Hemodilution therapy using automated erythrocytapheresis in central retinal vein occlusion: results of a multicenter randomized controlled study

Glacet–Bernard, A.; Atassi, Marielle; Fardeau, Christine; Romanet, Jean-Paul; Tonini, M.; Conrath, J.; Denis, Philippe; Mauget‐Faÿsse, Martine; Coscas, G.; Soubrane, G.; Souied, Eric H.

doi:10.1007/s00417-010-1532-5

Cited by 23 publications

(17 citation statements)

References 46 publications

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“…Our results for the effectiveness of hemodilution in CRVO therapy confirm data from two randomized, controlled trials by Glacet-Bernard et al [5,6]. …”

Section: Discussionsupporting

confidence: 79%

“…In the early 1980s, Hansen et al [4] showed favorable results concerning visual acuity in CRVO when treated with isovolemic hemodilution (IH) which was initiated early (duration of symptoms <8 weeks). Similar results have also been described by Glacet-Bernard et al [5,6]. Though based on a well-performed clinical trial, due to the small study sample, their IH results did not find worldwide acceptance as a general treatment regimen in CRVO [7].…”

Section: Introductionsupporting

confidence: 76%

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Intravitreal Ranibizumab versus Isovolemic Hemodilution in the Treatment of Macular Edema Secondary to Central Retinal Vein Occlusion: Twelve-Month Results of a Prospective, Randomized, Multicenter Trial

Kreutzer

Wolf²,

Dirisamer³

et al. 2014

Ophthalmologica

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Purpose: This is a prospective, randomized, multicenter, investigator-initiated trial to evaluate the 12-month effectiveness of isovolemic hemodilution (IH) with prompt versus deferred intravitreal injections (IVI) of ranibizumab 0.5 mg for the treatment of macular edema secondary to early central retinal vein occlusion (CRVO). Methods: Eyes with macular edema due to CRVO having occurred not more than 8 weeks previously received either monthly ranibizumab IVI in combination with IH (group I, n = 28) or IH alone (group II, n = 30). From month 2 to 12, the patients in both groups could be treated with monthly intravitreal ranibizumab. The main outcome variables were gain of visual acuity and the course of central retinal thickness as measured with optical coherence tomography. Results: At 12 months, eyes in group I on average gained +28.1 (±19.3) letters compared to +25.2 (±20.9) letters in group II (p = 0.326). This result was achieved with significantly fewer injections in group II. Additionally, 30% of the eyes in group II did not need ranibizumab IVI during the 12 months of the trial. Conclusion: Ranibizumab IVI in addition to IH proved to be highly effective in increasing visual acuity and reducing macular edema secondary to CRVO. Initial IH in early CRVO may be a first treatment option in patients anxious about IVI.

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“…Our results for the effectiveness of hemodilution in CRVO therapy confirm data from two randomized, controlled trials by Glacet-Bernard et al [5,6]. …”

Section: Discussionsupporting

confidence: 79%

Section: Introductionsupporting

confidence: 76%

Intravitreal Ranibizumab versus Isovolemic Hemodilution in the Treatment of Macular Edema Secondary to Central Retinal Vein Occlusion: Twelve-Month Results of a Prospective, Randomized, Multicenter Trial

Kreutzer

Wolf²,

Dirisamer³

et al. 2014

Ophthalmologica

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“…Emerging treatment modalities can be divided into those aimed to resolve the obstruction of venous outflow (endovascular fibrinolysis [105,106,107], endovascular cannulation [108], and systemic thrombolytics [109]) and those aimed at the sequelae of RVO (macular edema and macular ischemia). Therapies aimed at the latter can be grouped into those that minimize reperfusion injury [110], provide hemodilution [111], modify retinal vascular permeability [112], and offer neuroprotection [113] and pharmacologic vitreolysis [113,114,115,116,117]. …”

Section: Emerging Therapiesmentioning

confidence: 99%

Optimal Treatment of Retinal Vein Occlusion: Canadian Expert Consensus

et al. 2015

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Background: The availability of new therapeutic approaches, particularly intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapies, has prompted significant changes to the established treatment paradigms for retinal vein occlusion (RVO). Better visual outcomes and significantly lower rates of adverse events have been noted in multiple large randomized clinical trials and have led to a new standard of care for this sight-threatening condition. Objective: To develop an expert consensus for the management of RVO and associated complications in the context of recent clinical evidence. Methods: The development of a Canadian expert consensus for optimal treatment began with a review of clinical evidence, daily practice, and existing treatment guidelines and algorithms. The expert clinicians (11 Canadian retina specialists) met on February 1, 2014, in Toronto to discuss their findings and to propose strategies for consensus. Results: The result of this expert panel is a consensus proposal for Canadian ophthalmologists and retina specialists treating patients presenting with RVO. Treatment algorithms specific to branch and central RVO (BRVO and CRVO) were also developed. Conclusions: The consensus provides guidelines to aid clinicians in managing RVO and associated complications in their daily practice. In summary, laser remains the therapy of choice when neovascularization secondary to RVO is detected. Adjunctive anti-VEGF could be considered in managing neovascularization secondary to RVO in cases of vitreous hemorrhage. Intravitreal anti-VEGF should be considered for symptomatic visual loss associated with center-involving macular edema on optical coherence tomography. Patients with BRVO and a suboptimal response to anti-VEGF could be treated with grid laser, and those with CRVO and an inadequate response to anti-VEGF may be candidates for intravitreal steroids.

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“…Glacet-Bernard et al [ 347 ] performed isovolumic hemodilution in 142 eyes with CRVO or hemi-CRVO (without differentiating ischemic from nonischemic type) and claimed better visual acuity in patients treated within the fi rst 2 weeks of onset than those treated later. Glacet-Bernard et al [ 348 ] later did a prospective randomized controlled multicenter study of isovolumic hemodilution therapy in 61 consecutive CRVO patients, with CRVO lasting for 3 weeks or less and with visual acuity ranging from 20/200 to 20/32. They claimed that the visual acuity was better in the treated group ( p = 0.007) and there was less conversion into an ischemic form in the hemodilution group than in the control group ( p = 0.004).…”

Section: Hemodilutionmentioning

confidence: 97%

Central Retinal Vein Occlusion

Hayreh

2014

Ocular Vascular Occlusive Disorders

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Hemodilution therapy using automated erythrocytapheresis in central retinal vein occlusion: results of a multicenter randomized controlled study

Abstract: This multicenter controlled randomized study demonstrated that automated erythrocytapheresis is a safe and effective tool for performing hemodilution and confirmed that hemodilution therapy can improve the final prognosis of CRVO when applied in the early phase of the disease.

Cited by 23 publications

References 46 publications

Intravitreal Ranibizumab versus Isovolemic Hemodilution in the Treatment of Macular Edema Secondary to Central Retinal Vein Occlusion: Twelve-Month Results of a Prospective, Randomized, Multicenter Trial

Intravitreal Ranibizumab versus Isovolemic Hemodilution in the Treatment of Macular Edema Secondary to Central Retinal Vein Occlusion: Twelve-Month Results of a Prospective, Randomized, Multicenter Trial

Optimal Treatment of Retinal Vein Occlusion: Canadian Expert Consensus

Central Retinal Vein Occlusion

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