Clinical and Biologic Distinctions in Managing Retinal Vascular Diseases

This discussion explores key clinical distinctions that guide treatment decisions across retinal vascular diseases, with a particular focus on differentiating management strategies for branch versus central retinal vein occlusion (BRVO vs. CRVO) and diabetic macular edema (DME). The panel emphasizes tailoring therapy based on disease severity, ischemia, and patient vision status—treating CRVO more aggressively due to higher VEGF expression and neovascular risk. The conversation revisits landmark studies such as BVOS, CVOS, and Protocol I, reflecting on how evolving evidence has shifted clinical practice from selective steroid use to a predominantly anti-VEGF–based approach. Participants debate the role of fluorescein angiography versus ultra-widefield and OCT imaging in assessing ischemia and leakage, highlighting practical and safety considerations. The segment concludes with insights on Ang-2 inhibition and its potential influence on epiretinal membrane formation and fibrotic response, particularly in diabetic and proliferative retinal disease.