scholarly journals Effect of Alternate Treatment with Intravitreal Corticosteroid and Anti-VEGF for Macular Edema Secondary to Retinal Vein Occlusion

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Young Hwan Bae ◽  
Seong Mi Kim ◽  
Jin Young Kim ◽  
So Hyun Bae ◽  
Hakyoung Kim ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Visual Outcome ◽  
Vascular Endothelial ◽  
Vein Occlusion ◽  
Anti Vegf ◽  
Treatment Naïve ◽  
Endothelial Growth Factor

Purpose. To evaluate whether treatment with intravitreal corticosteroid and anti-vascular endothelial growth factor (VEGF) injections alternately can improve treatment outcomes of macular edema (ME) caused by retinal vein occlusion (RVO). Methods. This dual-center retrospective study included 112 eyes with treatment-naïve ME secondary to RVO that were alternately treated with intravitreal corticosteroid and anti-VEGF injections (33 eyes, alternate group) or treated only with intravitreal anti-VEGF injections (79 eyes, anti-VEGF group) on a pro re nata basis. Results. During the 12-month follow-up period, the alternate group achieved a visual acuity gain of 0.39 logMAR, while the anti-VEGF group achieved a gain of 0.21 logMAR ( P = 0.042 ). The alternate group demonstrated a reduction in the central macular thickness of 229.9-μm, while the anti-VEGF group achieved a reduction of 220.1 μm ( P = 0.887 ). The alternate group required an average of 5.2 injections, while the anti-VEGF received 4.2 injections ( P < 0.001 ). In a propensity score-matched cohort to compensate for the differences in the injection numbers between the two groups, the alternate group achieved a better visual acuity gain than the anti-VEGF group at month 12 (0.39 logMAR vs. 0.17 logMAR, P = 0.048 ). Conclusions. In ME secondary to RVO, treatment with intravitreal corticosteroid and anti-VEGF injections alternately resulted in a more favorable visual outcome compared with intravitreal anti-VEGF monotherapy.

scholarly journals Anti-VEGF Therapy In Central Retinal Vein Occlusions

2018 ◽  
Vol 1 (2) ◽  
Author(s):  
Meidina Rahmah ◽  
Ramzi Amin ◽  
AK Ansyori
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Visual Outcome ◽  
Vascular Endothelial ◽  
Medicine Department ◽  
Hard Exudates ◽  
Vein Occlusion ◽  
Anti Vegf ◽  
Endothelial Growth Factor ◽  
Central Retinal Vein

Introduction: Central retinal vein occlusion (CRVO) is the second most common retinal vascular disease after diabetic retinopathy and is estimated to affect more than 16 million adults worldwide. Treating the underlying cause of occlusion of the central retinal vein, reducing the risk factors, and early and proper management are the keys toward a better prognosis in patients with CRVO. Repeated frequent treatment of CRVO with macular edema with intravitreal anti-vascular endothelial growth factor (anti-VEGF) is an effective treatment to improve visual outcome. In this case report we assess the 3-month efficacy of anti-VEGF therapy in CRVO. Method: In this case, a 52-year-old man presented with an acute loss of vision over the last week in his left eye. His baseline visual acuity was 1/60 and his central retinal thickness (CRT) on Optical Coherence Tomography (OCT) was 523 μm. Fundus examination revealed a hemorrhage in all four quadrants, hard exudates, swelling of the optic nerve, and macular edema. Laboratory test confirms hyperlipidemia and we consult this patient to Internal Medicine Department. This patient got 3 monthly injections of 1,25 mg Bevacizumab. Results: By 3 months, the OCT appeared fairly normal and the visual acuity improved to 6/60 Conclusion: Anti-VEGF therapy is effective for treating macular edema secondary to CRVO

scholarly journals Intravitreal Anti Vascular Endothelial Growth Factor Agents in The Management of Retinal Diseases: An Audit

2017 ◽  
Vol 11 (1) ◽  
pp. 315-321 ◽  
Author(s):  
Bassey Fiebai ◽  
Victor Odogu
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Diabetic Macular Edema ◽  
Age Related Macular Degeneration ◽  
Retinal Diseases ◽  
Vascular Endothelial ◽  
Vein Occlusion ◽  
Anti Vegf ◽  
Treatment Type

Purpose: The study aimed to describe our initial experience with the use of anti vascular endothelial growth factors (anti-VEGFs) in the treatment of retinal diseases. Methods: The case records of all patients who had received at least 3 doses of intravitreal anti- VEGF injections between January 2012 to December 2016 were reviewed. Information culled from the data was age, sex, indications for treatment, type of injection, presenting visual acuity, post injection visual acuity, systemic and ocular co morbidities. Results were analyzed using Statistical Package for Social Sciences (SPSS) 20.0 for Windows statistical software Results: A total of 190 injections were given during the study period, to 58 eyes of 50 patients. Twenty-eight females (56.00%) and twenty-two males (44.00%) were seen with a mean age of 59.6± 11.66. Bevacizumab was the most frequently administered anti- VEGF, 142 (74.74%) while only 48(25.26%) injections of Ranibizumab were given. Three eyes had both bevacizumab and ranibizumab (1.58%). Retinal vein occlusion 61(32.11%) was the commonest indication for the injections followed by diabetic macular edema 43(22.63%) and proliferative diabetic retinopathy 42(22.11%). Others were neovascular age related macular degeneration, neovascular glaucoma, vitreous hemorrhage, myopic choroidal neovascularization and cystoid macular edema. There was an association between age and disease, (p = 0.001). There was an improvement in visual acuity after intervention in cases with retinal vein occlusion and diabetic macular edema, and this was statistically significant. Hypertension was the commonest systemic disorder in this series 81(42.36%) and the supero-temporal quadrant 131(68.95%) was the most preferred position to administer the injection. Floaters was the commonest complication seen. Conclusion: Anti VEGFs have become an invaluable tool in the management of a number of retinal diseases in our center. However, the cost implications are a hindrance to an increased uptake of this form of treatment. Cheaper alternative preparations should be made available to encourage the uptake. Government in developing countries should be encouraged to bear the health burden of the old aged pensioner (OAP).

Intraocular Injections of Ranibizumab in Patients with Macular Edema Following Branch Retinal Vein Occlusion

2020 ◽  
pp. 127-132
Author(s):  
Alan D. Penman ◽  
Kimberly W. Crowder ◽  
William M. Watkins
Keyword(s):  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Branch Retinal Vein Occlusion ◽  
Controlled Trial ◽  
Phase Iii ◽  
Vascular Endothelial ◽  
Vein Occlusion ◽  
Endothelial Growth Factor ◽  
First Line Treatment

The Ranibizumab for Macular Edema following Branch Retinal Vein Occlusion (BRAVO) study was a 6-month, phase III, randomized, injection-controlled trial, with an additional 6 months of follow-up (total 12 months), to evaluate the safety and efficacy of intraocular injections of 0.3 mg and 0.5 mg ranibizumab (an anti–vascular endothelial growth factor [VEGF] agent) in patients with macular edema following branch retinal vein occlusion (BRVO). The study showed that intraocular injections of 0.3 mg or 0.5 mg ranibizumab provided rapid, effective treatment for macular edema following BRVO with low rates of ocular and nonocular adverse events. This study led to a paradigm shift toward anti-VEGF agents as the first-line treatment for macular edema secondary to BRVO.

Long-Term Outcomes of Anti-VEGF Therapy in Patients With Macular Edema Secondary to Retinal Vein Occlusion

2017 ◽  
Vol 1 (5) ◽  
pp. 298-304 ◽  
Author(s):  
Jason M. Young ◽  
Karen M. Wai ◽  
Fabiana Q. Silva ◽  
Felipe F. Conti ◽  
Sunil K. Srivastava ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Routine Clinical Practice ◽  
Vascular Endothelial ◽  
Vein Occlusion ◽  
Anti Vegf ◽  
Central Subfield Thickness ◽  
Endothelial Growth Factor

Purpose: To evaluate long-term visual and anatomical outcomes of anti–vascular endothelial growth factor (VEGF) therapy for macular edema (ME) secondary to retinal vein occlusion (RVO) in routine clinical practice. Methods: Patients with ME secondary to hemi-RVO (HRVO), central RVO (CRVO), or branch RVO (BRVO) after initiating anti-VEGF therapy were followed for at least 36 months. Main outcomes were change in best visual acuity (BVA) and mean absolute change in central subfield thickness (CST) at 12, 24, 36, and 48 months. Results: Patients with BRVO showed significant increases in BVA that were maintained after 12, 24, 36, and 48 months (+11.03, +12.06, +10.71, and +9.26 letters, respectively; P < .05). CST significantly decreased after 12, 24, 36, and 48 months (−83.51, −67.93, −97.52, −127.85 µm, respectively; P < .05). In patients with CRVO/HRVO, significant improvements in BVA were seen at 12 and 24 months (+9.39 and +8.54 letters, respectively; P = .023). At 36 and 48 months, the visual gain was not significant (+2.64 and +3.42 letters, respectively; P > .05). For CST changes, there were significant decreases at 12, 24, and 36 months (−146.23, −149.54, and −166.44 µm, respectively; P < .05). At 48 months (−97.66 µm, P = .130), changes in CST were not significant. Conclusions: In routine clinical practice, visual and anatomical benefits of anti-VEGF agents in patients with BRVO were sustained at 36 and 48 months. For patients with CRVO/HRVO, anatomical improvements were maintained for 36, but not 48 months, while visual improvements were no longer maintained by 36 months.

scholarly journals Intravitreal Aflibercept Injection and Treatment Regimens in Macular Edema due to Branch Retinal Vein Occlusion

2019 ◽  
pp. 92-98
Keyword(s):  
Growth Factor ◽  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Branch Retinal Vein Occlusion ◽  
Vascular Endothelial ◽  
Treatment Regimens ◽  
Vein Occlusion ◽  
Anti Vegf ◽  
Intravitreal Aflibercept ◽  
Endothelial Growth Factor

Branch retinal vein occlusion (BRVO) is the most common form of retinal vein occlusions (RVO), which is the second most common retinal vascular disease after diabetic retinopathy. The most common cause of visual loss in BRVO is macular edema. Since the vascular endothelial growth factor (VEGF) was detected in the pathogenesis of macular edema due to BRVO, studies have been made with available anti-VEGF agents and different treatment regimens. Those treatment regimens can be listed as; monthly / bi-monthly fixed interval, as needed (Pro Re Nata; PRN), treat and extend (T&E). Aflibercept acts as a decoy receptor that binds to VEGF-A, VEGF-B, and placental growth factor. There are publications indicating that this agent binds VEGF with a higher affinity than other anti-VEGF agents and thus provides a longer treatment efficacy. This review summarizes the studies about the use of aflibercept in different regimens for the treatment of macular edema due to BRVO.

scholarly journals Visual outcome of Anti-Vascular Endothelial Growth Factor Injections at the University College Hospital, Ibadan

2020 ◽  
Author(s):  
Tunji Sunday Oluleye ◽  
Yewande Olubunmi Babalola ◽  
Oluwole Majekodunmi ◽  
Modupe Ijaduola ◽  
Adeyemi Timothy Adewole
Keyword(s):  
Vascular Endothelial Growth Factor ◽  
Visual Acuity ◽  
Visual Outcome ◽  
Vascular Endothelial ◽  
Anti Vegf ◽  
The Mean ◽  
One Year ◽  
Endothelial Growth Factor ◽  
Number Of Injections

AbstractAimTo evaluate the four-year outcome of intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy in an eye unit in sub-Saharan Africa.MethodologyThis retrospective study included 182 eyes of 172 patients managed in the vitreoretinal unit between 2016 and 2019 who were treated with intravitreal anti-VEGF Bevacizumab (1.25 mg/0.05 ml) with at least one year of follow up. The outcome measures were change in best-corrected visual acuity (BCVA) over one year of follow-up, the number of injections taken and complications.ResultsThe mean age was 61.1 ± 16.3 years (M: F of 1:1.1) and about 62.1% were > 60 years. A total of 330 injections were given during the period audited. The mean number of injections was 1.8 ± 0.93. Ninety-four (51.7%) eyes had only one injection while 33 (18.1%), 50 (27.5%) and 5 (2.7%) had 2, 3 and 4 injections, respectively. About 78.5% had moderate-severe visual impairment at baseline and 44.5%, 16.4%,12.6% and 7.1% at 1, 3, 6- and 12-months post injections, respectively. The mean BCVA improved for all eyes from 1.67 ±0.91 logMAR at baseline to 1.50±1.27 logMAR at one year. The logMAR letters gained was 23 at 1 month and 8.25 at 1 year with a statistically significant association between increasing number of injections and improved visual outcome (p= 0.015). One patient each developed endophthalmitis (0.6%) and inferior retinal detachment (0.6%) post-injection.ConclusionVisual acuity gain was recorded in patients who had at least two intravitreal Anti-VEGF injections in 1 year.

scholarly journals Cytokines and the Pathogenesis of Macular Edema in Branch Retinal Vein Occlusion

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Hidetaka Noma ◽  
Kanako Yasuda ◽  
Masahiko Shimura
Keyword(s):  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Branch Retinal Vein Occlusion ◽  
Vascular Endothelial ◽  
Intraocular Injection ◽  
Vein Occlusion ◽  
Anti Vegf ◽  
Lifestyle Related Diseases ◽  
Endothelial Growth Factor

Branch retinal vein occlusion (BRVO) is a very common retinal vascular problem in patients with lifestyle-related diseases, such as hypertension and arteriosclerosis. In patients with BRVO, development of macular edema is the main cause of visual impairment. BRVO is still a controversial condition in many respects. Over the years, various methods such as laser photocoagulation have been tried to treat macular edema associated with BRVO, but the results were not satisfactory. After vascular endothelial growth factor (VEGF) was found to have an important role in the pathogenesis of macular edema in BRVO patients, treatment of this condition was revolutionized by development of anti-VEGF therapy. Although macular edema improves dramatically following intraocular injection of anti-VEGF agents, repeated recurrence and resistance of edema is a major problem in some BRVO patients. This suggests that factors or cytokines other than VEGF may be associated with inflammation and retinal hypoxia in BRVO and that the pathogenesis of macular edema is complicated. The present review assesses the role of various factors and cytokines in the pathogenesis of macular edema associated with BRVO. We present a mechanism that is not only plausible but should also be useful for developing new therapeutic strategies.

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