scholarly journals Changes in Macular Microvascular Structure in Macular Edema Secondary to Branch Retinal Vein Occlusion Treated with Antivascular Endothelial Growth Factor for One Year

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Shuang Song ◽  
Xiaobing Yu ◽  
Peng Zhang ◽  
Hong Dai
Keyword(s):  
Macular Edema ◽  
Vascular Density ◽  
Vein Occlusion ◽  
Retinal Capillary ◽  
Antivascular Endothelial Growth Factor ◽  
Capillary Plexus ◽  
Area And Perimeter ◽  
One Year ◽  
Endothelial Growth Factor ◽  
Ranibizumab Treatment

Purpose. To observe the changes in macular microvascular structure and the correlation between anatomy and visual function in patients with macular edema secondary to branch retinal vein occlusion (BRVO) treated with antivascular endothelial growth factor for one year. Methods. This prospective study enrolled 39 patients (one eye per patient) who received intravitreal injections of ranibizumab for macular edema secondary to BRVO. All patients received a minimum of 3 initial monthly ranibizumab injections and criteria-driven pro re nata (PRN) dosing thereafter for visual acuity (VA) and central retinal thickness (CRT) stabilization. The follow-up period of this study was one year. The vascular density (VD) of the superficial retinal capillary plexus (SCP) and deep retinal capillary plexus (DCP), the foveal avascular zone (FAZ) area, the FAZ perimeter, the VD within a 300 μm wide ring surrounding the FAZ (FD-300), and the acircularity index (AI) were measured automatically by optical coherence tomography angiography (OCTA) at baseline, month 6, and month 12. Results. Compared with those before treatment, the VD of the SCP significantly decreased 6 months after treatment ( P < 0.05 ), while the area and perimeter of the FAZ increased significantly ( P < 0.01 ). After 12 months of treatment, the area and perimeter of the FAZ increased significantly ( P < 0.01 ). There was no significant difference in any parameters between 12 months and 6 months after treatment ( P > 0.05 ). The change in BCVA was negatively correlated with the VD of the SCP at 12 months ( P = 0.0447 , r = −0.3233). There was a relationship between the DBP and AI, and CRT was related to VD of DCP at baseline ( P = 0.028 ,   0.0209 ; r = 0.383, −0.384). The PERIM and AI at 12 months were significantly associated with the recurrence of macular edema, and the changes in vascular density in the SCP and PERIM were significantly associated with the number of injections within 12 months ( P < 0.05 ). Conclusions. One year after ranibizumab treatment, the area and perimeter of the FAZ were enlarged, while the VD of the SCP and DCP remained stable, which indicated that ranibizumab treatment did not improve macular blood supply and macular ischemia in BRVO patients.

scholarly journals OCT angiography features associated with macular edema recurrence after intravitreal bevacizumab treatment in branch retinal vein occlusion

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Kwang-Eon Choi ◽  
Cheolmin Yun ◽  
Jaehyung Cha ◽  
Seong-Woo Kim
Keyword(s):  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Branch Retinal Vein Occlusion ◽  
Intravitreal Bevacizumab ◽  
Intravitreal Bevacizumab Injection ◽  
Vein Occlusion ◽  
Anti Vegf ◽  
Bevacizumab Treatment ◽  
Capillary Plexus ◽  
Endothelial Growth Factor

Abstract We aimed to evaluate the relationship between the capillary abnormalities including nonperfusion area (NPA) in optical coherence tomography angiography (OCTA) images and the recurrence of macular edema (ME) secondary to branch retinal vein occlusion (BRVO) after intravitreal injection of anti-vascular endothelial growth factor (anti-VEGF; bevacizumab). The records of 40 patients who underwent intravitreal bevacizumab injection for ME secondary to BRVO and had at least six months of follow-up were reviewed. Central retinal thickness (CRT; μm) and macular edema type were evaluated prior to treatment. After ME resolution, nonperfusion areas in the 1 mm (NPA1) and 1–3 mm (NPA3) zones on the Early Treatment Diabetic Retinopathy Study (ETDRS) circle within the superficial capillary plexus (SCP) and deep capillary plexus (DCP) were measured using OCTA images. Furthermore, other microvascular abnormalities in the both SCP and DCP were compared between groups. ME recurred in 25 of 40 (62.5%) eyes. The NPA1 of the SCP and DCP (p = 0.002, 0.004, respectively), NPA3 of the SCP and DCP (p = 0.002, 0.008, respectively), and initial CRT (p = 0.022) differed significantly between eyes with and without ME recurrence. In multivariate logistic regression analyses, the NPA1 of the DCP (OR: 344.718; p = 0.029) and NPA3 of the SCP (OR: 4.072; p = 0.018) were significantly associated with ME recurrence. Other microvascular abnormalities were not significantly different between two groups. The central NPA and parafoveal NPA of the SCP in OCTA images correlated strongly with ME recurrence in BRVO patients after intravitreal anti-VEGF injection.

scholarly journals Outcome of Switching Anti-VEGF Agents at Fixed Intervals to Treat Eyes With Macular Edema Secondary to Branch Retinal Vein Occlusion

2021 ◽  
Author(s):  
Tsuyoshi Mito ◽  
Takeshi Kobayashi ◽  
Atsushi Shiraishi
Keyword(s):  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Branch Retinal Vein Occlusion ◽  
Retinal Thickness ◽  
Vascular Endothelial ◽  
Vein Occlusion ◽  
Injection Interval ◽  
One Year ◽  
The One ◽  
Endothelial Growth Factor

Abstract ObjectiveTo determine whether switching intravitreal injections of ranibizumab or aflibercept to the other will affect the interval of subsequent injections in patients with macular edema secondary to branch retinal vein occlusion (BRVO).ResultsThe medical charts of 16 eyes of 16 patients were reviewed. After injections of ranibizumab or aflibercept for >3 times/year, the type of anti-vascular endothelial growth factor agent was switched. A comparison was made of the average injection interval for the one year before switching and the interval of the first two injections post-switching. In the group that switched from ranibizumab to aflibercept (R to A group, n=8), the interval before was 85.4±6.6 days which was significantly increased to 125.9±23.2 days post-switching (P=0.0013). In the A to R group (n=8), a significant shortening from 103.9±11.8 days before to 85.9±12.6 days was observed (P=0.007). In the R to A group, the central retinal thickness at a recurrence was 522.1±79.6 µm which decreased significantly to 419.3±64.5 µm post-switching (P=0.005). The results suggest that the intervals can be different between ranibizumab and aflibercept in patients with macular edema secondary to BRVO who required repeat injections.

scholarly journals Evaluation of Microvascular Structure Changes after Conbercept Treatment on Macular Edema Secondary to Retinal Vein Occlusion

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Wenqi Song ◽  
Wanzhen Jiao ◽  
Fengjiao Li ◽  
Aihua Ma ◽  
Bojun Zhao
Keyword(s):  
Macular Edema ◽  
Intravitreal Injection ◽  
Retinal Vein Occlusion ◽  
Therapeutic Efficacy ◽  
Foveal Avascular Zone ◽  
Vascular Density ◽  
Vein Occlusion ◽  
Structure Changes ◽  
Significant Difference ◽  
Capillary Plexus

Aims. To confirm the therapeutic efficacy of conbercept for the treatment of macular edema (ME) secondary to retinal vein occlusion (RVO) by using optical coherence tomography angiography (OCTA) and to find out the differences in therapeutic efficacy between ischemic and nonischemic retinal vein occlusion (iRVO or non-iRVO) after conbercept treatment. Methods. In this prospective, randomized, and comparative study, 60 unilateral eyes suffered from RVO combined with macular edema were included and fellow eye as controls. After an initial intravitreal injection of conbercept (IVIC), a pro re nata (PRN) strategy was adopted, and the follow-up time was 6 months. The foveal avascular zone (FAZ), vascular density of superficial capillary plexus (SCP), and vascular density of deep retinal capillary plexus (DCP), nonperfused areas (NPAs) were evaluated with OCTA on baseline and after treatment. Results. The mean intravitreal injection number was 2.9±0.89 times during six months in iRVO patients and 2.1±0.86 times in non-iRVO patients, with statistically significant difference (p<0.05). On baseline, central macular thickness (CMT) and FAZ were significantly thickened and enlarged compared to those of healthy fellow eyes; the vascular density of SCP and DCP were significantly decreased, and the differences were statistically significant (p<0.05). Compared to baseline, after treatment, the best-corrected visual acuity (BCVA) was improved in either iRVO or non-iRVO (−0.601±0.387, −0.241±0.341 logMAR, p<0.05). In iRVO, the improvement was more substantial than that of the non-iRVO group. FAZ in the non-iRVO group had significantly decreased compared to that in iRVO group (−0.044±0.040 versus 0.014±0.043 mm2, p<0.05). CMT, the vascular density of SCP, and DCP had no significant difference. Conclusions. The changes of microvascular structure can be quantitatively evaluated by using OCTA for the patients with RVO. Conbercept had a significant effect on treatment of RVO with macular edema. A more profound effect was achieved in the iRVO group on visual improvement and FAZ reduction in the non-iRVO group after conbercept treatment.

Use of Anti-VEGF Drugs in Retinal Vein Occlusions

2020 ◽  
Vol 21 (12) ◽  
pp. 1181-1193
Author(s):  
Manuel AP Vilela
Keyword(s):  
Growth Factor ◽  
Macular Edema ◽  
Laser Therapy ◽  
Visual Loss ◽  
Western World ◽  
Vein Occlusion ◽  
Anti Vegf ◽  
Antivascular Endothelial Growth Factor ◽  
Endothelial Growth Factor ◽  
Retinal Vein Occlusions

Retinal vein occlusion (RVO) is one of the most prevalent causes of visual loss in the Western World. Its pathogenesis is still not completely known. Chronic macular edema and ischemia compromise the functional and anatomical status of the retina. Antivascular endothelial growth factor (anti-VEGF) injections have demonstrated better results than other previous options, including observation or laser therapy. This narrative review aims to analyze the current aspects related to these drugs.

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 Ranibizumab in Macular Edema Secondary to Branch Retinal Vein Occlusion – 24 Months Of Treatment

2019 ◽  
Vol 75 (4) ◽  
pp. 190-198
Author(s):  
Markéta Středová ◽  
Alexandr Stepanov ◽  
Jan Studnička ◽  
Jana Nekolová ◽  
Naďa Jirásková
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Intravitreal Ranibizumab ◽  
Duration Of Symptoms ◽  
Younger Patients ◽  
Vein Occlusion ◽  
The Mean ◽  
Common Clinical Practice ◽  
Baseline Visual Acuity ◽  
Ranibizumab Treatment

Purpose: To retrospectively evaluate the efficacy and safety of ranibizumab treatment for macular edema (ME) secondary to branch retina vein occlusion (BRVO) after 24 months. Materials and Methods: This study included 39 eyes of 39 patients with ME associated with BRVO treated at the Ophthalmology Department of Faculty Hospital in Hradec Kralove. The average age of included patiens was 69,3 years, the mean duration of symptoms before treament was 5,4 months, the mean baseline visual acuity (VA) was 54,6 ETDRS (Early Treatment Diabetic Retinopathy Study) letters, the mean baseline central retinal thickness (CRT) was 544,9 μm. At 64,1% patients a retinal laserphotocoagulation was performed before intravitreal ranibizumab. After one year, the study was discontinued by 17 patiens, the remaining 22 patients were observed for 24 months. Initially, there were 3 doses of intravitreal ranibizumab administered in monthly intervals, further injections were applied according to PRN (pro re nata) regiment. Patients were examined at baseline and then at 3, 6, 9, 12 and 24 months from initiation of the treatment. In this study, the effect of ranibizumab on functional and morphological parameters of the affected eye was monitored, the safety of this treatment was also evaluated. During the follow-up, a statistically significant improvement in VA was achieved in every visit in comparison to baseline parameters, the mean VA gain at the 3 month visit was 12,1 ETDRS letters (p < 0,001), at 6 months 12,5 letters (p < 0,001), at 9 months 10,5 letters (p < 0,001), at 12 months 12,5 (p < 0,001), at 24 months 8,6 letters (p < 0,05). There was a statistically significant decrease in CRT as well in the 3, 6, 9, 12 and 24 months visits, namely 249,0 μm (p < 0,001), 185,2 μm (p < 0,001), 187,0 μm (p < 0,001), 214,8 μm (p < 0,001) and 205,2 μm (p < 0,001). The average number of doses administered to a patient was 4,9 within 12 months and 7,1 within 24 months. The treatment had greater effect in younger patients with shorter duration of symptoms and baseline VA of less than 55 ETDRS letters (6/24 or worse. Nor serious, neighter long-term adverse events occured, only occasional intraocular pressure elevation after intravitreal application was found. Conclusion: Our results from common clinical practice are consistent with the results of large clinial trials, we confirmed particularly good treatment efficacy in younger patients with shorter duration of macular edema and poorer baseline visual acuity. The safety of ranibizumab treatment was confirmed.

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