Incidence of anterior segment neovascularization during intravitreal treatment for macular edema secondary to central retinal vein occlusion

Abstract

Early treatment with intravitreal antivascular endothelial growth factor therapy decreases the rates of ASN and NVG after CRVO.

Comparative efficacy of bevacizumab, ranibizumab, and aflibercept for treatment of macular edema secondary to retinal vein occlusion: a systematic review and network meta-analysis

“…Among 11 eligible studies, 5 RCTs (12 publications) were separately published at different follow-up periods. Three RCTs were excluded from quantitative synthesis: a study conducted by Khan and colleagues [17] comparing efficacy of 1.25 mg of IVB starting at month 0 (immediate) and month 4 (deferred), a study conducted by Moradian et al [18] which followed patients for only 3 months, and a study by Lucatto et al [19] that reported outcomes as graphs without specific values.…”

“…The studies of Khan et al [17] and Epstein et al [32,33] were suggested that prompt IVB treatment had greater efficacy and needed lesser numbers of the drug injection as well as rescue laser treatment compared to delayed treatment. A small study (n = 35) [19] examining functional and anatomic outcomes as secondary end point found that improvement of BCVA in IVB group was significantly better than intravitreal triamcinolone acetate (IVTA) and sham groups only at month 1, while there was no statistically significant difference in CMT reduction throughout the study period.…”

“…Retinal thickness at baseline had to be at least 250 or 300 μm in order to be eligible for participating in the studies. The optical coherence tomography (OCT) machines (manufacturers) used to measure CMT were varied across studies: Cirrus HD-OCT (Carl Zeiss Meditec Inc., Dublin, CA, USA) [13,17,31,32], Spectralis OCT (Heidelberg Engineering, Heidelberg, Germany) [13,19], Stratus OCT (Carl Zeiss Meditec Inc., Dublin, CA, USA and Carl Zeiss Meditec, Jena, Germany) [18,20,23,25,28,30], and 3D-OCT 1000 (Topcon Corporation, Tokyo, Japan) [20]. Using different OCT machines might result in slight difference in measured CMT values.…”

“…Approximately 73% of studies reported mean time from RVO diagnosis and they included only patients who were diagnosed with RVO within 12 months prior to enrollment. Most studies used ETDRS chart which was commonly used in clinical research studies except three studies [17][18][19] that measured BCVA by using the Snellen chart. In each trial, patients' baseline characteristics, including age, baseline BCVA, and baseline CMT, were similar between the comparison groups.…”

“…In most trials, patients received the monthly injection of the drugs for the first 5 or 6 months [13,19,[21][22][23][24][25][26][27][28][29][30] (for 3 months in ROCC [20]), then followed by monthly pro re nata (PRN or as needed) regimen in the extension phase. MARVEL [31] applied the monthly PRN regimen throughout the study period.…”