Anti-Vascular Endothelial Growth Factor Therapy for Macular Edema following Central Retinal Vein Occlusion: 1 Initial Injection versus 3 Monthly Injections

Osaka, Rie; Muraoka, Yuki; Miwa, Yuko; Manabe, Koichiro; Kobayashi, Mamoru; Takasago, Yukari; Ooto, Sotaro; Murakami, Tomoaki; Suzuma, Kiyoshi; Iida, Yuto; Tsujikawa, Akitaka

doi:10.1159/000479049

Cited by 12 publications

(9 citation statements)

References 19 publications

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“…Current treatment protocols rely heavily on clinician intuition, and it is not always clear when to transition patients from monthly schedules and how frequently injections should be administered after symptoms have diminished. [37][38][39] Our RBF measure, which aids in predicting need for anti-Vascular Endothelial Growth Factor (VEGF) injections independently of from RVO duration and CMT, could help to inform treatment strategies and perhaps decrease the frequency of injections required for effective RVO management.…”

Section: Discussionmentioning

confidence: 99%

Relative Retinal Blood Flow: A Novel and Informative Measure of Unilateral Retinal Vein Occlusion Severity

Koch

Seto

Yamada

et al. 2021

Trans. Vis. Sci. Tech.

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This study quantifies retinal vascular blood flow affected by unilateral central or branch retinal vein occlusion (CRVO or BRVO). We created a new, unitless metric for the severity of these diseases-relative blood flow (RBF)-and contextualized it with subject demographics, ocular presentation, and systemic conditions. Finally, we explored its efficacy as a predictor of future outcomes. Methods: Data were collected from 20 control subjects and 32 clinically diagnosed CRVO (n = 15) or BRVO (n = 17) patients. We used laser speckle flowgraphy to quantify blood flow as mean blur rate and present RBF as the ratio between the blood flow in a subject's diseased and undiseased eyes. Because of our demonstration that blood flow has high intrapatient (between eyes and over time) but low interpatient correlation in eyes of healthy subjects, any differences between eyes can be attributed to the disease. These data were correlated with subject demographics and disease characteristics. Results:In CRVO and BRVO eyes, average blood flow decreased by 26% and 7%, respectively. In CRVO, occlusion duration, central macular thickness, intraocular pressure, diabetes, previous laser and injection treatments, and injection within three months after measurement were significantly associated with RBF. In BRVO, no significant associations with RBF were found.Conclusions: Blood flow in CRVO and BRVO was reduced compared to the unaffected fellow eye in most patients. RBF was useful in determining the severity of RVOs and predicting future treatment needs.Translational Relevance: RBF is a promising new and informative metric for quantifying the severity of unilateral RVOs.

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Section: Discussionmentioning

confidence: 99%

Relative Retinal Blood Flow: A Novel and Informative Measure of Unilateral Retinal Vein Occlusion Severity

Koch

Seto

Yamada

et al. 2021

Trans. Vis. Sci. Tech.

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“…Thus, taking into account our findings, it is clear that the reductions in mean CFT and gains in mean VA in the 1 + PRN regimen are almost similar to those of the 3 + PRN regimen. A recent study [15] with similar study designs and using PRN treatment protocols also had similar outcomes. Both regimens showed similar efficacy.…”

Section: Discussionmentioning

confidence: 67%

Intravitreal conbercept for branch retinal vein occlusion induced macular edema: one initial injection versus three monthly injections

Chen

Zuo

et al. 2020

BMC Ophthalmol

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Background: To compare the efficacy of one initial intravitreal injection of conbercept (IVC) versus three monthly IVCs in patients with macular edema (ME) after branch retinal vein occlusion (BRVO). Both options were followed by a pro re nata (PRN) retreatment regimen. Methods: This study retrospectively investigated and followed 60 patients with acute ME secondary to BRVO for over a year. 30 subjects received one initial injection (1 + PRN group); while, 30 received three monthly injections (3 + PRN group). The functional and anatomic outcomes were assessed during each follow-up. Results: The general characteristics of the 60 subjects were as follows: mean [SD] age, 57.43 [13.06] years; 33 [55%] female; 36 [60%] non-ischemic form. Both groups showed a stable gain in visual acuity (VA) with similar logMAR (mean ± SD) (1 + PRN group 0.308 ± 0.399, 3 + PRN group 0.34 ± 0.352) during the first 12 months. Additionally, both groups exhibited a significant reduction in central foveal thickness (CFT) with no statistically significant difference between them (1 + PRN group 222.1 μm ± 197.1 μm, 3 + PRN group 228.4 μm ± 200.2 μm). Both treatment groups had similar improvements in logMAR and anatomic outcomes over time. The stratified analysis showed that patients with the non-ischemic form and those with the ischemic form had similar improvements in VA (0.346 ± 0.366 VS 0.29 ± 0.39, P = 0.575) during the 12 months follow-ups. The number of injections was lower in the 1 + PRN group (4.0 ± 1.6) than in the 3 + PRN group (4.7 ± 1.3) (P = 0.068). No adverse effects or unexpected safety issues were reported in either group. Conclusions: Conbercept yielded significant improvements in VA and CFT among patients with BRVO induced ME, independent of their retinal ischemia status. The results showed that the 3 + PRN regimen do not lead to better functional outcomes or lower treatment needs in clinical practice as compared to the 1 + PRN regimen.

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“…Thus, taking into account our findings, it is clear that the reductions in mean CFT and gains in mean VA in the 1 + PRN regimen are almost similar to those of the 3 + PRN regimen. A recent study [13] with similar study designs and using PRN treatment protocols also had similar outcomes.…”

Section: Safety Assessmentsmentioning

confidence: 67%

Intravitreal Conbercept For Branch Retinal Vein Occlusion induced Macular Edema: One Initial Injection Versus Three Monthly Injections

Chen

Zuo

et al. 2020

Preprint

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Objective To compare the efficacy of one initial intravitreal injection of conbercept (IVC) versus three monthly IVCs in patients with macular edema (ME) after branch retinal vein occlusion (BRVO). Both options were followed by a pro re nata (PRN) retreatment regimen.Methods This study retrospectively investigated and followed 49 patients with acute ME secondary to BRVO for over a year. 24 subjects received one initial injection (1+PRN group); while, 25 received three monthly injections (3+PRN group). The functional and anatomic outcomes were assessed during each follow-up.Results The general characteristics of the 49 subjects were as follows: mean [SD] age, 56.12 [12.54] years; 28 [57.1%] female; 30 [61.2%] non-ischemic form. Both groups showed a stable gain in visual acuity (VA) with similar logMAR (mean ± SD) (1+PRN group 0.308±0.431, 3+PRN group 0.345±0.366) during the first 12 months. Additionally, both groups exhibited a significant reduction in central foveal thickness (CFT) with no statistically significant difference between them (1+PRN group 220.5 μm ±219.9 μm , 3+PRN group 230.2 μm ±220 μm ). Both treatment groups had similar improvements in logMAR and anatomic outcomes over time. The stratified analysis showed that patients with the non-ischemic form and those with the ischemic form had similar improvements in VA (0.351±0.387 VS 0.289±0.417, P =0.601) during the 12 months follow-ups. The number of injections was lower in the 1+PRN group (4.0±1.7) than in the 3+PRN group (4.6±1.2) ( P =0.155). No adverse effects or unexpected safety issues were reported in either group.Conclusions Conpercept yielded stronger improvements in VA and CFT among patients with BRVO induced ME，independent of their retinal ischemia status. The results showed that the 3+PRN regimens do not lead to better functional outcomes or lower treatment needs in clinical practice as compared to the 1+PRN regimen.

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Anti-Vascular Endothelial Growth Factor Therapy for Macular Edema following Central Retinal Vein Occlusion: 1 Initial Injection versus 3 Monthly Injections

Cited by 12 publications

References 19 publications

Relative Retinal Blood Flow: A Novel and Informative Measure of Unilateral Retinal Vein Occlusion Severity

Relative Retinal Blood Flow: A Novel and Informative Measure of Unilateral Retinal Vein Occlusion Severity

Intravitreal conbercept for branch retinal vein occlusion induced macular edema: one initial injection versus three monthly injections

Intravitreal Conbercept For Branch Retinal Vein Occlusion induced Macular Edema: One Initial Injection Versus Three Monthly Injections

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