Comparing the effectiveness of treating branch retinal vein occlusion with a novel one and stepped pro re nata treatment protocol

This study aimed to investigate the anatomical and functional outcomes of branch retinal vein occlusion (BRVO) eyes treated with anti-vascular endothelial growth factor (anti-VEGF) injections using a novel one and stepped pro re nata protocol. This retrospective case series evaluated the electronic medical records from 22 BRVO patients who were treated with anti-VEGF agents under our novel "One and Stepped PRN" protocol at a single tertiary medical center between January 2016 and October 2022. Outcomes of interest included best-corrected visual acuity and central retinal thickness. Twenty-two treatment-naive BRVO eyes (14 males, 8 females) were included. The mean age was 65.82 ± 10.88 years. Average follow-up was 54.45 ± 7.65 weeks. 7 (31.81%) received mainly Ranibizumab, and 15 (68.18%) received mainly Aflibercept. The baseline average best corrected distance visual acuity was 45.86 ± 19.46 Early Treatment of Diabetic Retinopathy Study letters, and the baseline average central retinal thickness was 562.5 ± 164.02 μm. The mean number of injections received was 3.54 ± 1.74. Average best corrected distance visual acuity improvement was 23.91 ± 17.36 Early Treatment of Diabetic Retinopathy Study letters (P < .0001) and average central retinal thickness improvement was 245.55 ± 153.31 μm (P < .0001). Our results were comparable to the BRAVO and VIBRANT trials while comparatively using fewer anti-VEGF injections. In summary, our novel anti-VEGF protocol applied under real-world conditions achieved good anatomical and visual outcomes among treatment-naive BRVO eyes.