scholarly journals A 12-month, multicenter, parallel group comparison of dexamethasone intravitreal implant versus ranibizumab in branch retinal vein occlusion

2018 ◽  
Vol 28 (6) ◽  
pp. 697-705 ◽  
Author(s):  
Francesco Bandello ◽  
Albert Augustin ◽  
Adnan Tufail ◽  
Richard Leaback
Keyword(s):  
Visual Acuity ◽  
Retinal Vein Occlusion ◽  
Branch Retinal Vein Occlusion ◽  
Dexamethasone Intravitreal Implant ◽  
Vein Occlusion ◽  
Corrected Visual Acuity ◽  
Increased Risk ◽  
Intravitreal Implant ◽  
The Mean ◽  
Best Corrected Visual Acuity

Purpose: Dexamethasone intravitreal implant and intravitreal ranibizumab are indicated for the treatment of macular edema secondary to retinal vein occlusion. This non-inferiority study compared dexamethasone with ranibizumab in patients with branch retinal vein occlusion. Methods: In this randomized, 12-month head-to-head comparison, subjects with branch retinal vein occlusion were assigned to dexamethasone 0.7 mg at day 1 and month 5 with the option of retreatment at month 10 or 11, or ranibizumab 0.5 mg at day 1 and monthly through month 5 with subsequent as-needed injections at month 6–month 11. The primary efficacy outcome was the mean change from baseline in best-corrected visual acuity at month 12; secondary outcomes included average change in best-corrected visual acuity, proportion of eyes with ≥10- and ≥15-letter gain/loss, change in central retinal thickness, and change in Vision Functioning Questionnaire-25 score. Results: In all, 307 of a planned 400 patients were enrolled in the study and received (mean) 2.5 dexamethasone injections (n = 154) and 8.0 ranibizumab injections (n = 153) over 12 months. The mean change from baseline in best-corrected visual acuity at month 12 was 7.4 letters for dexamethasone versus 17.4 letters for ranibizumab (least-squares mean difference (dexamethasone minus ranibizumab), −10.1 letters; 95% confidence interval, −12.9, −7.2; p = 0.0006). Conclusion: Dexamethasone and ranibizumab improved best-corrected visual acuity and anatomical outcomes; however, dexamethasone did not show non-inferiority to ranibizumab in this under-powered study. Dexamethasone was associated with an increased risk of intraocular pressure elevation and cataract progression, but a lower injection burden, compared to ranibizumab.

scholarly journals Subthreshold Micropulse Photocoagulation for Persistent Macular Edema Secondary to Branch Retinal Vein Occlusion including Best-Corrected Visual Acuity Greater Than 20/40

2014 ◽  
Vol 2014 ◽  
pp. 1-10 ◽  
Author(s):  
Keiji Inagaki ◽  
Kishiko Ohkoshi ◽  
Sachiko Ohde ◽  
Gautam A. Deshpande ◽  
Nobuyuki Ebihara ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Branch Retinal Vein Occlusion ◽  
Disease Onset ◽  
Vein Occlusion ◽  
Corrected Visual Acuity ◽  
Group I ◽  
Group Ii ◽  
Best Corrected Visual Acuity

To assess the efficacy of subthreshold micropulse diode laser photocoagulation (SMDLP) for persistent macular edema secondary to branch retinal vein occlusion (BRVO), including best-corrected visual acuity (BCVA) > 20/40, thirty-two patients (32 eyes) with macular edema secondary to BRVO were treated by SMDLP. After disease onset, all patients had been followed for at least 6 months prior to treatment. Baseline Snellen visual acuity was used to categorize the eyes as BCVA ≤ 20/40 (Group I) or BCVA > 20/40 (Group II). Main outcome measures were reduction in central macular thickness (CMT) in optical coherence tomography (OCT) and BCVA at 6 months. In the total subject-pool at 6 months, BCVA had not changed significantly but CMT was significantly reduced. Group I exhibited no significant change in CMT at 3 months but exhibited significant reductions at 6 and 12 months. Group II exhibited a marginally significant reduction in CMT at 3 months and a significant reduction at 6 months. In patients with persistent macular edema secondary to BRVO, SMDLP appears to control macular edema with minimal retinal damage. Our findings suggest that SMDLP is an effective treatment method for macular edema in BRVO patients with BCVA > 20/40.

scholarly journals Spectral domain optical coherence tomography (SD OCT) pattern of macular edema and visual acuity in recent-onset branch retinal vein occlusion (BRVO) in a tertiary hospital

2018 ◽  
Vol 7 (3) ◽  
pp. 89-93
Author(s):  
Kiran Shakya ◽  
Ram Prasad Pokhrel ◽  
Om Krishna Malla
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Branch Retinal Vein Occlusion ◽  
Spectral Domain ◽  
Hypertensive Group ◽  
Vein Occlusion ◽  
Corrected Visual Acuity ◽  
Stage 1 ◽  
Best Corrected Visual Acuity

Background: Macular edema is the common sight-threatening condition following branch retinal vein occlusion. Objective: To find spectral domain optical coherence tomography characteristics of macular involvement and visual acuity in the patients with branch retinal vein occlusion Methodology: This is a cross-sectional study; consecutive new cases of branch retinal vein occlusion diagnosed at the ophthalmology department of Kathmandu Medical College, Kathmandu were carried out from November 2016 to October 2017. All subjects were divided three groups with normotensive/controlled hypertension, stage 1 hypertension (systolic pressure >140 mm Hg or diastolic pressure >90mm Hg) and Stage 2 hypertension (systolic pressure >160 mm Hg or diastolic pressure >100 mm Hg).The macular edema was evaluated by taking best corrected visual acuity and spectral domain optical coherence tomography for measurement of central foveal thickness. Results: Forty patients with forty eyes were enrolled. Mean age was 58.5 years SD ± 9.98 years. Stage 1 and stage 2 hypertensive groups had significantly worse best corrected visual acuity and more thickness of central foveal thickness than normotensive/controlled group (p<0.001). The best corrected visual acuity and central foveal thickness were successively worse among normotensive group, stage 1 hypertensive group and stage 2 hypertensive group (between normotensive/controlled group and stage 1 hypertensive group, p = 0.032 and 0.002 respectively and between stage I hypertensive group and stage 2 hypertensive group, p= 0.013 and 0.09 respectively). Conclusion: Control of hypertension could be a main contributing measure to lower incidence of branch retinal vein occlusion and the severity of macular edema.

Dexamethasone intravitreal implant downregulates PDGFR-α and upregulates caveolin-1 in experimental branch retinal vein occlusion

2018 ◽  
Vol 171 ◽  
pp. 174-182 ◽  
Author(s):  
Lasse Jørgensen Cehofski ◽  
Anders Kruse ◽  
Sigriður Olga Magnusdottir ◽  
Alexander Nørgård Alsing ◽  
Jonas Ellegaard Nielsen ◽  
...  
Keyword(s):  
Retinal Vein Occlusion ◽  
Branch Retinal Vein Occlusion ◽  
Caveolin 1 ◽  
Dexamethasone Intravitreal Implant ◽  
Vein Occlusion ◽  
Intravitreal Implant

scholarly journals Efficacy of Modified Treat-and-Extend Aflibercept Regimen for Macular Edema Due to Branch Retinal Vein Occlusion: 1-Year Prospective Study

2020 ◽  
Vol 9 (8) ◽  
pp. 2360
Author(s):  
Yusuke Arai ◽  
Hidenori Takahashi ◽  
Satoru Inoda ◽  
Shinichi Sakamoto ◽  
Xue Tan ◽  
...  
Keyword(s):  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Branch Retinal Vein Occlusion ◽  
Treat And Extend ◽  
Vein Occlusion ◽  
Corrected Visual Acuity ◽  
Intravitreal Aflibercept ◽  
Central Subfield Thickness ◽  
The Mean ◽  
First Recurrence

Purpose: To assess the efficacy and safety of a modified treat-and-extend (mTAE) regimen of aflibercept for macular edema (ME) due to branch retinal vein occlusion (BRVO). Methods: This prospective multicentre intervention study evaluated 50 eyes of 50 patients enrolled from October 2016 to September 2017. The patients received intravitreal aflibercept (IVA) injections on an mTAE regimen for a total of 12 months. The main outcome measures were best-corrected visual acuity (BCVA) and central subfield thickness (CST) at 12 months. Results: The baseline BCVA and CST were 0.33 (0.27) and 488 (171) µm (mean (standard deviation)), respectively. The BCVA and CST were significantly improved at month 12 (0.067 (0.19) LogMAR and 295 (110) µm; both p < 0.0001, paired t-test). The mean number of clinic visits and IVA injections was 6.71 (1.41) and 4.26 (0.71), respectively. The time to first recurrence from the first injection was most frequently 3 months. Conclusion: The mTAE regimen of IVA injections for ME due to BRVO effectively improved BCVA and reduced CST, and thus might be an effective therapy to reduce the number of injections and visits.

scholarly journals Branch Retinal Vein Occlusion, Macular Ischemia, and Intravitreal Anti-VEGF Therapy

2017 ◽  
Vol 8 (1) ◽  
pp. 271-278 ◽  
Author(s):  
Thomas Bertelmann ◽  
Hans Ulrich Frank ◽  
Hendrik Ansgar Fuchs ◽  
Nicolas Feltgen
Keyword(s):  
Retinal Vein Occlusion ◽  
Branch Retinal Vein Occlusion ◽  
Retinal Thickness ◽  
Retrospective Case ◽  
Case Presentation ◽  
Vein Occlusion ◽  
Corrected Visual Acuity ◽  
Anti Vegf ◽  
Best Corrected Visual Acuity ◽  
Macular Ischemia

Purpose: To report a case with ischemic macular edema (ME) due to an acute branch retinal vein occlusion (BRVO) which was treated with repeated intravitreal anti-VEGF injections. Methods: Retrospective case presentation. Results: A 66-year-old female patient was treated with repeated intravitreal anti-VEGF injections due to ischemic ME following an acute BRVO. Over a period of 2.5 years best corrected visual acuity increased from 0.06 to 0.6 (decimal notation) accompanied by a reduction in central retinal thickness from 546 to 292 µm. Overall 17 anti-VEGF injections were administered to treat repeated recurrence of ME. Macular ischemia did not worsen during this profound intravitreal anti-VEGF therapy. Conclusion: Intravitreal anti-VEGF therapy can be a beneficial treatment strategy even in ischemic ME following an acute BRVO.

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

2018 ◽  
Vol 28 (6) ◽  
pp. 690-696 ◽  
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.

scholarly journals Real-Life Management of Patients with Retinal Vein Occlusion Using I-Macula Web Platform

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Massimo Nicolò ◽  
Monica Bonetto ◽  
Raffaella Rosa ◽  
Donatella Musetti ◽  
Maria Musolino ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Real Life ◽  
Macular Thickness ◽  
Central Macular Thickness ◽  
Vein Occlusion ◽  
Corrected Visual Acuity ◽  
The Mean ◽  
Web Platform

Aim.Real-lifeevaluation in the management of patients affected by macular edema secondary to retinal vein occlusion.Material and Methods. A retrospective, observational study using theI-Macula Webplatform.Results. Thirty-five patients (37 eyes; 15 females and 20 male) affected by RVO were analysed. At 12 months, there was a statistically significant improvement of best-corrected visual acuity (p=0.0235) and central macular thickness (p<0.0001). The mean change in visual acuity was 8.9 letters. Twenty-seven eyes underwent DEX implant (n=62; mean: 2.29) only. Of these, 8, 4, 14, and 1 eyes underwent 1, 2, 3, and 4 DEX implants, respectively. The remaining 10 eyes were also injected with ranibizumab (n=49; mean: 4.9). At 12 months, 12 eyes (32.5%) presented a dry macula, whereas the remaining 25 eyes (67.5%) still had macular edema. Mean interval between the first and second treatment (T1) and between the second and third treatment (T2) were 5.15 and (T2) 3.7 months, respectively. Where only DEX implants were received, T1 and T2 was 5.1 and 4.9 months, respectively.Conclusions. This study confirms that DEX implants and/or anti-VEGF drugs improve visual acuity and central macular thickness in patients affected by RVO.

Macular vessel reduction as predictor for recurrence of macular oedema requiring repeat intravitreal ranibizumab injection in eyes with branch retinal vein occlusion

2018 ◽  
Vol 103 (10) ◽  
pp. 1367-1372 ◽  
Author(s):  
Taiji Hasegawa ◽  
Yohei Takahashi ◽  
Ichiro Maruko ◽  
Akiko Kogure ◽  
Tomohiro Iida
Keyword(s):  
Visual Acuity ◽  
Retinal Vein Occlusion ◽  
Macular Oedema ◽  
Branch Retinal Vein Occlusion ◽  
Initial Visit ◽  
Intravitreal Ranibizumab ◽  
Foveal Thickness ◽  
Central Foveal Thickness ◽  
Vein Occlusion ◽  
The Mean

AimTo determine whether there are factors that can predict the frequency of recurrences of macular oedema associated with branch retinal vein occlusion (BRVO).MethodsWe reviewed the medical records of 31 eyes with treatment-naïve macular oedema associated with BRVO. All eyes received an intravitreal ranibizumab (IVR) injection and were followed with a pro re nata protocol for at least 12 months. A reinjection of ranibizmab was performed when the central foveal thickness was ≥300 µm. At 1 month after IVR injection, the macular vessel reduction was calculated by comparing the vessel density in the optical coherence tomography angiography in the BRVO involved half to that in the non-involved half.ResultsThe mean visual acuity improved from 0.35±0.27 logarithm of the minimal angle of resolution (logMAR) units (20/45; Snellen) at initial visit to 0.06±0.15 logMAR units (20/23) at 12 months (p<0.0001). During 12 months, the mean number of IVR injections was 3.8±1.8. Multivariate regression analysis showed that a greater macular vessel reduction at 1 month after initial IVR injection was significantly a negative predictor of frequency of IVR injections (β=−0.5065, p=0.0082). The visual acuity and the central foveal thickness at the initial visit or at 1 month after initial IVR injection were not predictive factors for frequency of IVR injections.ConclusionsPatients with BRVO with a large macular vessel reduction at 1 month after an initial IVR injection have fewer recurrences and thus lower frequency of IVR injections during 12 months.

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