scholarly journals Intravitreal Bevacizumab for Macular Edema Secondary to Retinal Vein Occlusion

2020 ◽  
Vol 12 (2) ◽  
pp. 281-289
Author(s):  
Anil Parajuli ◽  
Purushottam Joshi ◽  
Prabha Subedi ◽  
Chandni Pradhan
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Vision Loss ◽  
Intravitreal Bevacizumab ◽  
Visual Outcome ◽  
Systemic Complications ◽  
Vein Occlusion ◽  
Final Visual Outcome

Introduction: The most common cause of vision loss in cases of Retinal vein occlusion (RVO) is due to macular edema. This study was conducted to examine the effect of intravitreal bevacizumab (IVB) in the treatment of macular edema secondary to RVO. Materials and methods: The authors conducted a retrospective study of 94 eyes (N) of 92 patients with macular edema associated with decreased visual acuity secondary to RVO who were treated with IVB. Patients received IVB at baseline, 1 month and 2 months. At each follow up patients were evaluated and re-injected if necessary. Results: The mean age of the patients was 56.6 ±11.51 years. The average number of injections per eye was 2.1 ± 0.87. The baseline median central macular thickness (CMT) and best-corrected visual acuity (BCVA) in LogMAR was 465.00μm (Min 254μm, Max 1218μm) and 1.00 (Min 0.30, Max 2.28), respectively. The median CMT at one month following first, second and third dose of IVB was 258μm (N=94, Z= -7.64, p <0.001), 261μm (N=63, Z= -0.17, p=0.86), and 292μm (N=41, Z= -0.21, p= 0.83), respectively. The median LogMAR BCVA at one month following first, second and third dose of IVB was 0.60 (N=94, Z= -5.70, p < 0.001), 0.60 (N=63, Z= -1.69, p=0.09), and 0.60 (N=41, Z= -0.03, p=0.97), respectively. Pre-operative BCVA was the best predictor of the final visual outcome after IVB in cases of RVO. None of the patients developed any serious ocular or systemic complications due to IVB. Conclusion: IVB is an effective and safe treatment for macular edema associated with decreased visual acuity secondary to RVO. The most beneficial effect of IVB is seen at one month after the first dose. The efficacy of subsequent doses could not be established in this study

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 Macular Hole Progression after Intravitreal Bevacizumab for Hemicentral Retinal Vein Occlusion

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Manish Nagpal ◽  
Vikram Mehta ◽  
Kamal Nagpal
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Macular Hole ◽  
Retinal Vein Occlusion ◽  
Intravitreal Bevacizumab ◽  
Full Thickness ◽  
Detailed Review ◽  
Off Label ◽  
Vein Occlusion ◽  
Full Thickness Macular Hole

Macular edema secondary to retinal vein occlusion is commonly being treated with off-label intravitreal bevacizumab with good outcomes. A significant reduction in macular edema and improvement in visual acuity is seen following such a treatment with no serious adverse effects. In the reported case, a full-thickness macular hole was noticed one month after intravitreal bevacizumab for macular edema secondary to hemicentral retinal vein occlusion. On a detailed review of the pre- and postoptical coherence tomography scans, it was realized that there was a preexisting stage 2-3 macular hole which was masked by the hemorrhages and edema at the fovea and the macular hole had progressed following the injection.

scholarly journals Pharmacological intravitreal treatment for macular edema in branch retinal vein occlusion: Three-month results

2015 ◽  
Vol 68 (9-10) ◽  
pp. 295-300
Author(s):  
Jelena Karadzic ◽  
Igor Kovacevic ◽  
Jelena Ljikar ◽  
Zorka Grgic ◽  
Gordana Devecerski
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Branch Retinal Vein Occlusion ◽  
Structural Damage ◽  
Intravitreal Bevacizumab ◽  
Vein Occlusion ◽  
Clinical Center ◽  
Permanent Loss ◽  
Novi Sad

Introduction. Macular edema is the main cause of visual loss in patients with branch retinal vein occlusion. Macular edema is initially reversible, but over time, permanent loss of vision occurs from structural damage to the macula. For this reason, there is a need for more rapid and effective treatments than laser photocoagulation which has been established as a gold standard. There are several pharmacologic agents which have changed the management of macular edema. Material and Methods. Twenty eyes of 20 consecutive patients of the Department of Eye Diseases, Clinical Center of Vojvodina, in Novi Sad, were enrolled in this prospective, randomized and consecutive study conducted from January 2012 to January 2013. The patients were randomly assigned into two treatment groups, and they were given an intravitreal injection of bevacizumab 1.25 mg/0.05 mL (Avastin?), or triamcinolone acetonid injection 4 mg/0.1mL (Kenalog?). Reinjections were performed according to the following retreatment criteria a loss of visual acuity or increase in central retinal thickness. Results. Both intravitreal bevacizumab and triamcinolonacetonid were very effective in reducing macular edema and improving visual acuity in the eyes with macular edema secondary to retinal vein occlusion. The effect of the treatment was more pronounced if it started early after the onset of macular edema. The reported temporary effects of intravitreal triamcinolon- acetonide and bevacizumab could be explained by their clearance from the eye. Conclusion. The short-term results of our clinical trial showed that pharmacological intravitreal agents, such as bevacizumab and triamcinolon-acetonid, lead to rapid resolution of macular edema and significant improvement of visual acuity.

scholarly journals BEVACIZUMAB FOR RETINAL VEIN OCCLUSION

2020 ◽  
Vol 3 (1) ◽  
Author(s):  
Andrea Radotma Silitonga ◽  
Sindy Boru Sembiring ◽  
Christina Josephina Bangun ◽  
Heri Purwoko
Keyword(s):  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Real Life ◽  
Intravitreal Bevacizumab ◽  
Functional Improvement ◽  
Vein Occlusion ◽  
Before And After ◽  
Treatment Naïve ◽  
The Mean

Introduction: Central retinal vein occlusion (CRVO) and branch retinal vein occlusion (BRVO) caused sudden visual decrease that most often treatable. This paper aims to describe clinical characteristic and outcome using bevacizumab for macular edema caused by retinal vein occlusion in real-life practice. Methods: This retrospective study included 91 treatment-naïve eyes with macular edema due to CRVO (55 eyes) and BRVO (36 eyes), who were treated with intravitreal bevacizumab (IVB) in pro re nata (PRN) regimen. Best corrected visual acuity (BCVA) and central macular thickness (CMT) before and after treatment were evaluated. Result: The mean age of patients was 60.3 + 11.2 years for CRVO and 55.7 + 8.2 years for BRVO. The mean baseline BCVA in the CRVO group was 1.41 + 0.55 logMAR. There was statistically significant improvement in BCVA after intravitreal bevacizumab compared to baseline (p < 0.001) in CRVO and BRVO group. Twenty six (47.3%) eyes with CRVO had BCVA > 1.0 logMAR (Snellen 20/200) at the last follow-up. In the BRVO group, the mean baseline BCVA was 0.93 + 0.48 logMAR. At the end of the follow up, 19 eyes (52.8%) with BRVO had BCVA > 0.3 logMAR (Snellen 20/40). There was also statistically significant improvement in CMT between all time points and baseline (p < 0.001) in both groups. At the end of the follow up, 26 (47.3%) eyes with CRVO and 25 eyes (69.4%) in BRVO group presented resolution of macular edema (CMT < 300). Conclusion: Intravitreal bevacizumab resulted in significant anatomical and functional improvement in macular edema associated with CRVO and BRVO, although outcome in CRVO group was sub-optimal.

scholarly journals Evaluation of the Effectiveness of Treatment with Dexamethasone Intravitreal Implant in Cystoid Macular Edema Secondary to Retinal Vein Occlusion

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Simone Donati ◽  
Carlo Gandolfi ◽  
Simona Maria Caprani ◽  
Jennifer Cattaneo ◽  
Laura Premoli ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Cystoid Macular Edema ◽  
Treatment Guidelines ◽  
Functional Improvement ◽  
Functional Evaluation ◽  
Dexamethasone Intravitreal Implant ◽  
Vein Occlusion

Purpose. To evaluate retinal functional improvement by means of visual acuity and retinal sensibility examination after intravitreal dexamethasone implant in patients affected by cystoid macular edema secondary to retinal vein occlusion. Methods. Twenty-six consecutive patients affected by retinal vein occlusion complicated by cystoid macular edema were enrolled in this prospective interventional study. All patients underwent a baseline complete ophthalmological evaluation as well as retinal angiography, OCT examination, and microperimetry evaluation. Each patient was treated with intravitreal injection of a long-term steroid implant (Ozurdex, Allergan). Follow-up evaluations were performed at months 1, 3, and 6 and completed by OCT and MP1 examination. Clinical data underwent statistical analysis. Results. Baseline functional evaluation showed mean visual acuity of 0,63±0,42 LogMAR and retinal sensitivity of 7,93±4,73 dB (mean±standard deviation); after treatment, at day 30 we found, respectively, 0,43±0,38 LogMAR (p<0.05, compared to baseline) and 10,15±4,410 dB (p<0.05); at day 90, we found 0,44±0,32 (p<0.05) and 9.61±4,29 dB (p<0.05); at day 180, we found 0,41±0,31 (p<0.05) and 9,95±3,79 dB (p<0.05). Fixation pattern improved significantly (p<0.05), showing a stable fixation in 30% of patients at baseline, increasing to 77% of patients at day 180. Baseline morphological evaluation showed a central retinal thickness (CRT) of 398,21±181,65 μm after treatment; we found a CRT of 222,64±95,21 μm at day 30 (p<0.05, compared to baseline), 307,50±120,25 μm (p<0.05) at day 90, and 294,93±135,86 μm (p<0.05) at day 180. About 15,3% patients showed already at month 3 a recurrence of macular edema. They underwent a retreatment before month 6 as for treatment guidelines. Conclusion. Our detailed analysis showed the significative increase in retinal function in the early phases of the follow-up. Retinal sensibility showed a stronger correlation than VA in macular edema reabsorption, better underlying the progressive functional recovery and increase in quality of vision and life for the patients. This trial is registered with ClinicalTrials.gov NCT03559491.

scholarly journals A Prospective Study of Safety Profile and Efficacy of three doses of Intravitreal Bevacizumab in Diabetic Macular Edema

2021 ◽  
Vol 4 (2) ◽  
pp. 127
Author(s):  
Nasrin Y ◽  
Sharma Ajay ◽  
Sharmila Yalakala
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Therapeutic Agent ◽  
Intravitreal Bevacizumab ◽  
Systemic Complications ◽  
Systemic Side Effects ◽  
The Mean ◽  
A Prospective Study

Introduction: Current study aimed to evaluate efficacy of intravitreal Bevacizumab in Diabetic macular edema, and to identify their ocular and systemic complications if any. Method: It is a prospective, interventional study with 68 patients in 82 eyes with Diabetic macular edema. All treated by 3 injection of intravitreal bevacizumab with 1 month interval. Visual acuity, macular edema, and complications evaluated at every month upto 6th months. Ranibizumab was offered if the patient is a non-respondent to Bevacizumab. Results: Majority age group of 61-70 years with a mean age of 59 ± 6.72 years. The mean duration of diabetes was 11.68 ± 7.2 years. The mean baseline BCVA and CRT are 0.64 ± 0.28 Log MAR units and 436.99 ± 135.10 μm. After 3 injections, BCVA values are 0.48±0.27 (p< 0.01)), 0.36±0.24 (p<0.01)), and 0.27±0.24 (p<0.01), 0.23±0.27 Log MAR (p<0.01)) at 1month, 2 months, and 3 months, and 6 months follow-up respectively. CMT levels are 315.79±124.60 μ at 1 month, after 3rd IVA and this significant change (p<0.01) followed with subsequent follow-up with mean CRT of 296.04±122.97 μ (p< 0.01) at 6th month. The BCVA improved ≥ 2 Snellen lines in 69.5% and 78% cases, resolution of CMT in 56% and 69.5% cases at 3 months and 6 months respectively. At the end of the 3rd month, 46 eyes macular edema completely resolved with 3 injections of IVA, 23 eyes persistent macular edema present, 13 eyes refractory to bevacizumab injections. Persistent & Refractory macular edema eyes (36) switched to Ranibizumab injections.In persistent macular edema, significant resolution (p≤0.01) of macular thickness (370.52 ± 71.43 µm vs. 341.08 ± 122.75 µm) without (p=0.09) improvement in visual acuity (0.45 ± 0.20 vs. 0.34 ± 0.23) was observed post Ranibizumab injections.  In Refractory macular edema, thickness of cases no significant (497.76 ± 161.07µm vs 407.84 ± 169.64 µm) improvement seen after Ranibizumab injections(p=0.1). Recurrence of macular edema seen in 10.9%. Subconjunctival haemorrhage seen in 10.9%-12.1% cases, raised IOP in 2.4%-3.6% cases at post injection day 1. No other ocular and systemic complications were observed during follow-up. Conclusions: Intravitreal bevacizumab is effective in treatment of diabetic macular edema but therapeutic effect is temporary and repeat treatment is needed. It does not show any potential drug related ocular and systemic side effects, hence it is safe and economical therapeutic agent

scholarly journals Outcomes of Intravitreal Bevacizumab for Macular Edema Secondary to Branch Retinal Vein Occlusion

2020 ◽  
Vol 36 (3) ◽  
Author(s):  
Nasir Chaudhry ◽  
Sarmad Zahoor ◽  
Usama Iqbal ◽  
Muhammad Owais Sharif ◽  
Muhammad Sharjeel ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Intravitreal Bevacizumab ◽  
Macular Thickness ◽  
Female Ratio ◽  
Vein Occlusion ◽  
Vitreoretinal Traction ◽  
Quasi Experimental ◽  
Study Institute

Purpose: To determine the functional and anatomical outcome of intravitreal Bevacizumab in patients withmacular edema secondary to branch retinal vein occlusion.Study Design: Quasi Experimental study.Place and Duration of Study: Institute of Ophthalmology, Mayo hospital, Lahore, from February 2016 to December 2018.Material and Methods: Forty eyes of 40 patients with macular edema on OCT secondary to BRVO were included in the study. All the patients suffering from other types of macular edemacaused by diabetes, epi-retinal membrane (ERM), surgery involving posterior segment, vitreoretinal traction andhistory of intravitreal VEGF or steroids were excluded from the study. Intravitreal Bevacizumab was given whenmacular thickness was > 300 μm or Visual acuity was < 6/12. Follow-up was at 1st, 3rd, 6th and 12th month.Results: The mean age of the patients was 52.12 ± 5.63 years. Male to female ratio was 1.5:1. Infero-temporalvenous arcade was the most common site of BRVO (55%) followed by supero-temporal (35%) and macularBRVO (10%). Baseline visual acuity was 6/12 or better in 17.5% of the patients at presentation. This proportionincreased to 27.5%, 40%, 52.5% and 67.5% at 1, 3, 6 and 12 months respectively. Macular thickness measuredat presentation was 540 ± 120 μm. Macular thickness gradually reduced on follow-up. At one month meanmacular thickness was 430 ± 90 μm. It was less than 300 μm after 6 months.Conclusion: Intravitreal bevacizumab results in improved functional and anatomical outcomes in cases ofmacular edema secondary to BRVO.

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.

Effect of Aflibercept on Cystoid Macular Edema Associated with Central Retinal Vein Occlusion. Results from a District Hospital in the United Kingdom

2019 ◽  
Vol 236 (04) ◽  
pp. 547-550
Author(s):  
Georgios Panos ◽  
Vassileios Kostakis ◽  
Grazyna Porter
Keyword(s):  
Visual Acuity ◽  
Adverse Effects ◽  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Central Retinal Vein Occlusion ◽  
Cystoid Macular Edema ◽  
Vein Occlusion ◽  
Intravitreal Aflibercept ◽  
Central Retinal Vein

Abstract Purpose The purpose of this study was to report the efficiency and safety of intravitreal aflibercept for the treatment of cystoid macular edema (CME) secondary to central retinal vein occlusion (CRVO). Methods This is a retrospective cohort study. Ten naive eyes of ten patients with CME secondary to CRVO were included. All eyes received a loading dose of 3 monthly aflibercept injections followed by as-needed injections at monthly follow-up visits. Best corrected visual acuity (BCVA) and central retinal thickness (CRT) were evaluated at baseline and at the end of the follow-up period. Results The median follow-up period was 6 months (range: 6 – 9). The median number of injections was 4 (range: 3 – 5). Median BCVA improved from 1.05 LogMAR units (range: 0.7 – 1.6) at baseline to 0.65 (range: 0.4 – 1.6) at the end of the follow-up period (p = 0.02). Median CRT improved from 690 µm (range: 561 – 1235) at baseline to 243 µm (range: 207 – 531) at the end of the follow-up period (p = 0.002). The power of all statistical tests was greater than 0.8. No adverse effects or complications were documented. Conclusion Intravitreal aflibercept treatment for CME secondary to CRVO significantly improved both macular anatomy and visual acuity without adverse effects.

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