prospective randomized interventional trial comparing branch retinal vein occlusion treatment with ultra wide field imaging guided peripheral laser in combination with ranibizumab vs ranibizumab only in treatment naive cases.

Branch retinal vein occlusion is a leading cause of vision loss. Treatment with ranibizumab (vascular endothelial growth factor (VEGF) inhibitor) on a monthly basis has been associated with improved vision results. There is a subgroup of patients with peripheral nonperfusion on ultrawidefield angiography that appears to be more dependent on anti-VEGF treatment.

In this trial the investigators compare the gold standard of monthly ranibizumab injections with ranibizumab + peripheral scatter laser to the areas of nonperfusion on angiography. Each group will have monthly injections for the first 3 months, then as needed by either visual acuity decrease or increased retinal thickness for the subsequent 3 months.

The primary outcome is visual acuity. Secondary outcomes are reduction in optical coherence tomography, and number of ranibizumab injections

The purpose of the study is to assess whether peripheral scatter laser has any role in decreasing the macular edema in BRVO patients in addition to anti-VEGF ( Ranibizumab ). 

Ultrawidefield FA reveals correlation between non perfusion in the peripheral retina with macular edema and retinal neovascularisation. The study hypothesis is to determine if laser photocoagulation of the non perfused retina decreases macular edema and neovascularisation.