Comparsion Visual Acuity and Macula Thickening in Macula Edema due Brunch Retinal Vein Occlusion with Intravitreal Injection of Tissue Plasminogen Activator and Avastin with Avastin Alone

The purpose of the study was to compare the effectiveness of intravitreal injection of tissue plasminogen activator and avastin with avastin on macular thickening and visual acuity in macular edema due to branch Retinal Vein Occlusion (BRVO) that had not received any treatment. In this double-blind randomized controlled trial, Fifty eyes of 50 patients with macular edema because of BRVO were randomly allocated to receive to 1.25 mg/ 0.05 ml avastin (25 patients, IVA group) or avastin (1.25 mg/ 0.05 ml) combined with 40000 units of t-PA diluted with 0.25 ml balanced salt solution (25 patients, IVB group). The best-corrected visual acuity (BCVA) and macular thickening were measured with OCT at baseline and 1, 3 and 6 months after it. In t-PA with avastin group significantly decrease in mean macular thickening was seen from 649.08 ± 179.66 μm at baseline to 422.88 ± 93.05μm after 6 months of follow up (p<0.001).Mean log MAR visual acuity improved significantly from 1.432 ± 0.217at baseline to 0.18 ± 0.160 log MAR after 6 months of follow up (p<0.001). At 1, 3 and 6 months follow-up, in the t-PA with avastin group compared with avastin group showed a statistically significant decrease in visual acuity (p<0.001). We observed no serious adverse events. We found that intravitreal injection of t-pa with avastin might be of greater benefit than avastin treatmentmodality to improve macular edema and visual acuity for macular edema due to BRVO.