Combined Intravitreal Bevacizumab and Grid Laser Photocoagulation for Macular Edema Secondary to Branch Retinal Vein Occlusion

Donati, Simone; Barosi, P.; Bianchi, Matteo; Oum, Muna Al; Azzolini, Claudio

doi:10.5301/ejo.5000085

Cited by 48 publications

(55 citation statements)

References 42 publications

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“…Donati et al [33] reported that in BRAVO study grid was allowed as rescue therapy, which complicates the indirect comparison results of the studies. In one trial compared grid laser photocoagulation in combination to intravitreal bevacizumab 1.25 mg to bevacizumab alone, and found even better results in the combination group (+20) letters (median 3 injections).…”

Section: Macular (Grid) Laser Photocoagulationmentioning

confidence: 99%

Laser Photocoagulation in Retinal Vein Occlusion

Altıntaş

2016

International Journal of Ophthalmic Research

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Retinal vein occlusion (RVO) is the second most common retinal vascular disease after diabetic retinopathy which is a frequently devastating cause of blindness in mainly in older patients over 60 years of age. Its prevalence changes according to studies in overall populations are from 5.2 to 16 per 1,000 [1][2][3][4] . People with end-organ damage caused by diabetes mellitus and hypertension have strongly increased risk for RVO. The majority of individual diagnosed with RVO defined more than one component of the systemic vascular and metabolic disease, such as the presence of Diabetes Mellitus, hyper tension and high serum lipids. Coexisting metabolic diseases are important factors for prognosis and laser treatment response [1][2][3][4][5] .There are mainly two types of RVO according to occlusion side branch retinal vein occlusion (BRVO) and central retinal vein occlusion (CRVO). In BRVO occlusion is located in the any branch of the retinal vein system, while occlusion located exactly in the central retinal vein in CRVO. Different researches shows that BRVO is 4-6 times more common than CRVO and it has been estimated that there are around 80 new cases of CRVO/million population/ year. Although CRVO most commonly affects one eye, in around 10% of patients the disease affects both eyes [2][3][4][5][6][7] . Even RVO was first recognized over a century ago, the exact pathogenesis is not completely nderstood and therefore exact treatment methods not found yet. The condition may be due to a combination of three systemic changes known as Virchow's triad: (1) hemodynamic changes such as venous stasis; (2) degenerative changes of the vessel wall; and (3) blood hypercoagulability [6,8,9] . According to clinical findings, fundus appearance, Fluorescein angiography and electrophisiological results Hayreh futher divided RVO into three types: (1) BRVO is divided further into major BRVO (a) and macular BRVO (b) according to localization; (2) CRVO is divided into ischemic and non-ischemic types due to presence or absence of ABSTRACTVisual acuity is primarily decreased secondary to macular edema, retinal ischemia and complications of neovascularisation in both BRVO and CRVO. Panretinal Laser photocoagulation or Focal photocoagulation is an effecting treatment for neovascularisation and prevention of complications of neovascularisation by ablating ischemic retina in either BRVO or CRVO. But Macular Laser photocoagulation can be use for treatment of non ischaemic macular oedema in only BRVO either alone or combination with other Anti-VEGF or Anti-inflammatory medication.

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Section: Macular (Grid) Laser Photocoagulationmentioning

confidence: 99%

Laser Photocoagulation in Retinal Vein Occlusion

Altıntaş

2016

International Journal of Ophthalmic Research

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“…Retinal vein occlusion (RVO) is the second most common type of retinal vascular disorder after diabetic retinopathy (1)(2)(3). Macular edema (ME) and vitreous hemorrhage are frequent causes of visual loss in cases of RVO (1)(2)(3)(4)(5).…”

Section: Introductionmentioning

confidence: 99%

“…Macular edema (ME) and vitreous hemorrhage are frequent causes of visual loss in cases of RVO (1)(2)(3)(4)(5). Both inflammation and increased vascular endothelial growth factor (VEGF) level play important role in pathogenesis of ME secondary to RVO (4)(5)(6)(7).…”

Section: Introductionmentioning

confidence: 99%

“…Both inflammation and increased vascular endothelial growth factor (VEGF) level play important role in pathogenesis of ME secondary to RVO (4)(5)(6)(7). Laser photocoagulation, vitreoretinal surgery, intravitreal anti-VEGF and steroid injections, and various surgical techniques have been reported to be effective in treatment of ME secondary to RVO (1)(2)(3)(4)(5)(6)(7)(8).Currently, intravitreal injections are particularly preferred as first-line treatment option for ME (8). Bevacizumab, ranibizumab, and aflibercept are the 3 anti-VEGF agents used in treatment.…”

Section: Introductionmentioning

confidence: 99%

“…Bevacizumab, ranibizumab, and aflibercept are the 3 anti-VEGF agents used in treatment. The first drug is used off-label; the others are approved for this purpose (2,8,(9)(10)(11)(12). In pivotal multicenter studies in which strict follow-up and treatment criteria were observed, successful treatment outcomes have been reported (9)(10)(11)(12)(13).…”

Section: Introductionmentioning

confidence: 99%

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Ranibizumab versus Aflibercept in Macular Edema Secondary to Retinal Vein Occlusion in Real Life: A Retrospective Case Control Study

Özkaya¹

2017

Beyoglu Eye J

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Objectives:The present study is comparison of efficacy of ranibizumab and aflibercept in the treatment of macular edema (ME) secondary to retinal vein occlusion (RVO) in real life. Methods: Design was retrospective, case-control study. Treatment naïve RVO patients with ME who were treated with ranibizumab or aflibercept and had minimum follow-up time of 6 months were included. Primary outcome measures were changes in best corrected visual acuity (BCVA) and central retinal thickness (CRT). Secondary outcome measure was number of injections administered. Results: Mean baseline, month 3, and month 6 BCVA in ranibizumab group was 0.95±0.61-, 0.50±0.30-, and 0.66±0.58 logarithm of the minimum angle of resolution (LogMAR), respectively. Mean baseline, month 3, and month 6 BCVA in aflibercept group was 0.85±0.65-, 0.61±0.58-, and 0.65±0.55 LogMAR, respectively. Mean baseline, month 3, and month 6 CRT in ranibizumab group was 598±189-, 473±162-, and 359±134 μm, respectively. Mean baseline, month 3, and month 6 CRT in aflibercept group was 512±141-, 345±154-, and 374±172 μm, respectively. Mean number of injections was 2.7±0.8 for ranibizumab group, and 2.2±1.0 for aflibercept group (p=0.08). Conclusion: Ranibizumab and aflibercept are both effective agents in the treatment of ME secondary to RVO. Visit and injection figures were lower than those reported in prospective, multicenter studies, as expected, but functional and anatomical outcomes were comparable.

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