Ranibizumab in Macular Edema Secondary to Branch Retinal Vein Occlusion – 24 Months Of 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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Comparison of ranibizumab and subthreshold micropulse laser in treatment of macular edema secondary to branch retinal vein occlusion

European Journal of Ophthalmology ◽

10.1177/1120672117750056 ◽

2018 ◽

Vol 28 (6) ◽

pp. 690-696 ◽

Cited By ~ 2

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.

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Correlation between improvement in visual acuity and QOL after Ranibizumab treatment for age-related macular degeneration patients: QUATRO study

BMC Ophthalmology ◽

10.1186/s12886-021-01816-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yuji Oshima ◽

Yumi Ishibashi ◽

Naoyasu Umeda ◽

Tatsuo Nagata ◽

Shigeo Yoshida ◽

...

Keyword(s):

Visual Acuity ◽

Visual Function ◽

Age Related Macular Degeneration ◽

Open Label ◽

Intravitreal Ranibizumab ◽

Satisfaction Questionnaire ◽

Age Related ◽

The Mean ◽

Baseline Visual Acuity ◽

Ranibizumab Treatment

Abstract Background To evaluate the correlation between visual acuity improvement and vision-related QOL after ranibizumab treatment in Japanese patients with AMD. Methods In this one-year prospective, interventional, open-label, multicenter study involving four sites, patients with neovascular AMD were enrolled and observed for 12 months. Treatment-naïve patients received 0.5 mg ranibizumab as needed after three initial monthly doses. The best corrected visual acuity (BCVA) and central macular thickness (CMT) were measured at every visit. Evaluations with the 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) and patient satisfaction questionnaire were performed at baseline and 3 and 12 months after initial treatment. The primary endpoint was change in BCVA and QOL 3 months after ranibizumab treatment. QOL outcomes were also assessed in the better and poor BVCA subgroups. Results The study enrolled 100 patients. The mean logMAR BCVA after treatment improved significantly from 0.43 to 0.30 at 3 months (p< 0.0001), and 0.28 at 12 months (p< 0.0001). The mean NEI-VFQ-25 composite scores improved from 79.48 to 84.13 at 3 months (p< 0.0001), and 86.0 at 12 months (p< 0.0001). The 3 and 12-month changes in NEI-VFQ-25 score and BCVA showed significant correlation. In the poor baseline visual acuity group (decimal BCVA ≤0.5), there was a significant correlation between the changes in the NEI-VFQ-25 score and BCVA (p=0.02) but not in the better baseline visual acuity group (decimal BCVA > 0.6, p=0.1) at 3 months. There were no significant differences in the satisfaction questionnaire score from baseline to at 3 months (p=0.54) and 12 months (p=0.23). The average CMT improved significantly from 340 to 264 μm at 3 months (p< 0.0001) and to 268 μm at 12 months (p< 0.0001). Conclusions Intravitreal ranibizumab treatment resulted in improvement in visual acuity, anatomical change, and visual function change in Japanese AMD patients. Significant improvement was seen in patient visual function, and this was correlated with changes in VA, except immediately after loading dose treatment in patients with higher baseline VA. The patients’ satisfaction with the treatment remained unchanged during the study period. Trial registration This study is registered at UMIN Clinical Trials Registry (UMIN000012013). Registered October 10, 2013, as prospective study.

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Comparison of the Effectiveness of Intravitreal Ranibizumab for Diabetic Macular Edema in Vitrectomized and Nonvitrectomized Eyes

Ophthalmologica ◽

10.1159/000446992 ◽

2016 ◽

Vol 236 (2) ◽

pp. 67-73 ◽

Cited By ~ 5

Author(s):

Yoshito Koyanagi ◽

Shigeo Yoshida ◽

Yoshiyuki Kobayashi ◽

Yuki Kubo ◽

Muneo Yamaguchi ◽

...

Keyword(s):

Visual Acuity ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Treatment Option ◽

Central Macular Thickness ◽

Intravitreal Ranibizumab ◽

Corrected Visual Acuity ◽

The Mean ◽

The Difference ◽

Best Corrected Visual Acuity

Purpose: To compare the effectiveness of intravitreal ranibizumab (IVR) for diabetic macular edema (DME) between eyes with and without previous vitrectomy. Procedures: We prospectively assessed the best-corrected visual acuity (BCVA) and central macular thickness (CMT) after IVR for 6 months. Results: There were no significant differences in the baseline BCVA and CMT between both groups. In the nonvitrectomized group (n = 15), the mean changes of BCVA and CMT from baseline to month 6 were significant (p < 0.01). In the vitrectomized group (n = 10), the improvement appeared to be slower, and the mean BCVA improvement was not significant (p = 0.5), although the mean CMT decrease was significant (p < 0.05). There were no significant differences in the mean changes of BCVA and CMT between both groups at 6 months. Conclusions: The difference in the effectiveness of IVR between both groups was not significant. IVR can be a treatment option even for vitrectomized DME eyes.

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The Difference Of Visual Acuity And Macular Thickness Post Bevacizumab Therapy In Secondary Macular Edema Retinal Vein Occlusion

Journal of Agromedicine and Medical Sciences ◽

10.19184/ams.v4i2.7875 ◽

2018 ◽

Vol 4 (2) ◽

pp. 110

Author(s):

Citra Rahmadani ◽

Nur Khoma Fatmawati ◽

Rahmat Bakhtiar

Keyword(s):

Visual Acuity ◽

Macular Edema ◽

Retinal Vein Occlusion ◽

Secondary Data ◽

Macular Thickness ◽

Vein Occlusion ◽

Before And After ◽

Quasi Experimental ◽

The Mean ◽

The Difference

Retinal vein occlusion is the second most common cause of blindness in retinal vascular disease after diabetic retinopathy and may lead to complications of macular edema. Bevacizumab is an influential treatment as an anti vascular endothelial growth factor (VEGF). This study aims to determine the difference of visual acuity and macular thickness before and after treatment of Bevacizumab. This is a quasi experimental study in patients with secondary macular edema retinal vein occlusion who meets the inclusion criteria. Visual acuity and macular thickness were evaluated after one month of treatment. This study was conducted for two months since May-June 2017 by collecting secondary data from medical record at SMEC Samarinda from January 2016 – June 2017. Data were analyzed using Wilcoxon. Sixteen eyes from 16 patients were diagnosed with macular edema secondary retinal vein occlusion given bevacizumab treatment. The mean visual acuity before therapy was 1.106 LogMAR ± 0.509 and increased to 0.889 logMAR ± 0.608 (p = 0.116) after treatment while the mean macular thickness before therapy was 504.06 μm ± 301.273 and decreased to 348.81 μm ± 181.17 (p = 0.017) after treatment. There was a significant effect on the decrease in macular thickness but no significant effect on visual acuity improvement in patients with macular edema secondary retinal vein occlusion at SMEC Samarinda. Keywords: Retinal vein occlusion, macular edema, bevacizumab

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Correlation Between Improvement in Visual Acuity and QOL After Ranibizumab Treatment for Age-related Macular Degeneration Patients: QUATRO Study

10.21203/rs.3.rs-116089/v1 ◽

2020 ◽

Author(s):

Yuji Oshima ◽

Yumi Ishibashi ◽

Naoyasu Umeda ◽

Tatsuo Nagata ◽

Shigeo Yoshida ◽

...

Keyword(s):

Visual Acuity ◽

Patient Satisfaction ◽

Visual Function ◽

Age Related Macular Degeneration ◽

Open Label ◽

Satisfaction Questionnaire ◽

Age Related ◽

The Mean ◽

Baseline Visual Acuity ◽

Ranibizumab Treatment

Abstract Background: To evaluate the correlation between visual acuity improvement and vision-related QOL after ranibizumab treatment in Japanese patients with AMD.Methods: In this one-year prospective, interventional, open-label, multicenter study involving four sites, patients with neovascular AMD were enrolled and observed for 12 months. Treatment-naïve patients received 0.5 mg ranibizumab as needed (PRN) after three initial monthly doses. The best corrected visual acuity (BCVA) and central macular thickness (CMT) were measured at every visit. Fluorescein and indocyanine green angiography, and evaluations with the 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) and patient satisfaction questionnaire were performed at baseline and 3 and 12 months after initial treatment. The primary endpoint was the change in BCVA and QOL 3 months after ranibizumab treatment. Secondary endpoints included change in BCVA, QOL, CMT, and patient satisfaction over 12 months.Results: The study enrolled 100 patients. The mean logMAR BCVA after the 3-month treatment improved significantly from 0.43 to 0.30 (p<0.0001). The mean NEI-VFQ-25 composite scores were higher after 3 months of ranibizumab treatment, improving from 79.48 to 84.13 (p<0.0001). The changes in the NEI-VFQ-25 score and BCVA showed significant correlation in the poor baseline visual acuity group (decimal BCVA below 0.5, p=0.02) but not in the better baseline visual acuity group (decimal BCVA above 0.6, p=0.1) after the three loading doses. There were no significant differences in the satisfaction questionnaire score from baseline to after the three loading doses (p=0.5466). The average CMT improved significantly from 340 to 264 mm after the loading doses (p<0.0001).Conclusions: Intravitreal ranibizumab treatment resulted in improvement in visual acuity, anatomical change, and visual function change in Japanese AMD patients. Significant improvement was seen in patient visual function, but this was not correlated with changes in VA in patients with higher or lower baseline VA. The patients' satisfaction with the treatment remained unchanged during the study period.

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

Journal of Ophthalmology ◽

10.1155/2017/5601786 ◽

2017 ◽

Vol 2017 ◽

pp. 1-5 ◽

Cited By ~ 1

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.

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

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2018-312769 ◽

2018 ◽

Vol 103 (10) ◽

pp. 1367-1372 ◽

Cited By ~ 3

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

Journal of Ophthalmology ◽

10.1155/2020/7817542 ◽

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.

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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

BMC Ophthalmology ◽

10.1186/s12886-020-01757-7 ◽

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.

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Intravitreal Ranibizumab Treatment in Macular Edema Secondary to Central Retinal Vein Occlusion

Güncel Retina Dergisi (Current Retina Journal) ◽

10.37783/crj-0133-1 ◽

2019 ◽

pp. 26-28

Keyword(s):

Macular Edema ◽

Retinal Vein Occlusion ◽

Central Retinal Vein Occlusion ◽

Current Treatment ◽

Intravitreal Ranibizumab ◽

Vascular Growth ◽

Vein Occlusion ◽

Vascular Growth Factor ◽

Central Retinal Vein ◽

Ranibizumab Treatment

The two main complications of central retinal vein occlusion are macular edema and neovascularizations. Intravitreal anti-vascular growth factor and corticosteroid injections are the mainstays of the current treatment of central retinal vein occlusion. In this review, we aimed to summarize the clinical studies of intravitreal ranibizumab in macular edema secondary to central retinal vein occlusion.

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