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 vein occlusion (BRVO) eyes treated with anti-VEGF injections using a novel One and Stepped pro re nata (PRN) 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. 22 treatment-naive BRVO eyes (14 males, eight 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 BCVA was 45.86 +/- 19.46 ETDRS letters, and the baseline average CRT was 562.5 +/- 164.02 µm. The mean number of injections received was 3.54 +/- 1.74. Average BCVA improvement was 23.91 +/- 17.36 ETDRS letters (p < 0.0001) and average CRT improvement was 245.55 +/- 153.31 µm (p < 0.0001). 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.