The purpose of this study is to determine the effect of ranibizumab for the treatment of macular edema (ME) secondary to branch retinal vein occlusion (BRVO) in patients with initial fair visual acuity.
Lucentis was approved for ME due to BRVO based on the results from BRAVO study. The inclusion criteria in BRAVO was "best corrected visual acuity (BCVA) 20/40 to 20/320". Therefore, the patients with VA better than 20/40 who are out of inclusion criteria of BRAVO study had no treatment and just wait to reach spontaneous improvement. But, there is unmet needs of these patients and, in actual clinical practice, many retina specialists treat these patients with Ranibizumab. These patients have been experiencing VA improvement after the injection. Based on these clinical backgrounds, the investigator wants to suggest the treatment guidelines in these patients group, which is, early treatment of ranibizumab would be effective and increase patients' QOL. In other words, there are many experiences in these cases among ophthalmologists, but there have been no clinical trials that can endorse the treatments. To confirm the efficacy of ranibizumab in patients with initial fair vision, the investigators started the prospective randomized clinical trial on the efficacy and safety of ranibizumab for the patients.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
19
Loading dose: three monthly intravitreal injections of ranibizumab 0.5 mg Lucentis stop criteria: V/A ≥20/20 and complete disappearance of macular edema Retreatment: visual loss of 5 or more letter compared to previous visit
Three monthly sham injections followed by retreatment (sham injections) as needed Stop criteria: V/A ≥20/20 and complete disappearance of macular edema Retreatment: visual loss of 5 or more letter compared to previous visit
In the Lucentis group: performed if BCVA \< 20/40 or CFT ≥ 350um despite of 3 sessions of previous Lucenis injection from Month 6 In the standard of care group: performed if BCVA \< 20/40 or CFT ≥ 350um from Month 3
Seoul National University Bundang Hospital
Seongnam, Gyunggi-do, South Korea
Samsung Medical Center
Seoul, South Korea
Time to achieve an improvement of 10 or more Early Treatment Diabetic Retinopathy Study (ETDRS) letters in best-corrected visual acuity
Time frame: 1 year
Mean change from baseline ETDRS letter score over time
Time frame: 6 months and 1 year
Percentage of patients gaining 10 or more letters in ETDRS letter score from baseline BCVA
Time frame: 6 months and 1 year
Percentage of patients gaining < 10 letters in ETDRS letter score from baseline BCVA
Time frame: 6 months and 1 year
Percentage of patients losing < 10 letters in ETDRS letter score from baseline BCVA
Time frame: 6 months and 1 year
Proportion of patients with who at least maintain baseline BCVA
Time frame: 6 months and 1 year
Percentage of patients with central foveal thickness (CFT) of < 300 um
Time frame: 6 months and 1 year
Safety outcomes
Frequency, type, and severity of adverse reactions
Time frame: 6 months and 1 year
Mean change from baseline CFT over time
Time frame: 6 months and 1 year
Mean change from baseline in National Eye Institute Visual Function Questionnaire-25 (NEI-VFQ-25) distance activities subscale score
Time frame: 6 months and 1 year
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Mean change from baseline in contrast sensitivity
Time frame: 6 months and 1 year
Mean change from baseline in multifocal electroretinogram (mfERG) P1 amplitude
Time frame: 6 months and 1 year
Percentage of patients losing 10 or more letters in ETDRS letter score from baseline BCVA
Time frame: 6 months and 1 year