Combined Use of Endonasal Retinalamin Electrophoresis and Lidase Magnetophoresis Enhances the Regenerative and Recovery Effects of Anti-VEGF Therapy in the Treatment of Non-Ischemic Branch Retinal Vein Occlusion: A Retrospective Cohort Study

Despite the documented efficacy and widespread clinical application of lidase magnetophoresis (LMP) and endonasal retinalamin electrophoresis (ERE) in Russia for the management of retinal vein occlusion (RVO), the synergistic potential of these methods remains insufficiently studied in current literature. Purpose: To evaluate the efficacy of LMP and ERE combined with intravitreal ranibizumab for the management of non-ischemic superior temporal RVO by analyzing longitudinal changes in central retinal thickness and total macular volume immediately post-treatment and at a three-month follow-up. Materials and Methods: In this retrospective, single-center, three-arm cohort study, we analyzed the clinical records of patients with non-ischemic superior temporal RVO who underwent LMP and ERE in combination with anti-VEGF therapy. In the final analysis were included 71 patients who underwent anti-VEGF monotherapy (control group). Additional to anti-VEGF therapy 71 patients passed LMP (LMP group) and 72 patients completed LMP and ERE (LMP + ERE group). Central retinal thickness and total macular volume were measured using optical coherence tomography at baseline, at one- and three-months post-treatment, and at the end of the follow-up period. Best-corrected visual acuity was evaluated at the same intervals. Results: A comparative analysis with anti-VEGF monotherapy revealed that combined application of ERE and LMP offers superior efficacy in reducing central retinal thickness by an additional 12.2% (t = 4.21, p-value = 0.0001, Cohen's d = 0.72) and total macular volume by 13.3% (t = 4.31, p-value = 0.0001, Cohen's d = 0.76) and in im-proving visual function by 66.7 (t = 30.2, p-value = 0.0001, Cohen's d = 6.5). Conclusions: Innovative complex use of ERE and LMP in the second month after the start of treatment with intravitreal anti-VEGF therapy enhances the protective and regenerative effect of anti-VEGF therapy. Application of this method leads to a more rapid reduction in central retinal thickness and total macular volume, which is critical for preventing permanent vision loss, scotoma, and optic nerve atrophy in patients following RVO.