speed inthe study eye was measured with enlarged text (letter size equivalent toapproximately 20/1500 at the test distance) at baseline and 1, 3, and 6 months.The number of correctly read words per minute (wpm) was reported. The readingspeed test requires a sixth-grade reading level and does not account forliteracy or cognitive state. RESULTS In patients with branch RVO, the mean gainfor the 0.5-mg group was 31.3 wpm compared with 15.0 wpm in sham-treated eyes(difference, 16.3 wpm; P = .007) at 6 months. In patients with central RVO, themean gain for the 0.5-mg group was 20.5 wpm compared with 8.1 wpm insham-treated eyes (difference, 12.4 wpm; P = .01) at 6 months. A gain of 15 ormore letters of best-corrected visual acuity letter score corresponded to anincrease in reading speed of 12.3 wpm and 15.8 wpm in patients with branch andcentral RVO, respectively. CONCLUSIONS AND RELEVANCE These results suggest thatpatients with macular edema after RVO treated monthly with ranibizumab are morelikely to have improvements in reading speed of the affected eyes through 6months compared with sham treatment. These results demonstrate the relevance ofthe treatment benefit to functional visual gain. TRIAL REGISTRATION clinicaltrials.gov Identifier:NCT00486018 and NCT00485836. CONCLUSAO :essesresultados sugerem que os pacientes com edema macular apos RVO mensalmentetratadas com ranibizumab sao mais propensos a ter melhorias na velocidade deleitura.. Estes resultados demonstram