Preoperative Visual Acuity as a Prognostic Indicator for Laser Treatment of Macular Edema Due to Branch Retinal Vein Occlusion

BACKGROUND AND OBJECTIVE To determine the visual outcome of laser treatments for macular edema due to branch retinal vein occlusion (BRVO) in patients with a preoperative visual acuity (VA) of 20/200 or worse compared to patients with a preoperative VA of better than 20/200. PATIENTS AND METHODS Records of 88 patients with macular edema secondary to BRVO undergoing laser treatment from 1984 to 2003 were reviewed. Mean VA was measured before and after each treatment and after the final treatment. RESULTS All patients received between one and five laser treatments. Preoperative VA was better than 20/200 in 56 patients (group 1) and 20/200 or worse in 32 patients (group 2). Patients in group 1 had a mean improvement of 0.48 lines and 57% had a final VA of 20/40 or better. Patients in group 2 had a mean improvement of 1.69 lines and 20% had a final VA of 20/40 or better. CONCLUSIONS Patients with poor VA (20/200 or worse) secondary to macular edema due to BRVO responded positively to laser treatment. The level of preoperative VA can be a useful predictor of visual outcome. These patients should consider laser treatment before alternative, more aggressive approaches. [Ophthalmic Surg Lasers Imaging 2006;37:462-467.] AUTHORS From Ophthalmic Consultants of Boston (MLS, JSH, TMT, ARF, MGM); Boston Children’s Hospital (EE), Harvard University School of Medicine; VA Boston Healthcare System (MLS); and Boston University School of Medicine (MLS, AKD), Boston, Massachusetts. Accepted for publication May 20, 2006. Presented in part at the annual meeting of the Association for Research and Vision in Ophthalmology, Fort Lauderdale, Florida, May 3-9, 2003. Address reprint requests to Manju L. Subramanian, MD, 85 East Concord Street, 8th Floor, Boston, MA 02118.