Differentiation between Good and Low-Responders to Intravitreal Ranibizumab for Macular Edema Secondary to Retinal Vein Occlusion

Background. Ranibizumab is approved for treatment of macular edema in eyes with retinal vein occlusion (RVO). Some eyes show low-response to treatment with regard to visual acuity gain (VA) and OCT central retinal thickness (CRT) reduction. The goal of this study was to quantify the percentage of low-responders. Methods. Treatment of naïve eyes with macular edema secondary to RVO was included and monthly VA and CRT were analyzed. Four weeks after the loading phase, and at the end of the study, eyes were grouped into low- and good responders based on predefined criteria. The responder and low-responder groups were then compared at various time points. Results. Forty-three eyes were included. Regarding VA, 27.9% were low-responders after the loading phase and 30.2% at the end of the study. For CRT, 34.9% were low-responders after the loading phase versus 27.9% at the end of the study. 75% of patients that were VA low-responders and 73.3% of CRT low-responders after loading phase remained low-responders at the end of the study. Conclusion. Approximately 30% of patients showed low response to ranibizumab after the loading phase and after 1 year of treatment. Two-thirds of patients that were low-responders after the loading phase remained low-responders after 1 year.

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Evaluation of clinical and immunological criteria of the effectiveness of intravitreal injection of ranibizumab at macular edema due to retinal vein occlusion

Regional blood circulation and microcirculation ◽

10.24884/1682-6655-2016-15-4-48-53 ◽

2016 ◽

Vol 15 (4) ◽

pp. 48-53

Author(s):

E. A. Drozdova ◽

D. Yu. Khokhlova

Keyword(s):

Macular Edema ◽

Retinal Vein Occlusion ◽

Retinal Thickness ◽

Control Group ◽

Clinical Parameters ◽

Ophthalmological Examination ◽

Intravitreal Ranibizumab ◽

Lacrimal Fluid ◽

Vein Occlusion ◽

Ranibizumab Treatment

Branch retinal vein occlusion (BRVO) leads to retinal ischemia, releases vascular endothelial growth factor (VEGF) and other cytokines that damage to the blood retinal barrier which causes to macular edema. The aim of the study was to determine the serum and the lacrimal fluid (LF) levels of VEGF-A and IL-6 in their association with clinical parameters in patients with BRVO on the background of ranibizumab treatment. Materials and methods: 32 patients (median age 58.9 years, women - 21) underwent a three month intravitreal ranibizumab injection (IRI) due to macular edema causes BRVO. Ophthalmological examination and spectral domain optical coherence tomography was performed every month. Serum and the LF levels of VEGF-A and IL-6 were measure by ELISA before and after 3 months of treatment with IRI. The control group consist of healthy volunteers in the same age. Results: The visual acuity was improved on the background of the three IRI to 0.3 (±0.1) by Snellen in nonischemic type and 0.15 (±0.04) in ischemic type BRVO. Reduction of the retinal thickness in the macula was obtained in both groups. The serum (714.6±311 pg/ml) and LF level (762.6±432 pg/ml) of VEGF-A were in 2 times higher than in a con-trol and significantly correlated (p=0.0001) with retinal thickness. The serum level of IL-6 was higher than in control in ischemic type BRVO. Ranibizumab treatment resulted to decrease serum and LF level of VEGF-A in all patients in correlation with clinical parameters. LF level of IL-6 was decreased in while non-ischemic type of occlusion. Conclusions: There were determined high serum and lacrimal fluid levels of VEGF-A correlated with retinal thickness in patients with macular edema due to BRVO. Intravitreal ranibizumab injections led to reduced VEGF-A in serum and tear, correlating with improvement in clinical parameters.

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Relationship between metamorphopsia and inner retinal microstructure following intravitreal ranibizumab injection for branch retinal vein occlusion

Scientific Reports ◽

10.1038/s41598-021-84038-7 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Yoshimi Sugiura ◽

Fumiki Okamoto ◽

Tomoya Murakami ◽

Shohei Morikawa ◽

Takahiro Hiraoka ◽

...

Keyword(s):

Macular Edema ◽

Retinal Vein Occlusion ◽

Branch Retinal Vein Occlusion ◽

Post Treatment ◽

Intravitreal Ranibizumab ◽

Vein Occlusion ◽

Treatment Naïve ◽

Pre Treatment ◽

Number Of Injections

AbstractTo evaluate the effects of intravitreal ranibizumab injection (IVR) on metamorphopsia in patients with branch retinal vein occlusion (BRVO), and to assess the relationship between metamorphopsia and inner retinal microstructure and other factors. Thirty-three treatment-naïve eyes of 33 patients with macular edema caused by BRVO with at least 12 months of follow-up were included. The degree of metamorphopsia was quantified using the M-CHARTS. Retinal microstructure was assessed with spectral-domain optical coherence tomography. Disorganization of the retinal inner layers (DRIL) at the first month after resolution of the macular edema (early DRIL) and at 12 months after treatment (after DRIL) was studied. Central retinal thickness (CRT), and status of the external limiting membrane as well as ellipsoid zone were also evaluated. IVR treatment significantly improved best-corrected visual acuity (BCVA) and CRT, but the mean metamorphopsia score did not improve even after 12 months. Post-treatment metamorphopsia scores showed a significant correlation with pre-treatment metamorphopsia scores (P < 0.005), the extent of early DRIL (P < 0.05) and after DRIL (P < 0.05), and the number of injections (P < 0.05). Multivariate analysis revealed that the post-treatment mean metamorphopsia score was significantly correlated with the pre-treatment mean metamorphopsia score (P < 0.05). IVR treatment significantly improved BCVA and CRT, but not metamorphopsia. Post-treatment metamorphopsia scores were significantly associated with pre-treatment metamorphopsia scores, the extent of DRIL, and the number of injections. Prognostic factor of metamorphopsia was the degree of pre-treatment metamorphopsia.

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Macular function following intravitreal ranibizumab for macular edema associated with branch retinal vein occlusion

Documenta Ophthalmologica ◽

10.1007/s10633-019-09696-5 ◽

2019 ◽

Vol 139 (1) ◽

pp. 67-74 ◽

Cited By ~ 1

Author(s):

Tomoharu Nishimura ◽

Shigeki Machida ◽

Atsushi Tada ◽

Eiki Oshida ◽

Tetsuya Muto

Keyword(s):

Macular Edema ◽

Retinal Vein Occlusion ◽

Branch Retinal Vein Occlusion ◽

Intravitreal Ranibizumab ◽

Macular Function ◽

Vein Occlusion

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Intravitreal Ranibizumab and/or Dexamethasone Implant for Macular Edema Secondary to Retinal Vein Occlusion

Ophthalmologica ◽

10.1159/000365639 ◽

2014 ◽

Vol 232 (4) ◽

pp. 216-222 ◽

Cited By ~ 9

Author(s):

Sylvia Nghiem-Buffet ◽

Franck Fajnkuchen ◽

Marc Buffet ◽

Sandrine Ayrault ◽

Anna Le Gloahec-Lorcy ◽

...

Keyword(s):

Macular Edema ◽

Retinal Vein Occlusion ◽

Dexamethasone Implant ◽

Intravitreal Ranibizumab ◽

Vein Occlusion

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Cytokines and Recurrence of Macular Edema after Intravitreal Ranibizumab in Patients with Branch Retinal Vein Occlusion

Ophthalmologica ◽

10.1159/000451062 ◽

2016 ◽

Vol 236 (4) ◽

pp. 228-234 ◽

Cited By ~ 4

Author(s):

Hidetaka Noma ◽

Tatsuya Mimura ◽

Kanako Yasuda ◽

Hayate Nakagawa ◽

Ryosuke Motohashi ◽

...

Keyword(s):

Macular Edema ◽

Retinal Vein Occlusion ◽

Branch Retinal Vein Occlusion ◽

Intravitreal Ranibizumab ◽

Vein Occlusion

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Comparison of ranibizumab and subthreshold micropulse laser in treatment of macular edema secondary to branch retinal vein occlusion

European Journal of Ophthalmology ◽

10.1177/1120672117750056 ◽

2018 ◽

Vol 28 (6) ◽

pp. 690-696 ◽

Cited By ~ 2

Author(s):

Yelda Buyru Özkurt ◽

Sezen Akkaya ◽

Sibel Aksoy ◽

Mert Hakan Şimşek

Keyword(s):

Visual Acuity ◽

Macular Edema ◽

Laser Treatment ◽

Retinal Vein Occlusion ◽

Branch Retinal Vein Occlusion ◽

Intravitreal Ranibizumab ◽

Micropulse Laser ◽

Vein Occlusion ◽

Subthreshold Micropulse Laser ◽

The Mean

Purpose: To compare the effects of intravitreal ranibizumab injection and yellow (577 nm) subthreshold micropulse laser treatment in patients with macular edema following non-ischemic branch retinal vein occlusion. Methods: The medical records of 51 patients who underwent intravitreal ranibizumab (0.5 mg) injection or subthreshold micropulse laser for the treatment of macular edema due to branch retinal vein occlusion were retrospectively reviewed. Subthreshold micropulse laser was administered with a 10% duty cycle, 100 μm spot diameter, 200 ms exposure time. The patients received an injection or laser treatment at baseline and were, then, retreated as needed and were followed for 12 months. The mean best corrected visual acuity changes over the follow-up and the decrease in the mean central macular thickness were evaluated. Results: A total of 27 and 24 patients were assigned to intravitreal ranibizumab and subthreshold micropulse laser subgroups, respectively. The mean number of treatment was 3.81 of intravitreal ranibizumab group and 1.5 of subthreshold micropulse laser group (p < 0.05). The subgroups were similar with regard to the mean score of best corrected visual acuity at baseline, at 1, 6, and 12 months (p > 0.05). The decrease in the mean central macular thickness was significant in both intravitreal ranibizumab and subthreshold micropulse laser groups at 1, 6, and 12 months than that of values at baseline (p < 0.05). No new ocular or systemic adverse events were observed. Conclusion: Our study results showed that intravitreal ranibizumab or yellow subthreshold micropulse laser treatment for macular edema due to branch retinal vein occlusion was not found to be superior to each other for reducing macular thickness and increasing visual acuity for 1-year period. Based on these results, subthreshold micropulse laser may be a useful alternative approach in the treatment of macular edema secondary to branch retinal vein occlusion.

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