Long-term outcomes for patients treated for macular oedema secondary to retinal vein occlusion: a systematic review

Hunter, Alexandra; Williams, Michael

doi:10.1136/bmjophth-2022-001010

Cited by 7 publications

(10 citation statements)

References 35 publications

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“…Intravitreal treatment with either anti‐VEGF agents or corticosteroids in eyes with MO due to CRVO is more effective than the natural history. Our results support previous meta‐analyses despite having different inclusion criteria 8,49 . Anti‐VEGF agents are considered first line treatment due to fewer ocular adverse events than intravitreal corticosteroid and better visual outcomes when corticosteroids are given 6‐monthly.…”

Section: Discussionsupporting

confidence: 88%

“…Our results support previous meta-analyses despite having different inclusion criteria. 8,49 Anti-VEGF agents are considered first line treatment due to fewer ocular adverse events than intravitreal corticosteroid and better visual outcomes when corticosteroids are given 6-monthly. Prompt treatment is associated with better visual outcomes.…”

Section: Clinical Recommendations For Crvomentioning

confidence: 99%

“…As in eyes with CRVO, anti-VEGF agents are considered first line treatment for eyes with MO due to BRVO, supporting previous meta-analyses despite different inclusion criteria. 8,46,49 Again, prompt treatment is paramount in order to gain maximum visual outcomes. 20,32,35 The anti-VEGF agent used does not appear to influence outcomes.…”

Section: Clinical Recommendations For Brvomentioning

confidence: 99%

“…As MO is the primary cause of visual loss in patients with RVO, various treatments have been trialled aimed at treating MO due to RVO. 8 Prior to the advent of intravitreal therapy, there was little evidence of any effective treatment to improve vision in eyes with MO due to CRVO. Whereas macular laser offered modest improvement in eyes with BRVO.…”

Section: Introductionmentioning

confidence: 99%

“…The upregulation of vascular endothelial derived growth factor can also lead to further progression of retinal ischaemia. As MO is the primary cause of visual loss in patients with RVO, various treatments have been trialled aimed at treating MO due to RVO 8 . Prior to the advent of intravitreal therapy, there was little evidence of any effective treatment to improve vision in eyes with MO due to CRVO.…”

Section: Introductionmentioning

confidence: 99%

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Management of macular oedema due to retinal vein occlusion: An evidence‐based systematic review and meta‐analysis

Cornish

Zagora

Spooner³

et al. 2023

Clinical Exper Ophthalmology

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Background Central retinal vein occlusion and branch retinal vein occlusion are common causes of visual loss due to associated macular oedema. The aim of this review was to assess the effectiveness of interventions improving vision and treating macular oedema in central retinal vein occlusion and branch retinal vein occlusion. Methods Medical search engines and clinical trial registries were systematically searched. Randomised clinical trials with ≥90 eyes and real‐world outcome studies with ≥100 eyes each with ≥6 months follow‐up were included. Results There were 11 randomised controlled trials evaluating treatments for central retinal vein occlusion which met the inclusion criteria and 10 for branch retinal vein occlusion. There were 10 real world outcome studies of central retinal vein occlusion and 5 real world outcome studies of branch retinal vein occlusion. Meta‐analysis was performed on studies that met the defined inclusion criteria. Main outcomes were change in visual acuity at 6‐, 12‐, 24‐ and 36 months by treatment. Conclusions Intravitreal anti‐vascular endothelial derived growth factor is recommended as first line treatment over intravitreal corticosteroid due to its effectiveness and lower rate of ocular adverse events. Best outcomes are achieved when intravitreal treatment is started early. Macular laser may have an adjunctive role in branch retina vein occlusion but not central retinal vein occlusion.

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Section: Discussionsupporting

confidence: 88%

Section: Clinical Recommendations For Crvomentioning

confidence: 99%

Section: Clinical Recommendations For Brvomentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Management of macular oedema due to retinal vein occlusion: An evidence‐based systematic review and meta‐analysis

Cornish

Zagora

Spooner³

et al. 2023

Clinical Exper Ophthalmology

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Aflibercept im klinischen Alltag: die AURIGA-Studie

Wachtlin,

Kaymak,

Hoerauf

et al. 2024

Ophthalmologie

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Zusammenfassung Hintergrund AURIGA ist die größte prospektive Real-World-Studie zur Behandlung eines Makulaödems (MÖ) nach retinalem Venenverschluss (RVV) oder eines diabetischen Makulaödems mit intravitrealem Aflibercept 2 mg (IVT-AFL). Hier werden die 24-Monats-Daten der deutschen behandlungsnaiven RVV-Kohorte mit MÖ präsentiert. Methoden Behandlungsnaive RVV-Patienten mit MÖ wurden mit IVT-AFL 2 mg in der klinischen Routine therapiert. Primärer Endpunkt war die mittlere Änderung des Visus (ETDRS-Buchstaben) zu Monat 12 gegenüber dem Ausgangswert. Die Analyse erfolgte deskriptiv. Ergebnisse Es wurden 130 Patienten mit RVV (n = 61 [46,9 %] mit Zentralvenenverschluss, n = 69 [53,1 %] mit Venenastverschluss) untersucht. Im Mittel (± SD) verblieben die RVV-Patienten für 18,4 ± 7,4 Monate in der Studie. Der mittlere Visusgewinn [95 % Konfidenzintervall] betrug in der Gesamtkohorte +10,9 [7,5; 14,2] Buchstaben zu Monat 12 und +9,7 [6,1; 13,3] zu Monat 24 (Baseline 56,5 ± 18,9 Buchstaben). Nach 24 Monaten hatten 67 % der RVV-Patienten ≥5 Buchstaben, 40 % ≥ 15 Buchstaben gewonnen. Von Baseline betrug die mittlere Injektionszahl 4,4 ± 1,3 bis Monat 6, 6,2 ± 2,7 bis Monat 12 und 8,2 ± 4,5 bis Monat 24. Die durchschnittliche Reduktion der zentralen Netzhautdicke (Ausgangswert 507 ± 177 µm) betrug in der Gesamtkohorte −206 (−252; −160) µm nach 12 Monaten und −219 (−263; −175) µm nach 24 Monaten. Das Sicherheitsprofil entsprach dem früherer Studien. Diskussion In der deutschen AURIGA-Kohorte behandlungsnaiver Patienten mit MÖ infolge RVV unter IVT-AFL-2 mg-Behandlung zeigten sich im klinischen Alltag ein rascher und klinisch relevanter Visusgewinn sowie eine Reduktion der zentralen Netzhautdicke. Diese wurden trotz niedriger Injektionsfrequenz ab Monat 6 über 24 Monate weitestgehend erhalten.

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Real-World Management of Macular Edema Secondary to Retinal Vein Occlusion with Intravitreal Aflibercept: 24-month Results from the AURIGA Observational Study

Giocanti-Aurégan,

Donati,

Hoerauf

et al. 2023

Ophthalmol Ther

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Introduction AURIGA is the largest real-world study to date to evaluate intravitreal aflibercept (IVT-AFL) treatment of diabetic macular edema or macular edema secondary to retinal vein occlusion (RVO) in routine clinical practice. Here, we report the 24-month outcomes in the RVO cohort from France, Germany, Italy, and Taiwan. Methods AURIGA (NCT03161912) was a prospective observational study. Eligible patients with RVO were enrolled for whom the decision to treat with IVT-AFL had already been made by the attending physician. Patients were treated with IVT-AFL for up to 24 months at physician discretion according to local practice. The primary endpoint was mean change in visual acuity (VA; Early Treatment Diabetic Retinopathy Study [ETDRS] letters) from baseline to month (M) 12. All statistical analyses were descriptive. Results In 554 treatment-naïve and 65 previously treated patients with RVO, the respective mean (95% confidence interval) change in VA from baseline was + 12.5 (10.8, 14.3) and + 7.9 (3.3, 12.6) letters by M12 and + 11.4 (9.4, 13.3) and + 4.4 (− 0.6, 9.5) letters by M24 (baseline mean ± standard deviation: 51.0 ± 21.9 and 51.9 ± 20.4 letters); 44.0% of treatment-naïve and 27.9% of previously treated patients reported ≥ 15-letter gains by M24. By M24, the mean change in central retinal thickness from baseline was − 247 (− 267, − 227) µm in treatment-naïve patients and − 147 (− 192, − 102) µm in previously treated patients. From baseline to M6, M12, and M24, treatment-naïve patients received a total of 4.0 ± 1.3, 5.5 ± 2.5, and 6.9 ± 4.2 injections, respectively, and previously treated patients received 3.8 ± 1.5, 5.0 ± 2.2, and 6.3 ± 3.7 injections, respectively. The safety profile of IVT-AFL was consistent with that of previous studies. Conclusions In AURIGA, patients with RVO experienced clinically relevant functional and anatomic improvements following IVT-AFL treatment in routine clinical practice. These improvements were largely maintained in treatment-naïve patients over the 24-month study despite the decreasing treatment frequency, suggesting long-term durability of IVT-AFL treatment outcomes. Infographic available for this article. Trial Registration ClinicalTrials.gov Identifier: NCT03161912 (May 19, 2017). Infographic Supplementary Information The online version contains supplementary material available at 10.1007/s40123-023-00830-w.

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Long-term outcomes for patients treated for macular oedema secondary to retinal vein occlusion: a systematic review

Cited by 7 publications

References 35 publications

Management of macular oedema due to retinal vein occlusion: An evidence‐based systematic review and meta‐analysis

Management of macular oedema due to retinal vein occlusion: An evidence‐based systematic review and meta‐analysis

Aflibercept im klinischen Alltag: die AURIGA-Studie

Real-World Management of Macular Edema Secondary to Retinal Vein Occlusion with Intravitreal Aflibercept: 24-month Results from the AURIGA Observational Study

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