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Ranibizumab for Refractory Macular Edema Secondary to Branch Retinal Vein Occlusion Resistant to Dexamethasone and Bevacizumab
Ann Optom Contact Lens 2018;17:77-81
Published online September 25, 2018
© 2018 The Korean Optometry & Contact Lens Study Society

Jin Young Kwon, MD, Hee Jun Song, MD, Ji Ho Yang, MD, Do Gyun Kim, MD, PhD

Department of Ophthalmology, Myongji Hospital, Goyang, Korea
Correspondence to: Do Gyun Kim, MD, PhD
Department of Ophthalmology, Myongji Hospital, #55 Hwasu-ro 14beon-gil, Deogyang-gu, Goyang 10475, Korea
Tel: 82-31-810-6250, Fax: 82-31-810-0500
E-mail: Kimdk89@empas.com
Received May 8, 2018; Revised July 11, 2018; Accepted July 11, 2018.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Purpose: To report a case of intravitreal ranibizumab for refractory macular edema secondary to branch retinal vein occlusion resistant to dexamethasone implant and bevacizumab.
Case summary: A-65-year old female patient was hospitalized for visual disturbance and metamorphosia in the left eye. The patient had the symptom for 8 months however did not go through any treatment. In addition, she was admitted to the other hospital four months before as the onset of symptom and had the intravitreal bevacizumab injection for the diagnosis of branch retinal vein occlusion. Her best corrected visual acuity was 1.0 in the right eye and 0.3 in the left eye on the first examine. Retinal edema including macular edema, cotton wool spot, retinal hemorrhage were observed in the left eye. Fluorescein angiopraphy showed fluorescein leakage around the branch retinal vein in the late phase and macular edema with cystic change in the optical coherence tomography. Intravitreal dexamethasone implant injection was performed first. Four months after the treatment, macular edema was worse and the visual acuity was not improved. Four times more intravitreal bevacizumab injection was performed. After 11 months of treatments, the subretinal fluid disappeared, but macular edema with cystic change was rather worse. Furthermore, ranibizumab injection was performed three times. Macular edema disappeared 16 months after the start of treatment and corrected visual improved to 0.6 in the left eye.
Conclusions: Intravitreal ranibizumab injection appeared to be an effective option for the treatment of macular edema secondary to branch retinal vein occlusion resistant to dexamethasone implant and bevacizumab.
Keywords : BRVO; Macular edema; Ranibizumab


September 2018, 17 (3)