scholarly journals Anti-VEGF Therapy In Central Retinal Vein Occlusions

2018 ◽  
Vol 1 (2) ◽  
Author(s):  
Meidina Rahmah ◽  
Ramzi Amin ◽  
AK Ansyori
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Visual Outcome ◽  
Vascular Endothelial ◽  
Medicine Department ◽  
Hard Exudates ◽  
Vein Occlusion ◽  
Anti Vegf ◽  
Endothelial Growth Factor ◽  
Central Retinal Vein

Introduction: Central retinal vein occlusion (CRVO) is the second most common retinal vascular disease after diabetic retinopathy and is estimated to affect more than 16 million adults worldwide. Treating the underlying cause of occlusion of the central retinal vein, reducing the risk factors, and early and proper management are the keys toward a better prognosis in patients with CRVO. Repeated frequent treatment of CRVO with macular edema with intravitreal anti-vascular endothelial growth factor (anti-VEGF) is an effective treatment to improve visual outcome. In this case report we assess the 3-month efficacy of anti-VEGF therapy in CRVO. Method: In this case, a 52-year-old man presented with an acute loss of vision over the last week in his left eye. His baseline visual acuity was 1/60 and his central retinal thickness (CRT) on Optical Coherence Tomography (OCT) was 523 μm. Fundus examination revealed a hemorrhage in all four quadrants, hard exudates, swelling of the optic nerve, and macular edema. Laboratory test confirms hyperlipidemia and we consult this patient to Internal Medicine Department. This patient got 3 monthly injections of 1,25 mg Bevacizumab. Results: By 3 months, the OCT appeared fairly normal and the visual acuity improved to 6/60 Conclusion: Anti-VEGF therapy is effective for treating macular edema secondary to CRVO

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.

Tractional retinal detachment (‘crunch’ phenomenon) from intravitreal anti-vascular endothelial growth factor injection in central retinal vein occlusion

2021 ◽  
Vol 14 (4) ◽  
pp. e240506
Author(s):  
Albert John Bromeo ◽  
Amadeo Veloso ◽  
Sweet Jorlene Lerit ◽  
Myron Carlo Gomez
Keyword(s):  
Vascular Endothelial Growth Factor ◽  
Growth Factor ◽  
Retinal Detachment ◽  
Central Retinal Vein Occlusion ◽  
Vascular Endothelial ◽  
Tractional Retinal Detachment ◽  
Vein Occlusion ◽  
Anti Vegf ◽  
Endothelial Growth Factor ◽  
Central Retinal Vein

Tractional retinal detachment is an uncommon complication of intravitreal anti-vascular endothelial growth factor (VEGF) injection wherein the drug triggers tractional retinal detachment as a result of fibrovascular membrane contraction. We present a case of a 42-year-old hypertensive woman diagnosed with chronic central retinal vein occlusion on both eyes. The right eye had total retinal detachment and neovascular glaucoma, while the left eye had retinal neovascularisation. Panretinal photocoagulation and intravitreal anti-VEGF injection was started on the left eye. However, she was lost to follow-up. She returned 4 months later with extensive tractional retinal detachment involving the macula on the left eye. She subsequently underwent vitrectomy with endolaser and silicone oil tamponade on the left eye. The anti-VEGF ‘crunch’ results from regression of fibrovascular proliferation with a concurrent increase in fibrosis, resulting in worsening retinal traction. With the widespread use of anti-VEGF agents, ophthalmologists need to be aware of this vision-threatening complication.

scholarly journals Real world evidence on 5661 patients treated for macular oedema secondary to branch retinal vein occlusion with intravitreal anti-vascular endothelial growth factor, intravitreal dexamethasone or macular laser

2020 ◽  
pp. bjophthalmol-2020-315836 ◽  
Author(s):  
Richard Gale ◽  
Maria Pikoula ◽  
Aaron Y Lee ◽  
Spiros Denaxas ◽  
Catherine Egan ◽  
...  
Keyword(s):  
Vascular Endothelial Growth Factor ◽  
Visual Acuity ◽  
Growth Factor ◽  
Macular Oedema ◽  
Branch Retinal Vein Occlusion ◽  
Vascular Endothelial ◽  
Vein Occlusion ◽  
Anti Vegf ◽  
Intravitreal Dexamethasone ◽  
Endothelial Growth Factor

Background/aimsClinical trials suggest anti-vascular endothelial growth factor is more effective than intravitreal dexamethasone as treatment for macular oedema secondary to branch retinal vein occlusion. This study asks if ‘real world’ data from a larger and more diverse population, followed for a longer period, also support this conclusion.MethodsData collected to support routine care at 27 NHS (National Health Service) Trusts between February 2002 and September 2017 contained 5661 treatment-naive patients with a single mode of treatment for macular oedema secondary to branch retinal vein occlusion and no history of cataract surgery either during or recently preceding the treatment. Number of treatment visits and change in visual acuity from baseline was plotted for three treatment groups (anti-vascular endothelial growth factor (anti-VEGF), intravitreal dexamethasone, macular laser) for up to 3 years.ResultsMean baseline visual acuity was 57.1/53.1/62.3 letters in the anti-VEGF/dexamethasone/macular laser groups, respectively. This changed to 66.72 (+9.6)/57.6 (+4.5)/63.2 (+0.9) at 12 months. Adequate numbers allowed analysis at 18 months for all groups (66.6 (+9.5)/56.1 (+3.0)/60.8 (-1.5)) and for anti-VEGF at 36 months (68.0, +10.9) Mean number of treatments were 5.1/1.5/1.2 at 12 months, 5.9/1.7/1.2 at 18 months for all three groups and 10.3 at 36 months for anti-VEGF.ConclusionsVisual acuity improvements were higher and more sustained with anti-VEGF. Higher treatment burden occurred with anti-VEGF but this reduced over 36 months. Patients with better vision at baseline than those in the clinical trials maintained high levels of vision with both anti-VEGF and dexamethasone.

Cotton Wool Spots after Anti-Vascular Endothelial Growth Factor Therapy for Macular Edema Associated with Central Retinal Vein Occlusion

2016 ◽  
Vol 235 (2) ◽  
pp. 106-113 ◽  
Author(s):  
Teruyo Kida ◽  
Akitaka Tsujikawa ◽  
Yuki Muraoka ◽  
Seiyo Harino ◽  
Rie Osaka ◽  
...  
Keyword(s):  
Vascular Endothelial Growth Factor ◽  
Growth Factor ◽  
Macular Edema ◽  
Central Retinal Vein Occlusion ◽  
Vascular Endothelial ◽  
Cotton Wool ◽  
Cotton Wool Spots ◽  
Vein Occlusion ◽  
Endothelial Growth Factor ◽  
Central Retinal Vein

Purpose: To report a case series, whereby we encountered a transient increase in retinal cotton wool spots (CWS) following anti-vascular endothelial growth factor (anti-VEGF) therapy for the treatment of macular edema secondary to central retinal vein occlusion (CRVO). Methods: Eighteen eyes were treated with intravitreal aflibercept (IVA), and 5 were treated with intravitreal ranibizumab (IVR). Fundus photographs obtained 1 month after initial IVA or IVR injections were retrospectively evaluated for the presence of CWS. Results: Twenty-one (91.3%) patients had the following systemic diseases: hypertension, diabetes mellitus without retinopathy, dyslipidemia, or chronic renal failure requiring dialysis. One month after treatment, reduced macular edema was observed in 21 (91.3%) eyes. Initial injections facilitated complete resolution in 14 eyes, and CWS gradually became fainter with additional injections. Conclusion: Some eyes with CRVO-related macular edema can show a transient increase in CWS after initial anti-VEGF therapy; however, macular edema, retinal hemorrhage, and visual acuity were improved in almost every case.

scholarly journals Multicentre study of 4626 patients assesses the effectiveness, safety and burden of two categories of treatments for central retinal vein occlusion: intravitreal anti-vascular endothelial growth factor injections and intravitreal Ozurdex injections

2020 ◽  
pp. bjophthalmol-2020-317306
Author(s):  
Richard Gale ◽  
Claire Gill ◽  
Maria Pikoula ◽  
Aaron Y Lee ◽  
Rachel L W Hanson ◽  
...  
Keyword(s):  
Vascular Endothelial Growth Factor ◽  
Growth Factor ◽  
Central Retinal Vein Occlusion ◽  
Vascular Endothelial ◽  
Treatment Burden ◽  
Vein Occlusion ◽  
Anti Vegf ◽  
Endothelial Growth Factor ◽  
Central Retinal Vein ◽  
Number Of Injections

Background/AimsTo assess the effectiveness, burden and safety of two categories of treatment for central retinal vein occlusion (CRVO): intravitreal injections of anti-vascular endothelial growth factor (anti-VEGF) and dexamethasone (Ozurdex).MethodsA retrospective analysis of Medisoft electronic medical record (EMR) data from 27 National Health Service sites in the UK identified 4626 treatment-naive patients with a single mode of treatment for macular oedema secondary to CRVO. Statistics describing the overall CRVO patient cohort and individual patient subpopulations stratified by treatment type were generated. Mean age at baseline, gender, ethnicity, social deprivation and visual acuity (VA) follow-up was reported. Absolute and change in VA using ETDRS are used to describe treatment effectiveness, the number of injections and visits used to describe treatment burden and endophthalmitis rates as a marker of treatment safety.ResultsMean VA was 47.9 and 45.3 EDTRS letters in the anti-VEGF and Ozurdex groups, respectively. This changed to 57.9/53.7 at 12 months, 58.3/46.9 at 18 months and 59.4/51.0 at 36 months. Mean number of injections were 5.6/1.6 at 12 months, 6.0/1.7 at 18 months and 7.0/1.8 at 36 months. Endophthalmitis rates were 0.003% (n=4) for the anti-VEGF group and 0.09% (n=1) for the Ozurdex group.ConclusionsVA improvements were greater and more sustained with anti-VEGF treatment. Lower starting acuity resulted in bigger gains in both groups, while higher starting acuity resulted in higher VA at 36 months. Although treatment burden was greater with anti-VEGF, Ozurdex was associated with higher rates of endophthalmitis.

scholarly journals Intravitreal Anti Vascular Endothelial Growth Factor Agents in The Management of Retinal Diseases: An Audit

2017 ◽  
Vol 11 (1) ◽  
pp. 315-321 ◽  
Author(s):  
Bassey Fiebai ◽  
Victor Odogu
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Diabetic Macular Edema ◽  
Age Related Macular Degeneration ◽  
Retinal Diseases ◽  
Vascular Endothelial ◽  
Vein Occlusion ◽  
Anti Vegf ◽  
Treatment Type

Purpose: The study aimed to describe our initial experience with the use of anti vascular endothelial growth factors (anti-VEGFs) in the treatment of retinal diseases. Methods: The case records of all patients who had received at least 3 doses of intravitreal anti- VEGF injections between January 2012 to December 2016 were reviewed. Information culled from the data was age, sex, indications for treatment, type of injection, presenting visual acuity, post injection visual acuity, systemic and ocular co morbidities. Results were analyzed using Statistical Package for Social Sciences (SPSS) 20.0 for Windows statistical software Results: A total of 190 injections were given during the study period, to 58 eyes of 50 patients. Twenty-eight females (56.00%) and twenty-two males (44.00%) were seen with a mean age of 59.6± 11.66. Bevacizumab was the most frequently administered anti- VEGF, 142 (74.74%) while only 48(25.26%) injections of Ranibizumab were given. Three eyes had both bevacizumab and ranibizumab (1.58%). Retinal vein occlusion 61(32.11%) was the commonest indication for the injections followed by diabetic macular edema 43(22.63%) and proliferative diabetic retinopathy 42(22.11%). Others were neovascular age related macular degeneration, neovascular glaucoma, vitreous hemorrhage, myopic choroidal neovascularization and cystoid macular edema. There was an association between age and disease, (p = 0.001). There was an improvement in visual acuity after intervention in cases with retinal vein occlusion and diabetic macular edema, and this was statistically significant. Hypertension was the commonest systemic disorder in this series 81(42.36%) and the supero-temporal quadrant 131(68.95%) was the most preferred position to administer the injection. Floaters was the commonest complication seen. Conclusion: Anti VEGFs have become an invaluable tool in the management of a number of retinal diseases in our center. However, the cost implications are a hindrance to an increased uptake of this form of treatment. Cheaper alternative preparations should be made available to encourage the uptake. Government in developing countries should be encouraged to bear the health burden of the old aged pensioner (OAP).

Sign in / Sign up

Export Citation Format

Share Document