scholarly journals Real-World Outcomes in Patients with Branch Retinal Vein Occlusion- (BRVO-) Related Macular Edema Treated with Anti-VEGF Injections Alone versus Anti-VEGF Injections Combined with Focal Laser

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Meredith E. Thomley ◽  
Cole N. Gross ◽  
Ana Preda-Naumescu ◽  
Kelly S. Chen ◽  
Thomas Swain ◽  
...  
Keyword(s):  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Real World ◽  
Branch Retinal Vein Occlusion ◽  
The Other ◽  
Visual Outcomes ◽  
Vein Occlusion ◽  
Anti Vegf ◽  
Significant Difference ◽  
Number Of Injections

The purpose of this study was to assess outcomes in a real-world nonclinical trial setting of antivascular endothelial growth factor (VEGF) injections alone vs. focal laser combined with anti-VEGF injections in patients with branch retinal vein occlusion- (BRVO-) related macular edema (ME). This study included 88 BRVO with ME patients who were treated over three years at both a tertiary referral center in the Birmingham metropolitan area and satellites in rural Alabama. One group received only anti-VEGF injections (n = 56); the other group received both anti-VEGF injections and focal laser (n = 32). The following outcome measures were evaluated: initial and final visual acuities (VA), initial central subfield thickness (CST) on OCT, number of injections, number of lasers, percentage of patients with a gain of 3 lines of VA, percentage of patients with VA better than or equal to 20/40, and percentage of patients with VA worse than or equal to 20/200. We found that there was no difference in initial VA ( p = 0.913 ) or CST ( p = 0.961 ) between the two groups. The injection only group required a median of 7 injections, while the combination group required a median of 4 injections, but this was not a statistically significant difference ( p = 0.117 ). There was no difference in final VA ( p = 0.414 ) or any of the other visual outcomes between the two groups. In conclusion, focal laser did not decrease the number of injections required or improve the VA in BRVO-related ME. Although visual outcomes were similar in both groups, focal laser does not appear to be of additional benefit in BRVO-related ME in the anti-VEGF era.

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

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.

Treatment Patterns and Clinical Outcomes for Branch Retinal Vein Occlusion: An 8-Year Experience at a Tertiary Eye Center

2021 ◽  
pp. 247412642097887
Author(s):  
Terry Lee ◽  
Cason B. Robbins ◽  
Akshay S. Thomas ◽  
Sharon Fekrat
Keyword(s):  
Visual Acuity ◽  
Diabetic Retinopathy ◽  
Retinal Vein Occlusion ◽  
Real World ◽  
Early Treatment ◽  
Branch Retinal Vein Occlusion ◽  
Treatment Patterns ◽  
Vein Occlusion ◽  
Anti Vegf ◽  
Treatment Naïve

Purpose: This work aims to investigate real-world treatment patterns and outcomes in eyes with branch retinal vein occlusion in the antivascular endothelial growth factor (anti-VEGF) era. Methods: A retrospective, nonrandomized, comparative study was conducted on eyes diagnosed with branch retinal vein occlusion at a single tertiary center between 2009 and 2017. Medical history, treatment patterns, and visual acuity outcomes were examined. Subanalysis was performed for eyes that met the eligibility criteria for the BRAVO (Ranibizumab for the Treatment of Macular Edema Following Branch Retinal Vein Occlusion) trial. Results: A total of 315 eyes were included, of which 244 were treatment naive. In all eyes, the most common first treatment was the following: intravitreal bevacizumab (38.4%), aflibercept (15.1%), ranibizumab (8.1%), sectoral scatter laser (6.2%), and triamcinolone (3.1%). At 1 year, treatment-naive eyes had received an average of 2.43 anti-VEGF injections. During follow-up, treatment-naive eyes gained an average of 0.21 Early Treatment Diabetic Retinopathy Study lines. Forty eyes that met BRAVO trial criteria received an average of 5.05 anti-VEGF injections in the first year and gained an average of 1.83 Early Treatment Diabetic Retinopathy Study lines. Conclusions: This real-world cohort received fewer anti-VEGF injections at year 1 and experienced less improvement in visual acuity during the course of treatment than clinical trial participants. Trial-eligible patients received more injections and had greater visual gains than those who would not have been eligible for the trial.

scholarly journals Retinal venous pressure is decreased after anti-VEGF therapy in patients with retinal vein occlusion–related macular edema

2021 ◽  
Author(s):  
Teruyo Kida ◽  
Josef Flammer ◽  
Katarzyna Konieczka ◽  
Tsunehiko Ikeda
Keyword(s):  
Macular Edema ◽  
Intravitreal Injection ◽  
Retinal Vein Occlusion ◽  
Venous Pressure ◽  
Decisive Role ◽  
Retinal Venous Pressure ◽  
Vein Occlusion ◽  
Anti Vegf ◽  
Significant Difference ◽  
Endothelial Growth Factor

Abstract Purpose The pathomechanism leading to retinal vein occlusion (RVO) is unclear. Mechanical compression, thrombosis, and functional contractions of veins are discussed as the reasons for the increased resistance of venous outflow. We evaluated changes in the retinal venous pressure (RVP) following intravitreal injection of anti-vascular endothelial growth factor (VEGF) agent to determine the effect on RVO-related macular edema. Methods Twenty-six patients with RVO-related macular edema (16 branch RVOs [BRVOs] and 10 central RVOs [CRVOs], age 72.5 ± 8.8 years) who visited our hospital were included in this prospective study. Visual acuity (VA), intraocular pressure (IOP), central retinal thickness (CRT) determined by macular optical coherence tomography, and RVP measured using an ophthalmodynamometer were obtained before intravitreal injection of ranibizumab (IVR) and 1 month later. Results Comparison of the BRVOs and CRVOs showed that VA was significantly improved by a single injection in BRVOs (P < 0.0001; P = 0.1087 for CRVOs), but CRT and RVP were significantly decreased without significant difference in IOP after the treatment in both groups (P < 0.0001). Conclusion The anti-VEGF treatment resulted in a significant decrease in the RVP, but the RVP remained significantly higher than the IOP. An increased RVP plays a decisive role in the formation of macula edema, and reducing it is desirable.

scholarly journals Conbercept Versus Conbercept Combined with Retinal Photocoagulation for Macular Edema Secondary to Branch Retinal Vein Occlusion

2021 ◽  
Author(s):  
Gengmin Tong ◽  
Yishan Hu ◽  
Dawei Wang ◽  
Yanhua Jin
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Branch Retinal Vein Occlusion ◽  
Therapy Group ◽  
Combined Therapy ◽  
Vein Occlusion ◽  
Significant Difference ◽  
Retinal Photocoagulation

Abstract Background: To evaluate the efficacy of intravitreal injection of conbercept (IVC) with or without laser photocoagulation for recurrent macular edema secondary to branch retinal vein occlusion (BRVO). Methods: 82 patients (82 eyes) with recurrent macular edema secondary to BRVO were collected. The central macular thickness (CMT) and best corrected visual acuity (BCVA) were recorded. Results: The BCVA in both groups was significantly superior to that before treatment (P<0.05). Compared with initial values, CMT was reduced significantly in both groups (P<0.05). But at 1 month to 6 month after treatment, there are no significant difference was observed between the two groups (P>0.05). In the combined therapy group for Hemispheric Retinal Vein Occlusion, we observed a lower number of reinjections during follow-up. Conclusion: Conbercept with or without retinal photocoagulation can effectively improve the visual acuity and reduce the CMT.

scholarly journals Incomplete Treatment Response, Treatment Resistance, Pharmaceutical Changes and Combined Treatments in Branch Retinal Vein Occlusion and Macular Edema

2019 ◽  
pp. 108-111
Keyword(s):  
Macular Edema ◽  
Treatment Response ◽  
Retinal Vein Occlusion ◽  
Branch Retinal Vein Occlusion ◽  
Vision Loss ◽  
Combined Treatment ◽  
Treatment Resistance ◽  
Vein Occlusion ◽  
Anti Vegf ◽  
Incomplete Treatment

Branch retinal vein occlusion (BRVO) is the second most common retinal vascular disease after diabetic retinopathy. Vision loss varies depending on the affected area. The main causes of vision loss in BRVO are macular edema and macular ischemia. Anti-VEGF agents are preferred in the treatment of macular edema due to BRVO because of the increase in visual acuity. Although anti-VEGF therapy provides an early response, in some cases macular edema is resistant to the treatment. In this review, incomplete treatment response, treatment resistance, pharmaceutical changes, and combined treatment are mentioned in cases with BRVO and macular edema.

Treatment of Macular Edema following Branch Retinal Vein Occlusion

2013 ◽  
Vol 06 (02) ◽  
pp. 148 ◽  
Author(s):  
Raafay Sophie ◽  
Peter A Campochiaro ◽  
◽  
Keyword(s):  
Disease Activity ◽  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Branch Retinal Vein Occlusion ◽  
Foveal Avascular Zone ◽  
Rapid Improvement ◽  
Persistent Disease ◽  
Vein Occlusion ◽  
Anti Vegf

Branch retinal vein occlusion (BRVO) is a relatively prevalent cause of reduced vision primarily due to macular edema. Vascular endothelial growth factor (VEGF) is the major stimulator of excessive vascular leakage and also contributes to retinal hemorrhages and progressive retinal nonperfusion (RNP). Progressive RNP results in worsening of retinal ischemia further increasing levels of VEGF, resulting in a positive feedback loop for disease worsening over time. Aggressive early treatment with a specific antagonist of VEGF causes rapid improvement in edema and visual acuity, speeds resolution of hemorrhages, and stabilizes or improves RNP. Therefore, first-line treatment of acute BRVOs is monthly injections of an anti-VEGF agent for at least 6 months. After that, a period of monthly follow up with anti-VEGF treatment, only if there is recurrent edema, can be used to gauge persistent disease activity and the need for grid laser photocoagulation to diffuse leakage in the macula outside the foveal avascular zone. Following grid laser, another period of monthly follow up with anti-VEGF treatment only if there is recurrent edema provides a measure of persistent disease activity, and if frequent injections are still needed to control edema, the benefits and risks for switching to dexamethasone implants should be discussed with the patient.

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