***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: PURPOSE To evaluate intravitreal aflibercept injections ( IAI ; also called VEGF Trap-Eye ) for patients with macular edema secondary to central retinal vein occlusion ( CRVO ) . DESIGN R and omized controlled trial . METHODS This multicenter study r and omized 189 patients ( 1 eye/patient ) with macular edema secondary to CRVO to receive 6 monthly injections of either 2 mg intravitreal aflibercept ( IAI 2Q4 ) ( n = 115 ) or sham ( n = 74 ) . From week 24 to week 52 , all patients received 2 mg intravitreal aflibercept as needed ( IAI 2Q4 + PRN and sham + IAI PRN ) according to retreatment criteria . The primary endpoint was the proportion of patients who gained ≥15 ETDRS letters from baseline at week 24 . Additional endpoints included visual , anatomic , and quality -of-life NEI VFQ-25 outcomes at weeks 24 and 52 . RESULTS At week 24 , 56.1 % of IAI 2Q4 patients gained ≥15 letters from baseline compared with 12.3 % of sham patients ( P < .001 ) . At week 52 , 55.3 % of IAI 2Q4 + PRN patients gained ≥15 letters compared with 30.1 % of sham + IAI PRN patients ( P < .001 ) . At week 52 , IAI 2Q4 + PRN patients gained a mean of 16.2 letters of vision vs 3.8 letters for sham + IAI PRN ( P < .001 ) . The most common adverse events for both groups were conjunctival hemorrhage , eye pain , reduced visual acuity , and increased intraocular pressure . CONCLUSIONS Monthly injections of 2 mg intravitreal aflibercept for patients with macular edema secondary to CRVO result ed in a statistically significant improvement in visual acuity at week 24 , which was largely maintained through week 52 with intravitreal aflibercept PRN dosing . Intravitreal aflibercept injection was generally well tolerated Background : To compare the effectiveness of subthreshold grid laser treatment ( SGLT ) with infrared micropulse diode laser alone or in combination with intravitreal triamcinolone injection ( SGLT-IVTJ ) for the treatment of macular oedema ( MO ) secondary to branch retinal vein occlusion ( BRVO ) . Methods : Pilot r and omised clinical trial including 24 patients ( 24 eyes ) who were r and omised either to the SGLT ( 13 eyes ) or to SGLT-IVTJ ( 11 eyes ) . Complete ophthalmic examinations , including Early Treatment of Diabetic Retinopathy Study visual acuity , OCT and fluorescein angiography , were performed at the moment of the study entry and at 3-month intervals , with a planned follow-up of 12 months . Main outcome measures were the decrease in mean foveal thickness ( MFT ) on OCT , and the proportion of eyes that gained at least 10 letters ( approximately two or more lines of visual acuity gain ) at the 12-month examination . Secondary outcomes were the decrease in mean total macular volume on OCT , and the timing of MO resolution . Results : The change in MFT from the initial values was statistically significant for the SGLT-IVTJ from the 3-month examination and for the SGLP from the 6-month examination ( p<0.001 ) . At the 12-month evaluation , 10 patients of the SGLT-IVTJ group ( 91 % ) and eight of the SGLT group ( 62 % ) gained at least 10 letters ( two lines ) in visual acuity . The mean number of lines gained was 3.4 and 1.3 in the SGLT-IVTJ and in the SGLT group , respectively . Conclusions : The combined SGLT-IVT treatment of MO secondary to BRVO allows a significant visual acuity improvement , when compared with simple grid laser treatment OBJECTIVE To describe effects of ranibizumab and bevacizumab when administered monthly or as needed for 2 years and to describe the impact of switching to as-needed treatment after 1 year of monthly treatment . DESIGN Multicenter , r and omized clinical trial . PARTICIPANTS Patients ( n = 1107 ) who were followed up during year 2 among 1185 patients with neovascular age-related macular degeneration who were enrolled in the clinical trial . INTERVENTIONS At enrollment , patients were assigned to 4 treatment groups defined by drug ( ranibizumab or bevacizumab ) and dosing regimen ( monthly or as needed ) . At 1 year , patients initially assigned to monthly treatment were reassigned r and omly to monthly or as-needed treatment , without changing the drug assignment . MAIN OUTCOME MEASURES Mean change in visual acuity . RESULTS Among patients following the same regimen for 2 years , mean gain in visual acuity was similar for both drugs ( bevacizumab-ranibizumab difference , -1.4 letters ; 95 % confidence interval [ CI ] , -3.7 to 0.8 ; P = 0.21 ) . Mean gain was greater for monthly than for as-needed treatment ( difference , -2.4 letters ; 95 % CI , -4.8 to -0.1 ; P = 0.046 ) . The proportion without fluid ranged from 13.9 % in the bevacizumab-as-needed group to 45.5 % in the ranibizumab monthly group ( drug , P = 0.0003 ; regimen , P < 0.0001 ) . Switching from monthly to as-needed treatment result ed in greater mean decrease in vision during year 2 ( -2.2 letters ; P = 0.03 ) and a lower proportion without fluid ( -19 % ; P < 0.0001 ) . Rates of death and arteriothrombotic events were similar for both drugs ( P > 0.60 ) . The proportion of patients with 1 or more systemic serious adverse events was higher with bevacizumab than ranibizumab ( 39.9 % vs. 31.7 % ; adjusted risk ratio , 1.30 ; 95 % CI , 1.07 - 1.57 ; P = 0.009 ) . Most of the excess events have not been associated previously with systemic therapy targeting vascular endothelial growth factor ( VEGF ) . CONCLUSIONS Ranibizumab and bevacizumab had similar effects on visual acuity over a 2-year period . Treatment as needed result ed in less gain in visual acuity , whether instituted at enrollment or after 1 year of monthly treatment . There were no differences between drugs in rates of death or arteriothrombotic events . The interpretation of the persistence of higher rates of serious adverse events with bevacizumab is uncertain because of the lack of specificity to conditions associated with inhibition of VEGF PURPOSE Assess 12-month efficacy and safety of intraocular injections of 0.3 mg or 0.5 mg ranibizumab in patients with macular edema after branch retinal vein occlusion ( BRVO ) . DESIGN Prospect i ve , r and omized , sham injection-controlled , double-masked , multicenter trial . PARTICIPANTS A total of 397 patients with macular edema after BRVO . METHODS Eligible patients were r and omized 1:1:1 to 6 monthly injections of 0.3 mg or 0.5 mg ranibizumab or sham injections . After 6 months , all patients with study eye best-corrected visual acuity ( BCVA ) ≤20/40 or central subfield thickness ≥250 μm were to receive ranibizumab . Patients could receive rescue laser treatment once during the treatment period and once during the observation period if criteria were met . MAIN OUTCOME MEASURES The main efficacy outcome reported is mean change from baseline BCVA letter score at month 12 . Additional visual and anatomic parameters were assessed . RESULTS Mean ( 95 % confidence interval ) change from baseline BCVA letter score at month 12 was 16.4 ( 14.5 - 18.4 ) and 18.3 ( 15.8 - 20.9 ) in the 0.3 mg and 0.5 mg groups , respectively , and 12.1 ( 9.6 - 14.6 ) in the sham/0.5 mg group ( P<0.01 , each ranibizumab group vs. sham/0.5 mg ) . The percentage of patients who gained ≥15 letters from baseline BCVA at month 12 was 56.0 % and 60.3 % in the 0.3 mg and 0.5 mg groups , respectively , and 43.9 % in the sham/0.5 mg group . On average , there was a marked reduction in central foveal thickness ( CFT ) after the first as-needed injection of 0.5 mg ranibizumab in the sham/0.5 mg group , which was sustained through month 12 . No new ocular or nonocular safety events were identified . CONCLUSIONS At month 12 , treatment with ranibizumab as needed during months 6 - 11 maintained , on average , the benefits achieved by 6 monthly ranibizumab injections in patients with macular edema after BRVO , with low rates of ocular and nonocular safety events . In the sham/0.5 mg group , treatment with ranibizumab as needed for 6 months result ed in rapid reduction in CFT to a similar level as that in the 0.3 mg ranibizumab treatment group and an improvement in BCVA , but not to the extent of that in the 2 ranibizumab groups . Intraocular injections of ranibizumab provide an effective treatment for macular edema after BRVO . FINANCIAL DISCLOSURE(S ) Proprietary or commercial disclosure may be found after the references PURPOSE Assess the 12-month efficacy and safety of intraocular injections of 0.3 mg or 0.5 mg ranibizumab in patients with macular edema after central retinal vein occlusion ( CRVO ) . DESIGN Prospect i ve , r and omized , sham injection-controlled , double-masked , multicenter clinical trial . PARTICIPANTS We included 392 patients with macular edema after CRVO . METHODS Eligible patients were r and omized 1:1:1 to receive 6 monthly intraocular injections of 0.3 mg or 0.5 mg of ranibizumab or sham injections . After 6 months , all patients with BCVA ≤20/40 or central subfield thickness ≥250 μm could receive ranibizumab . MAIN OUTCOME MEASURES Mean change from baseline best-corrected visual acuity ( BCVA ) letter score at month 12 , additional parameters of visual function , central foveal thickness ( CFT ) , and other anatomic changes were assessed . RESULTS Mean ( 95 % confidence interval ) change from baseline BCVA letter score at month 12 was 13.9 ( 11.2 - 16.5 ) and 13.9 ( 11.5 - 16.4 ) in the 0.3 mg and 0.5 mg groups , respectively , and 7.3 ( 4.5 - 10.0 ) in the sham/0.5 mg group ( P<0.001 for each ranibizumab group vs. sham/0.5 mg ) . The percentage of patients who gained ≥15 letters from baseline BCVA at month 12 was 47.0 % and 50.8 % in the 0.3 mg and 0.5 mg groups , respectively , and 33.1 % in the sham/0.5 mg group . On average , there was a marked reduction in CFT after the first as-needed injection of 0.5 mg ranibizumab in the sham/0.5 mg group to the level of the ranibizumab groups , which was sustained through month 12 . No new ocular or nonocular safety events were identified . CONCLUSIONS On average , treatment with ranibizumab as needed during months 6 through 11 maintained the visual and anatomic benefits achieved by 6 monthly ranibizumab injections in patients with macular edema after CRVO , with low rates of ocular and nonocular safety events . After sham injections for 6 months , treatment with ranibizumab as needed for 6 months result ed in rapid reduction in CFT in the sham/0.5 mg group to a level similar to that in the 2 ranibizumab treatment groups and an improvement in BCVA , but not to the same level as that in the 2 ranibizumab groups . Intraocular injections of ranibizumab provide an effective treatment for macular edema after CRVO . FINANCIAL DISCLOSURE(S ) Proprietary or commercial disclosure may be found after the references Purpose To evaluate long-term efficacy of intravitreal bevacizumab ( IVB ) versus combined IVB and macular grid laser photocoagulation for the treatment of macular edema secondary to branch retinal vein occlusion ( BRVO ) . Methods In this prospect i ve study , 18 eyes were r and omized into 2 groups according to treatment : Group 1 ( 9 eyes ) underwent IVB at baseline , at month 1 , and at month 2 ; Group 2 ( 9 eyes ) underwent same IVB protocol combined with macular grid laser photocoagulation .  Macular edema and visual acuity represented the endpoints of the study . IVB reinjections were performed in both groups if rec 
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CONCLUSIONS Anti-VEGF agents result in a promising gain of visual acuity , but require a high injection frequency .
Dexamethasone implant might be an alternative , but comparison is impaired as the effect is temporary and it has not yet been tested in PRN regimen .
The ocular risk profile seems to be favorable for anti-VEGF agents in comparison to steroids .