Effect of Supra-Choroidal Triamcinolone Injection on Best-Corrected Visual Acuity and Central Retinal Thickness in Patients with Macular Edema Secondary to Retinal Vein Occlusion

Purpose: To find out the effect of suprachoroidal Triamcinolone injection on best corrected visual acuity (BCVA) and central retinal thickness (CRT) in patients with macular edema secondary to retinal vein occlusion. Study Design: Interventional case series. Place and Duration of Study: College of Ophthalmology and Allied vision Sciences, Ophthalmology department, Unit II Mayo hospital, Lahore, from September 2019 to January 2020. Methods: This study included 45 patients diagnosed with unilateral, retinal vein occlusion associated with macular edema. Patients with previous anti-vascular endothelial growth factor injection or any steroid injection received in the last 3 months or macular edema due to any other cause were excluded from the study. Only one eye of each patient was enrolled. The patients were treated with suprachoroidal triamcinolone injection (4 mg/100µL concentration). Patients with baseline central retinal thickness (CRT) of > 300 µm were included in the study. Serial changes in this parameter were evaluated at 1 week, 1 month and 3?months after suprachoroidal triamcinolone injection. Final CRT and Best-corrected visual acuity (BCVA) was recorded after three months. Results: Out of 45 patients, 26 (57.7%) were males and 19 (42.2%) were females. Majority of the patients (35.4%) were 51–60 years old. During first week the visual acuity was 0.321 ± 0.273 LogMAR, after one month it was 0.468 ± 0.291 and 0.406 ± 0.318 after 03 months with a p value of 0.003. After three months significant decrease in CRT was observed. With a p-value of 0.002. Conclusions: Suprachoroidal injection significantly improves BCVA and decreases CRT in patients with macular edema due to retinal vein Occlusion. Keywords: Retinal vein occlusion, suprachoroidal injection, triamcinolone acetonide.

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

Journal of Ophthalmology ◽

10.1155/2014/251257 ◽

2014 ◽

Vol 2014 ◽

pp. 1-10 ◽

Cited By ~ 16

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.

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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

Journal of Kathmandu Medical College ◽

10.3126/jkmc.v7i3.22676 ◽

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.

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Discontinuous to continuous therapy for persistent diabetic macular edema leads to reduction in treatment frequency

European Journal of Ophthalmology ◽

10.1177/1120672120901691 ◽

2020 ◽

pp. 112067212090169 ◽

Cited By ~ 1

Author(s):

Olufemi E Adams ◽

Sidney A Schechet ◽

Seenu M Hariprasad

Keyword(s):

Visual Acuity ◽

Intraocular Pressure ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Retinal Thickness ◽

Fluocinolone Acetonide ◽

Central Retinal Thickness ◽

Corrected Visual Acuity ◽

Persistent Diabetic Macular Edema ◽

Best Corrected Visual Acuity

Objective: To evaluate, in the setting of persistent diabetic macular edema, the impact that continuous fluocinolone acetonide delivery has on treatment burden, visual acuity, central retinal thickness, and intraocular pressure. Materials and methods: A single-center, retrospective, cohort study of patients with persistent diabetic macular edema, previously treated with anti–vascular endothelial growth factor injections, dexamethasone implants, or focal laser, who were subsequently treated with fluocinolone acetonide was conducted. All retinal visits were analyzed prior to fluocinolone acetonide, until the most recent follow-up visit. Primary outcomes were pre– and post–fluocinolone acetonide changes in the best-corrected visual acuity and number of treatments required for diabetic macular edema. Secondary outcomes included changes in the central retinal thickness and intraocular pressure. Results: A total of 19 eyes with persistent diabetic macular edema were included and followed for a mean (SD) of 399.3 (222.9) days. Post–fluocinolone acetonide, the mean best-corrected visual acuity improved by 0.4 ETDRS letters for all eyes ( p = 0.895) and the central retinal thickness decreased by 34.2 µm ( p = 0.077). After fluocinolone acetonide, the number of treatments decreased from an average of one treatment every 2.7 months to one every 6 months ( p = 0.009). Furthermore, post–fluocinolone acetonide, 10/19 eyes (52.6%) did not require additional treatment due to a dry macula, and those who did experienced a non-statistically significant reduction of treatments, from one every 2.6 months pre–fluocinolone acetonide, to one every 2.8 months post–fluocinolone acetonide ( p = 0.622). Conclusions: In the setting of persistent diabetic macular edema, fluocinolone acetonide significantly reduces the therapeutic burden, while maintaining best-corrected visual acuity and improving the central retinal thickness. In patient-centered discussions, judiciously employing fluocinolone acetonide should be performed to mitigate this therapeutic burden for patients.

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Safety and effectiveness of intravitreal injection of dexamethasone for macular edema secondary to retinal vein occlusion: a meta-analysis

10.21203/rs.2.21159/v1 ◽

2020 ◽

Author(s):

Gao Xiaorong ◽

Dan Yujiao ◽

Chen Jie ◽

Tian Gang ◽

Yue He

Keyword(s):

Intraocular Pressure ◽

Macular Edema ◽

Intravitreal Injection ◽

Retinal Vein Occlusion ◽

Retinal Thickness ◽

Meta Analysis ◽

Central Retinal Thickness ◽

Vein Occlusion ◽

Corrected Visual Acuity ◽

Long Time

Abstract Background: This meta-analysis aimed to investigate the efficacy and safety of intravitreal injection of dexamethasone (DEX) in treating macular edema secondary to retinal vein occlusion. Method: PubMed, Embase-clinical key, clinicaltrials.gov, Web of Science, and SinoMed were searched to compare the application of DEX implant in patients with retinal vein occlusion secondary macular edema (RVO-ME). The central retinal thickness, best-corrected visual acuity (BCVA), postoperative intraocular pressure, and postoperative cataract were extracted. RevMan 5.3 was used to analyze and evaluate the data. Results: This study was based on six randomized trials. A total of 393 eyes were studied. DEX implant could effectively reduce macular edema caused by retinal vein occlusion. After 6 months, the drug could significantly improve the patients’ BCVA [95% confidence interval (CI), 9.669–21.649, P = 21.649]. At the same time, it also could significantly reduce the patients’ central retinal thickness (95% CI: 274.965–142.236, P = 0.0000). DEX implant could increase the intraocular pressure in some patients and greatly increase the risk of cataracts. Conclusions: DEX implant can effectively improve the BCVA of patients with RVO-ME, reduce the central thickness of the retina, and reduce the number of injections for a relatively long time. Therefore, intravitreal injection of DEX can be used as an effective method for treating RVO-ME.

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Real-world outcomes of two-year Conbercept therapy for diabetic macular edema

International Journal of Ophthalmology ◽

10.18240/ijo.2021.03.14 ◽

2021 ◽

Vol 14 (3) ◽

pp. 416-422

Author(s):

Yong Cheng ◽

◽

Ming-Wei Zhao ◽

Tong Qian ◽

◽

...

Keyword(s):

Visual Acuity ◽

Adverse Events ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Vision Loss ◽

Retinal Thickness ◽

Corrected Visual Acuity ◽

The Mean ◽

Number Of Injections ◽

Best Corrected Visual Acuity

AIM: To evaluate the two-year outcomes of patients treated for diabetic macular edema (DME) with intravitreal Conbercept (IVC). METHODS: The clinical data of 30 DME patients (36 eyes) were retrospectively reviewed. The patients were treated with IVC for 3mo. Additional IVC was given at subsequent monthly visits, if needed (3+PRN). The patients were followed up for 24mo. RESULTS: The best-corrected visual acuity (BCVA) at 24mo significantly increased (66.7±15.3 letters) in comparison with the baseline (54.4±15.4 letters, P<0.0001). The mean improvement in BCVA was 11.0±2.9 letters. At 24mo, 44.1% of the eyes surveyed gained ≥15 letters, 52.9% of the eyes gained ≥10 letters, and 70.6% of the eyes gained ≥5 letters. No vision loss was noted in 96.8% of the eyes, and 5.9% of the eyes lost ≥5 letters, but ≤10 letters. The central retinal thickness (CRT) at 24mo was significantly reduced (277.1±122.9 μm) in comparison with the baseline (510.9±186.1 μm, P<0.0001). At 24mo, 43.3% of the patients had a CRT ≤250 μm. The mean number of injections over 24mo was 10.6±2.0. No severe eye or systemic adverse events related to either the drug or injection were noted. CONCLUSION: IVC is safe and effective for the treatment of DME.

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

Case Reports in Ophthalmology ◽

10.1159/000475520 ◽

2017 ◽

Vol 8 (1) ◽

pp. 271-278 ◽

Cited By ~ 1

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.

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

European Journal of Ophthalmology ◽

10.1177/1120672117750058 ◽

2018 ◽

Vol 28 (6) ◽

pp. 697-705 ◽

Cited By ~ 13

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.

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Three-Month Results of Brolucizumab Intravitreal Therapy in Patients with Wet Age-Related Macular Degeneration

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18168450 ◽

2021 ◽

Vol 18 (16) ◽

pp. 8450

Author(s):

Katarzyna Michalska-Małecka ◽

Dorota Śpiewak ◽

Dorota Luksa

Keyword(s):

Visual Acuity ◽

Retinal Thickness ◽

Age Related Macular Degeneration ◽

Central Retinal Thickness ◽

Membrane Flow ◽

Membrane Area ◽

Corrected Visual Acuity ◽

Age Related ◽

The Mean ◽

Best Corrected Visual Acuity

The purpose of the study was to evaluate changes in best corrected visual acuity, central retinal thickness, area and flow in the neovascular membrane and to compare therapeutic outcomes from baseline in patients who received three doses of Beovu (brolucizumab) at three-month follow-up. Material and methods: A prospective observational study conducted at the Prof. K. Gibiński University Clinical Center of the Medical University of Silesia in Katowice. Eight patients with exudative form of age-related macular degeneration (AMD) were observed. Results: The mean best corrected visual acuity (BCVA) outcome increased with each subsequent visit. The mean central retinal thickness (CRT) result also improved (decreased) with each subsequent visit, except for the last measurement. A statistically significant change in neovascular membrane area was observed after the first injection. In further treatment, the membrane area underwent changes that were not statistically significant. A statistically significant change in neovascular membrane flow was demonstrated after the first and second injections. Discussion: Our study confirmed the efficacy of brolucizumab in the treatment of patients with exudative AMD in terms of improvements in best corrected visual acuity (BCVA), central retinal thickness (CRT), neovascular membrane area, and neovascular membrane flow area.

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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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Anti-VEGF-Therapie bei myopischer choroidaler Neovaskularisation: Langzeitergebnisse

Karger Kompass Ophthalmologie ◽

10.1159/000370022 ◽

2015 ◽

Vol 1 (1) ◽

pp. 38-39

Keyword(s):

Visual Acuity ◽

Choroidal Neovascularization ◽

Retinal Thickness ◽

Central Retinal Thickness ◽

Myopic Choroidal Neovascularization ◽

Retrospektive Analyse ◽

Corrected Visual Acuity ◽

Anti Vegf ◽

Best Corrected Visual Acuity

Ziel: Beurteilung der mittel- und langfristigen Wirksamkeit von Anti-VEGF-Wirkstoffen in der Behandlung der choroidalen Neovaskularisation infolge einer pathologischen Myopie (myopic choroidal neovascularization; mCNV).Methoden: Retrospektive Analyse von mCNV-Patienten, die 2 Jahre oder länger mit einer intravitrealen Anti-VEGF-Therapie behandelt worden waren. Wir verglichen die Sehschärfe mit bester Korrektur (best-corrected visual acuity; BCVA) sowie die zentrale Netzhaut-Dicke (central retinal thickness; CRT) vor und nach der Behandlung. Die Anzahl der Injektionen pro Jahr wurde ebenfalls erfasst.Ergebnisse: Auswertungen der Ergebnisse erfolgten nach 2 Jahren für 67 Augen, nach 3 Jahren für 52 Augen, nach 4 Jahren für 28 Augen und nach 5 Jahren für 13 Augen. Die mittlere Veränderung der BCVA gegenüber dem Ausgangswert war nach 2 Jahren signifikant (+8,6 Buchstaben; p < 0,001); diese Verbesserung blieb über einen Zeitraum von 5 Jahren signifikant stabil bestehen. Die mittlere CRT nahm im Verlauf signifikant ab; der Tiefstwert war nach 2 Jahren erreicht (-104,0 μm; p < 0,001). Die mittlere Anzahl der Injektionen betrug im 1. Jahr 5,2 und ging in den nachfolgenden Jahren zurück (p < 0,001).Schlussfolgerung: In der hier beschriebenen Untergruppe von mCNV-Patienten war die intravitreale Anti-VEGF-Therapie über einen Zeitraum von 5 Jahren wirksam, wobei sich der BCVA-Wert fortwährend erhöhte.Übersetzung aus Ophthalmologica 2014;232:57-63 (DOI: 10.1159/000360307)

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