scholarly journals Intravitreal injections during COVID-19 outbreak: Real-world experience from an Italian tertiary referral center

2020 ◽  
pp. 112067212096203
Author(s):  
Adriano Carnevali ◽  
Giuseppe Giannaccare ◽  
Valentina Gatti ◽  
Gianfranco Scuteri ◽  
Giorgio Randazzo ◽  
...  
Keyword(s):  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Real World ◽  
Intravitreal Injections ◽  
Tertiary Referral ◽  
Priority Level ◽  
Tertiary Referral Center ◽  
Vein Occlusion ◽  
Treatment Priority ◽  
Priority Levels

We report our experience during COVID-19 outbreak for intravitreal injections in patients with maculopathy. We proposed a treatment priority levels and timings; the “High” priority level includes all monocular patients; the “Moderate” is assigned to all patients with an active macular neovascularization; the patients affected by diabetic macular edema or retinal vein occlusion belong to the “Low” class. This organization allowed us to treat the most urgent patients although the injections performed had a 91.7% drop compared to the same period of 2019.

scholarly journals Sub-optimal gain in vision in retinal vein occlusion due to under-treatment in the real world: results from an open-label prospective study of Intravitreal Ranibizumab

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Raja Narayanan ◽  
Aditya Kelkar ◽  
Zahir Abbas ◽  
Neha Goel ◽  
Manoj Soman ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Real World ◽  
Intravitreal Injections ◽  
Open Label ◽  
Intravitreal Ranibizumab ◽  
The Real ◽  
Vein Occlusion ◽  
The Mean

Abstract Background Macular edema secondary to retinal vein occlusion (RVO) is an important cause of loss of vision. Intravitreal injections (IVI) of anti-vascular endothelial growth factor (VEGF) are the standard of care in this disease, as shown in numerous randomized controlled trials. The purpose of this study was to study the efficacy and safety of ranibizumab, an anti-VEGF agent, in the real-world setting. Methods This was 48 weeks, open-label, prospective, multicentre, observational study. Patients diagnosed with ME secondary to RVO were treated with IVI of Ranibizumab 0.5 mg in real-world conditions. Efficacy was measured by improvement seen in best-corrected visual acuity (BCVA) in terms of Early Treatment of Diabetic Retinopathy Study (ETDRS) Letter Scores and change in central retinal thickness (CRT) measured by optical coherence tomography. Results One hundred eyes of 100 patients (79 with branch retinal vein occlusion and 21 with central retinal vein occlusion) were recruited in the study. The mean (standard deviation, SD) BCVA was 52.8 (21.99) letters at baseline and 62.3 (24.40) letters at week 48. From baseline, there was a significant improvement in BCVA by 7.7 letters (p = 0.001) at 48 weeks. The mean (SD) of CRT was 479.9 (216.25) μm at baseline and it decreased significantly to 284.9 (171.35) μm at week 48 (p < 0.001). During the study period, the average number of intravitreal injections was 3.5 per patient. There was no report of endophthalmitis in any eye. Conclusions Ranibizumab is well tolerated and effective in treating macular edema secondary to RVO in real-world clinical settings. However, there is under-treatment compared to controlled clinical trials, and the gain in vision is sub-optimal with under-treatment. Trial registration Clinical Trials Registry - India: CTRI/2015/07/005985.

Treatment of macular edema due to branch retinal vein occlusion with single or multiple intravitreal injections of bevacizumab

2012 ◽  
Vol 56 (2) ◽  
pp. 159-164 ◽  
Author(s):  
Tatsuya Yunoki ◽  
Akio Miyakoshi ◽  
Tomoko Nakamura ◽  
Kazuya Fujita ◽  
Chiharu Fuchizawa ◽  
...  
Keyword(s):  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Branch Retinal Vein Occlusion ◽  
Intravitreal Injections ◽  
Vein Occlusion

EFFICACY OF COMBINED INTRAVITREAL INJECTIONS OF BEVACIZUMAB AND TRIAMCINOLONE ACETONIDE IN PATIENTS WITH NON-RESOLVING MACULAR EDEMA SECONDARY TO BRANCH RETINAL VEIN OCCLUSION

2021 ◽  
pp. 48-49
Author(s):  
Haniyaa Mufti ◽  
Syed Tariq Qureshi ◽  
Birjees Hakak
Keyword(s):  
Combination Therapy ◽  
Macular Edema ◽  
Triamcinolone Acetonide ◽  
Retinal Vein Occlusion ◽  
Branch Retinal Vein Occlusion ◽  
Common Adverse Effect ◽  
Visual Outcome ◽  
Intravitreal Injections ◽  
Therapeutic Effects ◽  
Vein Occlusion

Purpose: To study the effects of combined intravitreal injections of bevacizumab (IVB) and triamcinolone acetonide (IVTA) in patients with non-resolving macular edema (ME) secondary to Branch Retinal Vein Occlusion (BRVO). Methods: In a prospective observational study, 50 pseudophakic eyes of BRVO patients with non-resolving central macular edema who had received more than 3 doses of IVB previously were injected with combination therapy of 1.25 mg/0.05 ml IVB and 4 mg of IVTA and followed up for 6 months with best corrected visual acuity(BCVA), intraocular pressure(IOP) and central macular thickness(CMT) Results: The mean BCVA was logMAR 0.75±0.25 at baseline and 0.65±0.15, 0.48±0.20, and 0.22±0.25 at 6weeks, 3 months and 6 months respectively. Mean CMT at baseline was 668.32±254.66 and 434.43±99.55, 243.22±58.92, and 220.83±42.60 at 6 weeks, 3 months and 6 months respectively. Baseline IOP measured was 16.5±3.1 mmHg which progressed to 19.6±3.4mmHg and 21.4±2.8mmHg at 6 weeks and 3 months respectively and decreased to 17.3±2.2 at 6 months. The most common adverse effect seen was increase in IOP in 24(48%)patients, out of which 3(6%) patients needed to start anti-glaucoma medication (AGM). 3(6%) patients had sub-conjunctival hemorrhage(SCH). Conclusion: The prolonged therapeutic effects of combination therapy leads to outstanding anatomical and visual outcome in non resolving ME due to BRVO, with fewer doses and thus fewer adverse effects.

INTRAVITREAL INJECTIONS OF ZIV-AFLIBERCEPT FOR THE TREATMENT OF A PATIENT WITH MACULAR EDEMA SECONDARY TO BRANCH RETINAL VEIN OCCLUSION

2018 ◽  
Vol 12 (2) ◽  
pp. 93-96 ◽  
Author(s):  
Gabriel Costa de Andrade ◽  
João Rafael de Oliveira Dias ◽  
André Maia ◽  
Michel Eid Farah ◽  
Somaia Mitne ◽  
...  
Keyword(s):  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Branch Retinal Vein Occlusion ◽  
Intravitreal Injections ◽  
Vein Occlusion

Longitudinal Follow-Up of Choroidal Thickness in Central Retinal Vein Occlusion With and Without Cystoid Macular Edema

2018 ◽  
Vol 2 (5) ◽  
pp. 289-296 ◽  
Author(s):  
Atalie C. Thompson ◽  
Akshay S. Thomas ◽  
Adam L. Rothman ◽  
Duncan Berry ◽  
Sharon Fekrat
Keyword(s):  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Central Retinal Vein Occlusion ◽  
Cystoid Macular Edema ◽  
Choroidal Thickness ◽  
Intravitreal Injections ◽  
Vein Occlusion ◽  
Over Time ◽  
Central Retinal Vein

Purpose: To investigate the longitudinal relationship between subfoveal choroidal thickness (CT) and central retinal vein occlusion (CRVO). Methods: Retrospective cohort of 104 subjects with enhanced-depth imaging optical coherence tomography for unilateral CRVO. Mean CT and best-corrected visual acuity (BCVA) were compared in eyes with and without CRVO and in eyes with CRVO with and without cystoid macular edema (CME). Results: CT was thicker in eyes with CRVO-related CME than uninvolved contralateral eyes at baseline (263.9 ± 86.9 versus 230.2 ± 87.9 µm; P < .001) and final follow-up (261.1 ± 94.7 versus 222.3 ± 86.2 µm; P = .007). CRVO eyes treated with intravitreal antivascular endothelial growth factor with or without steroid therapy showed a significant reduction in CT at final follow-up (256.3 ± 90.7 versus 236.9 ± 85.9 µm; P = .004). Subjects with CRVO who were not treated with intravitreal injections also showed a significant but more modest decline in CT over time (234.4 ± 94.2 versus 221.5 ± 97.1 µm; N = 31; P = .02). However, contralateral uninvolved eyes without CRVO did not show a significant change in CT over time (233.3 ± 87.9 versus 219.5 ± 90.6 µm; N = 71; P = .40). Persistent CME at final follow-up was associated with thicker baseline (277.6 ± 96.4 versus 235.1 ± 86.5 µm; P = .02) and final CT (265.7 ± 93.4 versus 215.0 ± 82.1 µm; P = .005). Change in CT was not related to change in BCVA ( P > .05). Conclusions: CT was greater in eyes with CRVO-related CME compared to eyes with CRVO but no CME and compared to uninvolved contralateral eyes. CT decreased in eyes with CRVO over time both among eyes that received intravitreal injections and among eyes that did not receive injections. CT may be a prognosticator of treatment response in CRVO-related CME.

scholarly journals Initial Dose of Three Monthly Intravitreal Injections versus PRN Intravitreal Injections of Bevacizumab for Macular Edema Secondary to Branch Retinal Vein Occlusion

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Seong Joon Ahn ◽  
Jeeyun Ahn ◽  
Se Joon Woo ◽  
Kyu Hyung Park
Keyword(s):  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Initial Dose ◽  
Branch Retinal Vein Occlusion ◽  
Dose Group ◽  
Intravitreal Bevacizumab ◽  
Intravitreal Injections ◽  
Vein Occlusion ◽  
Corrected Visual Acuity ◽  
Initial Injection

Purpose. To compare visual and anatomic outcomes of intravitreal bevacizumab injections administered as needed (PRN group) and initial treatment with 3 monthly injections followed by as-needed injections (3 monthly initial dose group) in patients with macular edema (ME) secondary to branch retinal vein occlusion (BRVO).Methods. This retrospective study included 69 and 26 patients in the PRN and 3 monthly initial dose groups, respectively. Best-corrected visual acuity (BCVA) and central retinal thickness (CRT) were compared between the 2 groups 6 months after initial injection.Results. At month 6, BCVA change from baseline was-0.27±0.28(mean ± standard deviation) logMAR in the PRN group and-0.28±0.20 logMAR in the 3 monthly initial dose group. Mean CRT changes were-204±168in the PRN group and-161±149 μm in the 3 monthly initial dose group at month 6. There were no statistically significant differences in BCVA or CRT changes between groups at any time point. The number of intravitreal injections over 6 months was significantly lower in the PRN group (1.8±0.8injections) than in the 3 monthly initial dose group (3.4±0.5injections;P<0.001).Conclusions. Our results suggest that as-needed intravitreal bevacizumab injections are more tolerable for patients with ME secondary to BRVO.

scholarly journals Intravitreal Injections for Macular Edema Secondary to Retinal Vein Occlusion: Long-Term Functional and Anatomic Outcomes

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Emilia Maggio ◽  
Maurizio Mete ◽  
Giorgia Maraone ◽  
Marcella Attanasio ◽  
Massimo Guerriero ◽  
...  
Keyword(s):  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Clinical Setting ◽  
Real Life ◽  
Intravitreal Injections ◽  
Intravitreal Ranibizumab ◽  
Vein Occlusion ◽  
The Mean ◽  
Number Of Injections

Purpose. To report the long-term visual and anatomic outcomes of intravitreal injections for macular edema (ME) secondary to retinal vein occlusion (RVO) in a real-life clinical setting. Design. Retrospective interventional case series. Methods. A total of 223 consecutive eyes with ME secondary to RVO, treated with the first three intravitreal Ranibizumab or dexamethasone injections between August 2008 and September 2018, were enrolled in the study. Subsequent retreatment was guided by best-corrected visual acuity (BCVA) and central macular thickness (CMT) measurements, aimed at achieving macular fluid regression and BCVA stability. BCVA and CMT were recorded at baseline and at subsequent annual time points. The mean number of injections administered each year and the incidence of adverse events were recorded. Results. The mean BCVA and CMT at baseline were 0.79 logMar (SD 0.71) and 615.7 μm (SD 257.5), respectively. The mean follow-up (FU) period was 47.8 months (min 12–max 120). At 12 months, the mean BCVA and CMT had significantly improved to 0.62 logMar (SD 0.68; p<0.0001) and 401.04 μm (SD 183.8; p<0.0001). Improvements remained significant at the final FU visit. Eyes with BRVO and nonischemic RVO showed significantly better visual outcomes when compared to eyes with CRVO and ischemic RVO, over the entire FU period. An average of 4.08 (SD 2.1) Ranibizumab and 1.5 (SD 0.6) Ozurdex injections were administered over the first 12 months. The number of injections decreased thereafter progressively. One eye with CRVO developed endophthalmitis and one with BRVO developed an intraocular pressure increase that was refractory to topical medications and ultimately treated with trabeculectomy. Conclusion. Intravitreal Ranibizumab and/or dexamethasone injections were found to be effective at inducing a long-lasting improvement of BCVA and CMT in a real-life clinical setting. A safety profile similar to that already well-established in Ranibizumab and dexamethasone treatment was observed, as well as a steady decrease in the number of intraocular injections required. The results support intravitreal treatments for BRVO and CRVO in patient populations with similar characteristics in similar settings.

scholarly journals The choice of treatment for macular edema following retinal vein occlusion

2015 ◽  
Vol 8 (4) ◽  
pp. 5-15
Author(s):  
Larisa Konstantinovna Moshetova ◽  
Tat'yana Vyacheslavovna Tsikhonchuk ◽  
Kseniya Ivanovna Turkina ◽  
Sergey Aleksandrovich Ignat'ev
Keyword(s):  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Disease Onset ◽  
Pathological Process ◽  
Intravitreal Injections ◽  
Vascular Endothelial ◽  
Vein Occlusion ◽  
Choice Of Treatment ◽  
Efficacy Assessment ◽  
Endothelial Growth Factor

A clinical efficacy assessment was performed for the therapy of post-occlusive cystoid macular edema using intravitreal anti-VEGF-ranibizumab injections at short and remote terms from the disease onset. It has been shown that ranibizumab intravitreal injections in retinal vein occlusion allow to increase visual acuity and to reduce retinal edema, and thus rehabilitate patients in maximally short terms. Intravitreal injections of vascular endothelial growth factor inhibitors at short terms from the disease onset allow achieving stabilization of the pathological process with preservation or improvement of visual functions, while reducing the number of repeated intravitreal injections.

scholarly journals The Role of Steroids in the Management of Macular Edema from Retinal Vein Occlusion

2019 ◽  
Vol 16 (1) ◽  
pp. 95-101
Author(s):  
M. V. Budzinskaya ◽  
A. V. Shelankova ◽  
A. A. Plukhova ◽  
N. M. Nuriyeva ◽  
A. S. Sorokin
Keyword(s):  
Macular Edema ◽  
Intravitreal Injection ◽  
Retinal Vein Occlusion ◽  
Intravitreal Injections ◽  
Ophthalmological Examination ◽  
Dexamethasone Implant ◽  
Duration Of Treatment ◽  
Vein Occlusion ◽  
Anti Vegf ◽  
Group 1

Aim: To analyze the effectiveness of intravitreal injection of an anti-VEGF agent (ranibizumab) and an dexametazon implant for the intravitreal injection, in real clinical life.Patients and Methods. 137 patients with MO due to retinal venous occlusion were included in the study. Patients were retrospectively divided into groups: patients who received monotherapy with ranibizumab 94 people; and monotherapy with dexamethasone implant — 15 patients; patients who initially were injected with a dexamethasone implant, but due the study transferred to ranibizumab 15 patients; patients who initially received ranibizumab, but then transferred to the dexamethasone implant -13. For the treatment of macular edema were used an anti-VEGF agent — ranibizumab (Lucentis) 0.05 ml (0.5 mg) manufactured by Novartis (Switzerland) or glucocorticosteroid — dexamethasone implant for intravitreal injection of 0.7 mg (Ozurdex) manufactured by Allergan Pharmaceutical Ireland (Ireland). The injections were administered on a pro re nata basis (the presence of macular edema). Standard ophthalmological examination and fluorescent angiography (PAG), optical coherent tomography (OCT), optical coherence tomography angiography (OCT-A) were used. Visual acuity changes (BCVA), central retinal thickness (CRT) and intraocular pressure (IOP) were analyzed depending on the study group (group 1–4), the duration of treatment and the number of injections. Results: In group 1, from 1 to 8 IVVs were performed in 24 months, an average of 3.77. In group 2, from 1 to 4 intravitreal injections were performed in 24 months, an average of 1.37. In group 3, from 1 to 2 of intravitreal injections Ozurdex and from 1 to 4 intravitreal injections of ranibizumab for 24 months. In group 4, from 1 to 4 intravitreal injections of anti-VEGF drug and from 1 to 4 intravitreal dexamethasone implant were performed in 24 months of follow-up. Monotherapy with the Ozurdex drug (12 months) had the most stable effect, with a relapse of the process, repeated injections were required, conducted only in 3 out of 15 patients. Conclusion: In real clinical practice, the dexamethasone implant showed a good safety profile and high efficacy in the resorption of macular edema in patients with retinal vein occlusion, which corresponds to the clinical trials that was made earlier. 

scholarly journals Ranibizumab and retinal photocoagulation in the treatment of ischemic retinal vein occlusion

2015 ◽  
Vol 8 (2) ◽  
pp. 11-27 ◽  
Author(s):  
Svetlana Nikolaevna Tultseva ◽  
Yury Sergeevich Astakhov ◽  
Pavel Andreevich Nechiporenko ◽  
Andranik Yuraevich Ovnanyan ◽  
Varvara Andreevna Khatina
Keyword(s):  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Randomized Study ◽  
Treatment Algorithm ◽  
Drop Out ◽  
Intravitreal Injections ◽  
Peripheral Ischemia ◽  
Vein Occlusion ◽  
The Mean ◽  
Retinal Photocoagulation

Introduction. This investigation was focused on the post-RVO (retinal vein occlusion) macular edema treatment in cases with peripheral retinal ischemia, and on methods to estimate the ischemic area. Aim. To develop an examination and treatment algorithm for patients with chronic macular edema due to ischemic RVO. Material and methods. A prospective non-randomized study included 250 patients with RVO, the mean follow-up was 24.5 ± 6.5 months. Results. The drop-out of retinal capillary perfusion was detected in 175 patients (70 %). Peripheral ischemia was found in 125 cases, that is in 50% of all RVO patients and 71.4 % of all patients with ischemia. The mean number of ranibizumab injections performed after retinal photocoagulation was 2.9 ± 1.4. Patients treated with ranibizumab monotherapy for 24 months received 10.6 ± 2.5 intravitreal injections. Conclusions. The combination of ranibizumab intravitreal injections with retinal photocoagulation in the capillary non-perfusion areas can significantly reduce the number of injections and reduce the amount of neovascular complications.

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