Rapid regression of retinal neovascularization following intravitreal bevacizumab in branch retinal vein occlusion imaged by optical coherence tomography angiography

Retinal neovascularization developing secondary to ischemic branch retinal vein occlusion (BRVO) is conventionally treated with sector panretinal photocoagulation (PRP). Elevated levels of the vascular endothelial growth factor (VEGF) play an important role in the development of these new vessels[1] and thus administration of anti-VEGF agents has been reported to be of therapeutic use as well.[23] We present a case of BRVO in a 55-year-old female, previously treated with PRP that had persistent neovascularization that was treated with a single anti-VEGF injection. The authors report the use of optical coherence tomography-angiography (OCT-A) as a noninvasive imaging platform to demonstrate its value in diagnosing retinal neovascularization and treatment response following anti-VEGF injection [Fig. 1].Figure 1: Optical coherence tomography angiography scans. Retina slab (6 × 6 mm) fovea centered (a) and 8 mm × 8 mm (b) inferior to the macula demonstrated profound capillary nonperfusion in the inferotemporal quadrant (star). Morphology of the retinal neovascularization; that is large frond of abnormal vasculature (bold arrow) and terminal loops of irregular proliferation of small-caliber new vessels (small arrows) called as exuberant vascular proliferation (EVP) are seen. 4 weeks postbevacizumab injection showed pruning of new vessel (bold arrow) with dramatic reduction in the EVP (small arrow) (c and d)Conclusion Intravitreal injection of anti-VEGF achieved short-term reduction of leakage from persistent active neovascularization (NVE) with ischemic BRVO as demonstrated using noninvasive OCT-A. Declaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.