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      In the RELATE study, we found that scatter photocoagulation and focal/grid laser photocoagulation in patients with retinal vein occlusion (RVO) did not improve long-term visual outcomes, speed edema resolution, or reduce the injection burden of anti-vascular endothelial growth factor (VEGF) neutralizing proteins. Laser treatment was divided into 3 sessions. In the first session, areas of retinal nonperfusion were treated along with the far periphery of the retina (where it is difficult to identify retinal nonperfusion). If patients continued to have recurrent edema requiring anti-VEGF injections, scatter photocoagulation was given to all untreated retina in the periphery sparing the retina in the posterior pole and within 5 disc diameters of the temporal arcade vessels. If patients continued to have recurrent edema requiring anti-VEGF injections, the region adjacent to the temporal arcade vessel(s) was treated combined with focal/grid laser therapy. This staged approach was done to test whether scatter photocoagulation targeted to areas of nonperfusion would be useful and to identify the minimum amount of laser photocoagulation that would prevent recurrent edema and allow injections to be discontinued. We found that not only does targeted scatter photocoagulation to areas of nonperfused retina fail to reduce macular edema and the need for anti-VEGF injections, but the same was true when the entire retina outside the macula was treated.
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      References

        • Campochiaro P.A.
        • Clark W.L.
        • Boyer D.S.
        • et al.
        Intravitreal aflibercept for macular edema following branch retinal vein occlusion: the 24-week results of the VIBRANT study.
        Ophthalmology. 2015; 122: 538-544
        • Clark W.L.
        • Boyer D.S.
        • Heier J.S.
        • et al.
        Intravitreal aflibercept for macular edema following branch retinal vein occlusion: 52-week results of the VIBRANT study.
        Ophthalmology. 2016; 123: 330-336
        • Pournaras C.
        • Tsacopoulos M.
        • Strommer K.
        • et al.
        Experimental retinal branch vein occlusion in miniature pigs induces local tissue hypoxia and vasoproliferative microangiopathy.
        Ophthalmology. 1990; 97: 1321-1328
        • Pournaras C.J.
        • Tsacopoulos M.
        • Strommer K.
        • et al.
        Scatter photocoagulation restores tissue hypoxia in experimental vasoproliferative microangiopathy in miniature pigs.
        Ophthalmology. 1990; 97: 1329-1333
        • Brucker A.J.
        • Qin H.
        • Antoszyk A.N.
        • et al.
        • The Diabetic Retinopathy Clinical Research Network
        Observational study of the development of diabetic macular edema following panretinal (scatter) photocoagulation given in 1 or 4 sittings.
        Arch Ophthalmol. 2009; 127: 132-140

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