Management of Retinal Vein Occlusion – Consensus Document

Coscas, G.; Loewenstein, Anat; Augustin, Albert J.; Bandello, Francesco; Parodi, Maurizio Battaglia; Lanzettà, Marco; Monés, Jordi; Smet, Marc D. de; Soubrane, G.; Staurenghi, Giovanni

doi:10.1159/000327391

Cited by 109 publications

(100 citation statements)

References 244 publications

(235 reference statements)

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“…Secondary analysis of all trials shows that early treatment of macular edema secondary to RVO is more effective than delayed treatment [1,34] . The sooner the macular edema is treated, the better the structural response (resolved edema).…”

Section: Time To Treatmentmentioning

confidence: 99%

“…In GENEVA, only 16.4% of patients were treated with intravitreal dexamethasone implant after a disease duration < 3 months, the majority presented with macular edema duration between 3 and 6 months (51.3%) or longer (32.3%). In trials investigating triamcinolone (SCORE BRVO/ CRVO) and anti-VEGF agents (BRAVO, CRUISE, GALILEO, COPERNICUS) the proportion of patients with a duration of macular edema < 3 months was significantly higher: SCORE BRVO > 50%, SCORE CRVO 36%, BRAVO 51.5-53.8%, CRUISE 51.5-61.5% [1,34] . Thus, comparison between trials must be performed with caution.…”

Section: Prognosis -Predictive Factorsmentioning

confidence: 99%

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Anti-VEGF Therapy for Retinal Vein Occlusion

Danzmann¹,

Pielen²,

Bajor³

2016

International Journal of Ophthalmic Research

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Current recommendations for treatment of macular edema secondary to BRVO or CRVO favour intravitreal anti-VEGF agents compared to intravitreal steroids. An upload of 3 injections is reasonable to address intravitreal VEGF levels. Prognosis for visual improvement is good and time to treatment is crucial. There is evidence that an early targeted laser photocoagulation of ischemic areas may lead to additional treatment effects, less injections and improved prognosis if administered early after RVO. In the course of the disease patients must be frequently monitored for recurrence of edema to initiate re-treatment and for conversion to ischemic RVO. Ischemia, proliferations and rubeosisiridis must not be treated with intravitreal anti-VEGF alone. Laser treatment of peripheral retina remains the standard-of-care to treat ischemia. In this article we review up-to-date information on intravitreal anti-VEGF therapy in RVO, international guidelines, safety and efficacy of treatment. We discuss new insights on factors that may improve prognosis or burden of intravitreal treatment. And we discuss the role of ischemia in RVO.

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Section: Time To Treatmentmentioning

confidence: 99%

Section: Prognosis -Predictive Factorsmentioning

confidence: 99%

Anti-VEGF Therapy for Retinal Vein Occlusion

Danzmann¹,

Pielen²,

Bajor³

2016

International Journal of Ophthalmic Research

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“…В настоящее время эффективно применяют сочетание интравитреального введения анти-VEGF-препаратов с ПЛК в борьбе с неоваску-лярными осложнениями после окклюзии вен сет-чатки [12].…”

Section: лечение неоваскулярных осложнений окклюзий ретинальных венunclassified

“…Так, в Европейском кон-сенсусе по ведению пациентов с РВО при выражен-ной (более 10 диаметров ДЗН), нарастающей ише-мии периферических отделов целесообразно вы-полнять раннюю ПЛК, поскольку данное состояние считается угрожающим по развитию неоваскуляри-зации УПК [12,33]. В 2012 г. G. Coscas и F. Bandello [34] к вышеперечисленным показаниям добавили низкий комплаенс пациента (невозможность еже-месячных осмотров) и тяжелую сопутствующую па-тологию (некомпенсированная артериальная гипер-тензия, системный атеросклероз, осложнившийся инфарктами или инсультами и т.д.).…”

Section: выводы и результаты исследованияunclassified

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Retinal vein occlusion management algorithm. Part 3. Neovascular complications

Nk²,

et al. 2015

Vestn. oftal'mol.

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Reading Speed Improvements in Retinal Vein Occlusion After Ranibizumab Treatment

et al. 2013

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IMPORTANCE Treatment of macular edema secondary to retinal vein occlusion with ranibizumab has been shown to improve visual acuity compared with macular laser or observation. It is important to determine whether these visual acuity improvements translate into measurable improvements in visual function. OBJECTIVE To examine the benefit of ranibizumab (Lucentis) on measured reading speed, a direct performance assessment, through 6 months in eyes of patients with macular edema after retinal vein occlusion (RVO). DESIGN Two multicenter, double-masked, phase 3 trials in which participants with macular edema after branch RVO or central RVO were randomized 1:1:1 to monthly sham, ranibizumab, 0.3 mg, or ranibizumab, 0.5 mg, for 6 months. SETTING Community-and academic-based ophthalmology practices specializing in retinal diseases. PARTICIPANTS Seven hundred eighty-nine eyes of 789 participants who were at least aged 18 years with macular edema secondary to retinal vein occlusion in the branch vein occlusion (BRAVO) and central vein occlusion (CRUISE) trials. INTERVENTIONS Eyes were randomized 1:1:1 to 1 of 3 groups for monthly injections for 6 months: sham (132 in BRAVO and 130 in CRUISE), intravitreal ranibizumab, 0.3 mg (134 in BRAVO and 132 in CRUISE), and intravitreal ranibizumab, 0.5 mg (131 in BRAVO and 130 in CRUISE). Patients were able to receive macular laser after 3 months if they met prespecified criteria. MAIN OUTCOMES AND MEASURES Reading speed in the study eye was measured with enlarged text (letter size equivalent to approximately 20/1500 at the test distance) at baseline and 1, 3, and 6 months. The number of correctly read words per minute (wpm) was reported. The reading speed test requires a sixth-grade reading level and does not account for literacy or cognitive state. RESULTS In patients with branch RVO, the mean gain for the 0.5-mg group was 31.3 wpm compared with 15.0 wpm in sham-treated eyes (difference, 16.3 wpm; P = .007) at 6 months. In patients with central RVO, the mean gain for the 0.5-mg group was 20.5 wpm compared with 8.1 wpm in sham-treated eyes (difference, 12.4 wpm; P = .01) at 6 months. A gain of 15 or more letters of best-corrected visual acuity letter score corresponded to an increase in reading speed of 12.3 wpm and 15.8 wpm in patients with branch and central RVO, respectively. CONCLUSIONS AND RELEVANCE These results suggest that patients with macular edema after RVO treated monthly with ranibizumab are more likely to have improvements in reading speed of the affected eyes through 6 months compared with sham treatment. These results demonstrate the relevance of the treatment benefit to functional visual gain. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00486018 and NCT00485836

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Management of Retinal Vein Occlusion – Consensus Document

Cited by 109 publications

References 244 publications

Anti-VEGF Therapy for Retinal Vein Occlusion

Anti-VEGF Therapy for Retinal Vein Occlusion

Retinal vein occlusion management algorithm. Part 3. Neovascular complications

Reading Speed Improvements in Retinal Vein Occlusion After Ranibizumab Treatment

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