Effect of Aflibercept on Cystoid Macular Edema Associated with Central Retinal Vein Occlusion. Results from a District Hospital in the United Kingdom

2019 ◽  
Vol 236 (04) ◽  
pp. 547-550
Author(s):  
Georgios Panos ◽  
Vassileios Kostakis ◽  
Grazyna Porter
Keyword(s):  
Visual Acuity ◽  
Adverse Effects ◽  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Central Retinal Vein Occlusion ◽  
Cystoid Macular Edema ◽  
Vein Occlusion ◽  
Intravitreal Aflibercept ◽  
Central Retinal Vein

Abstract Purpose The purpose of this study was to report the efficiency and safety of intravitreal aflibercept for the treatment of cystoid macular edema (CME) secondary to central retinal vein occlusion (CRVO). Methods This is a retrospective cohort study. Ten naive eyes of ten patients with CME secondary to CRVO were included. All eyes received a loading dose of 3 monthly aflibercept injections followed by as-needed injections at monthly follow-up visits. Best corrected visual acuity (BCVA) and central retinal thickness (CRT) were evaluated at baseline and at the end of the follow-up period. Results The median follow-up period was 6 months (range: 6 – 9). The median number of injections was 4 (range: 3 – 5). Median BCVA improved from 1.05 LogMAR units (range: 0.7 – 1.6) at baseline to 0.65 (range: 0.4 – 1.6) at the end of the follow-up period (p = 0.02). Median CRT improved from 690 µm (range: 561 – 1235) at baseline to 243 µm (range: 207 – 531) at the end of the follow-up period (p = 0.002). The power of all statistical tests was greater than 0.8. No adverse effects or complications were documented. Conclusion Intravitreal aflibercept treatment for CME secondary to CRVO significantly improved both macular anatomy and visual acuity without adverse effects.

Longitudinal Follow-Up of Choroidal Thickness in Central Retinal Vein Occlusion With and Without Cystoid Macular Edema

2018 ◽  
Vol 2 (5) ◽  
pp. 289-296 ◽  
Author(s):  
Atalie C. Thompson ◽  
Akshay S. Thomas ◽  
Adam L. Rothman ◽  
Duncan Berry ◽  
Sharon Fekrat
Keyword(s):  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Central Retinal Vein Occlusion ◽  
Cystoid Macular Edema ◽  
Choroidal Thickness ◽  
Intravitreal Injections ◽  
Vein Occlusion ◽  
Over Time ◽  
Central Retinal Vein

Purpose: To investigate the longitudinal relationship between subfoveal choroidal thickness (CT) and central retinal vein occlusion (CRVO). Methods: Retrospective cohort of 104 subjects with enhanced-depth imaging optical coherence tomography for unilateral CRVO. Mean CT and best-corrected visual acuity (BCVA) were compared in eyes with and without CRVO and in eyes with CRVO with and without cystoid macular edema (CME). Results: CT was thicker in eyes with CRVO-related CME than uninvolved contralateral eyes at baseline (263.9 ± 86.9 versus 230.2 ± 87.9 µm; P < .001) and final follow-up (261.1 ± 94.7 versus 222.3 ± 86.2 µm; P = .007). CRVO eyes treated with intravitreal antivascular endothelial growth factor with or without steroid therapy showed a significant reduction in CT at final follow-up (256.3 ± 90.7 versus 236.9 ± 85.9 µm; P = .004). Subjects with CRVO who were not treated with intravitreal injections also showed a significant but more modest decline in CT over time (234.4 ± 94.2 versus 221.5 ± 97.1 µm; N = 31; P = .02). However, contralateral uninvolved eyes without CRVO did not show a significant change in CT over time (233.3 ± 87.9 versus 219.5 ± 90.6 µm; N = 71; P = .40). Persistent CME at final follow-up was associated with thicker baseline (277.6 ± 96.4 versus 235.1 ± 86.5 µm; P = .02) and final CT (265.7 ± 93.4 versus 215.0 ± 82.1 µm; P = .005). Change in CT was not related to change in BCVA ( P > .05). Conclusions: CT was greater in eyes with CRVO-related CME compared to eyes with CRVO but no CME and compared to uninvolved contralateral eyes. CT decreased in eyes with CRVO over time both among eyes that received intravitreal injections and among eyes that did not receive injections. CT may be a prognosticator of treatment response in CRVO-related CME.

Intravitreal Aflibercept for Macular Edema Secondary to Central Retinal Vein Occlusion: 18-Month Results of the Phase 3 GALILEO Study

2014 ◽  
Vol 158 (5) ◽  
pp. 1032-1038.e2 ◽  
Author(s):  
Yuichiro Ogura ◽  
Johann Roider ◽  
Jean-François Korobelnik ◽  
Frank G. Holz ◽  
Christian Simader ◽  
...  
Keyword(s):  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Central Retinal Vein Occlusion ◽  
Phase 3 ◽  
Vein Occlusion ◽  
Intravitreal Aflibercept ◽  
Central Retinal Vein

scholarly journals The Effect of Antivascular Endothelial Growth Factor Therapy on the Development of Neovascular Glaucoma after Central Retinal Vein Occlusion: A Retrospective Analysis

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Christina L. Ryu ◽  
Adrian Elfersy ◽  
Uday Desai ◽  
Thomas Hessburg ◽  
Paul Edwards ◽  
...  
Keyword(s):  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Central Retinal Vein Occlusion ◽  
Significant Risk ◽  
Case Series ◽  
Neovascular Glaucoma ◽  
Vein Occlusion ◽  
Anti Vegf ◽  
Central Retinal Vein

Purpose. Ischemic central retinal vein occlusion (CRVO) eyes are at high risk of developing neovascular glaucoma (NVG). Our purpose is to investigate the effect of anti-VEGF therapy for macular edema after CRVO on the development of neovascular glaucoma (NVG) in ischemic CRVO eyes.Methods. This is a retrospective case series of 44 eyes from 44 patients with CRVO treated with anti-VEGF therapy for macular edema. The primary outcome was the development of NVG.Results. Of the 44 eyes, 14 eyes had ischemic CRVO, and 30 eyes had nonischemic CRVO. Nonischemic eyes received a mean of 8.4 anti-VEGF doses, over mean follow-up of 24 months. One nonischemic eye (3.3%) developed NVD but not NVG. The 14 ischemic eyes received a mean of 5.6 anti-VEGF doses, with mean follow-up of 23 months. Of these 14 ischemic eyes, two eyes (14%) developed iris neovascularization and 3 eyes (21%) developed posterior neovascularization. Three of these 5 eyes with neovascularization progressed to NVG, at 19.7 months after symptom onset, on average.Conclusion. Anti-VEGF therapy for macular edema may delay, but does not prevent, the development of ocular NV in ischemic CRVO. Significant risk of NVG still exists for ischemic CRVO eyes.

scholarly journals Intravitreal Steroid Injections in Macular Edema due to Central Retinal Vein Occlusion

2019 ◽  
pp. 38-44
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Central Retinal Vein Occlusion ◽  
Side Effect ◽  
Lamina Cribrosa ◽  
Initial Application ◽  
Vein Occlusion ◽  
Intravitreal Dexamethasone ◽  
Central Retinal Vein

Retinal vein occlusion is the most common retinal vascular disease after diabetic retinopathy. An occlusion that affects the entire retinal venous system at the level of the lamina cribrosa is called central retinal vein occlusion (CRVO). One of the major complications that threaten visual acuity in CRVO patients is macular edema. Intravitreal dexamethasone implant is widely used in the treatment of macular edema. Efficacy has been shown in terms of short-term edema resolution and increased visual acuity. It seems that the effect on the macula decreases on average in the third month. It is a good option for patients who need to reduce the number of visits. There is no additional side effect except an increase in the incidence of cataracts with recurrent injections. Increasing of intraocular pressure appears to be a tolerable side effect. Their activities are reduced when they are done every six months or when the initial application period is long. Intravitreal steroid treatment is an effective alternative for macular edema secondary to CRVO.

scholarly journals Central retinal vein occlusion: A patient with systemic sclerosis

2016 ◽  
Vol 73 (9) ◽  
pp. 868-872
Author(s):  
Jelena Karadzic ◽  
Aleksandra Radosavljevic ◽  
Igor Kovacevic
Keyword(s):  
Visual Acuity ◽  
Systemic Sclerosis ◽  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Central Retinal Vein Occlusion ◽  
Case Reports ◽  
Immunosuppressive Treatment ◽  
Central Vein ◽  
Vein Occlusion ◽  
Central Retinal Vein

Introduction. Scleroderma (systemic sclerosis) is a severe chronic connective tissue disease, which results in involvement of numerous internal organs. Changes in the eye are the consequences of organ-specific manifestations of scleroderma or adverse effects of immunosuppressive treatment applied. Case report. We reported a 42-year-old woman with systemic sclerosis and acute deterioration of vision in the left eye, with visual acuity 0.9. After thorough clinical examination, including fluorescein angiography and optical coherence tomography, the diagnosis of nonischemic central retinal vein occlusion was made. Further biochemical, rheumatological and immunological investigation, apart from inactive systemic sclerosis, showed normal findings. Therefore, the cause of central retinal vein occlusion could only be attributed to the microvascular changes in systemic sclerosis. After three months, visual acuity deteriorated to 0.6 due to the development of cystoid macular edema. The patient received intravitreal injection of bevacizumab and after a single dose visual acuity improved to 0.9. After a 6- month follow-up, macular edema resolved and visual acuity stabilized. Conclusion. According to our knowledge and current data from the literature, central retinal vein occlusion is a rare vision threatening manifestation of scleroderma. There are only few published case reports on central vein occlusion in scleroderma patients. Examination of the ocular fundus is recommended for evaluation of vascular disease in patients with systemic sclerosis.

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