Branch Retinal Vein Occlusion (BRVO) Medication

Updated: Sep 28, 2018
  • Author: Lihteh Wu, MD; Chief Editor: Douglas R Lazzaro, MD, FAAO, FACS  more...
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Medication Summary

The goals of pharmacotherapy are to reduce morbidity and to prevent complications.



Class Summary

Have potent anti-inflammatory and antipermeability properties.

Triamcinolone (Kenalog-40)

Through its antipermeability properties secondary to its anti-VEGF effects, strengthens blood retinal barrier and prevents its disruption.

Dexamethasone intravitreal implant (Ozurdex)

Corticosteroids suppress inflammation by inhibiting multiple inflammatory cytokines, resulting in decreased edema, fibrin deposition, capillary leakage, and migration of inflammatory cells. Indicated for treatment of macular edema following branch retinal vein occlusion or central retinal vein occlusion.


Vascular Endothelial Growth Factor (VEGF) Inhibitors

Class Summary

Nonspecific monoclonal anti-VEGF angiogenesis that targets and inhibits vascular endothelial growth factor (VEGF) activity.

Bevacizumab (Avastin)

Murine derived monoclonal antibody that inhibits angiogenesis by targeting and inhibiting VEGF. Inhibiting new blood vessel formation denies blood, oxygen, and other nutrients needed for tumor growth.

Ranibizumab (Lucentis)

Recombinant humanized IgG1-kappa isotype monoclonal antibody fragment designed for intraocular use. Indicated for neovascular (wet) age-related macular degeneration (ARMD). In clinical trials, about one third of patients had improved vision at 12 mo that was maintained by monthly injections. Binds to VEGF-A, including biologically active, cleaved form (ie, (VEGF110). VEGF-A has been shown to cause neovascularization and leakage in ocular angiogenesis models and is thought to contribute to ARMD disease progression. Binding VEGF-A prevents interaction with its receptors (ie, VEGFR1, VEGFR2) on surface of endothelial cells, thereby reducing endothelial cell proliferation, vascular leakage, and new blood vessel formation.

Aflibercept intravitreal (Eylea)

Binds and prevents activation of vascular endothelial growth factors (VEGF-A) and placental growth factor (PIGF). Activation of VEGF-A and PIGF can result in neovascularization and vascular permeability. It is indicated for treatment of macular edema following retinal vein occlusion (branched or central retinal vein occlusion).