Purpose To evaluate the effect of single-dose intravitreal bevacizumab followed by panretinal and macular grid laser, early in the course of central retinal vein occlusion (CRVO). Methods It is a prospective, non-randomized, interventional study of nine eyes of nine patients with o10 days origin of CRVO who received 2.5 mg (0.1 ml) intravitreal bevacizumab, followed 3 weeks later by panretinal and macular grid photocoagulation. Its effect on visual acuity and anatomical features of CRVO were studied. Results Nine eyes of nine patients (male : female ¼ 8 : 1, mean age 54 years), with o10days (average 2.67days) onset of CRVO, received intravitreal bevacizumab within 7 days of presentation (average 3.1days) followed 3 weeks later by panretinal with macular grid laser. Presenting mean baseline visual acuity was 20/320 (1.2 logarithm of the minimum angle of resolution (LOGMAR) units). All the patients showed rapid improvement in the form of rapid clearance of retinal hemorrhages, decreased optic disc swelling and venous dilation, and tortuosity. Mean final visual acuity was 20/63 (0.5 LOGMAR units). No patient showed conversion from non-ischemic to ischaemic CRVO, recurrence of macular edema, and disc collateral formation. Conclusion Early intravitreal bevacizumab followed by panretinal and macular grid laser may provide visually and anatomically favourable results in a case of CRVO. It may also obviate the need for repeated injection. It requires a large randomized study to substantiate the results.

Background Macular edema secondary to retinal vein occlusion (RVO) is an important cause of loss of vision. Intravitreal injections (IVI) of anti-vascular endothelial growth factor (VEGF) are the standard of care in this disease, as shown in numerous randomized controlled trials. The purpose of this study was to study the efficacy and safety of ranibizumab, an anti-VEGF agent, in the real-world setting. Methods This was 48 weeks, open-label, prospective, multicentre, observational study. Patients diagnosed with ME secondary to RVO were treated with IVI of Ranibizumab 0.5 mg in real-world conditions. Efficacy was measured by improvement seen in best-corrected visual acuity (BCVA) in terms of Early Treatment of Diabetic Retinopathy Study (ETDRS) Letter Scores and change in central retinal thickness (CRT) measured by optical coherence tomography. Results One hundred eyes of 100 patients (79 with branch retinal vein occlusion and 21 with central retinal vein occlusion) were recruited in the study. The mean (standard deviation, SD) BCVA was 52.8 (21.99) letters at baseline and 62.3 (24.40) letters at week 48. From baseline, there was a significant improvement in BCVA by 7.7 letters (p = 0.001) at 48 weeks. The mean (SD) of CRT was 479.9 (216.25) μm at baseline and it decreased significantly to 284.9 (171.35) μm at week 48 (p < 0.001). During the study period, the average number of intravitreal injections was 3.5 per patient. There was no report of endophthalmitis in any eye. Conclusions Ranibizumab is well tolerated and effective in treating macular edema secondary to RVO in real-world clinical settings. However, there is under-treatment compared to controlled clinical trials, and the gain in vision is sub-optimal with under-treatment. Trial registration Clinical Trials Registry - India: CTRI/2015/07/005985.

Diabetic retinopathy (DR) is considered one of the leading causes of vision loss globally. It principally causes upregulation of pro-angiogenic, proinflammatory, and vascular permeability factors such as vascular endothelial growth factor (VEGF), leading to neovascularisation. The advanced stage of DR or proliferative diabetic retinopathy (PDR) is of more concern, as it leads to vitreous haemorrhage and traction retinal detachment. Various risk factors associated with PDR include hyperglycemia, hypertension, neuropathy, dyslipidemia, anaemia, nephropathy, and retinal complications of drugs used for diabetes. Current management approaches for PDR have been stratified and involve pan-retinal photocoagulation, vitrectomy, and anti-VEGF agents. Given the emerging role of anti-VEGF agents as a favourable adjunct or alternative therapy, they have a critical role in the management of PDR. The review emphasises current management approaches for PDR focusing on anti-VEGF therapy. The review also highlights the risk/benefit evaluation of the various approaches employed for PDR management in various clinical scenarios.

To understand the clinical practice pattern of general ophthalmologists in the management of retinal diseases. Also, aimed to explore the ophthalmologist’s perspective towards patient compliance and unmet need in the management of neovascular age-related macular degeneration (nAMD).A total of 108 ophthalmologists participated in this cross-sectional questionnaire-based survey. A paper-based questionnaire with a tool of twelve questions, with response options ranging on a five-point Likert scale of ‘strongly agree’ to ‘strongly disagree’ was provided to participants.Out of 108, 95.4% ophthalmologists confirmed that they were commonly consulted for nAMD amongst the different retinal disorders (RDs). The majority of respondents (87%) confirmed that 60% or fewer patients continue the treatment for a year. About 81.5% of ophthalmologists stated that fluid (Intra-retinal fluid, Sub-retinal fluid) on optical coherence tomography (OCT) was an extremely important parameter for disease activity. The survey revealed that injection frequency was the factor for non-compliance in majority of (&#62;50%) patients. More than 64% of respondents opined that improved efficacy (70.4%), reduced treatment burden (64.8%), and longer acting agents/sustained delivery (64.8%) are the most critical unmet needs for nAMD patients.Based on the findings, it can be concluded that, in addition to functional outcomes i.e. visual acuity, ophthalmologists also considered retinal fluid and central retinal thickness as important parameters for treatment-related decisions. Ophthalmologists suggested that there is a need to develop longer-acting agents with improved efficacy which may help in reducing treatment burden in nAMD management.Longer acting anti-vascular endothelial growth factor (VGEF) agents with improved efficacy may help in reducing the treatment burden in nAMD management.