Ranibizumab for Macular Edema Due to Retinal Vein Occlusions; Implication of VEGF as a Critical Stimulator

Campochiaro, Peter A.; Hafiz, Gulnar; Shah, Syed Mahmood; Nguyen, Quan Dong; Ying, Howard S.; Diana, V; Quinlan, Edward; Zimmer-Galler, Ingrid; Haller, Julia A.; Solomon, Sharon D.; Sung, Jennifer; Hadi, Yasmin; Janjua, Kashif; Jawed, Nida; Choy, David F.; Arron, Joseph R.

doi:10.1038/sj.mt.6300416

Cited by 58 publications

(87 citation statements)

References 21 publications

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“…3,5,6,8,11) in the IBe group classified as ischaemic CRVO had been treated with panretinal photocoagulation during the follow-up periods as the prophylactic management of the neovascular sequelae. Six patients (cases 10,17,18,19,20,21) received one-time reinjection of triamcinolone acetonide between baseline and the follow-up. Six patients (cases 1, 2, 5, 7, 8, 13) received reinjection once and one patient (case 6) received three reinjections of bevacizumab within the follow-up period.…”

Section: Discussionmentioning

confidence: 99%

“…Recurrence of macular oedema and a concomitant decrease in visual acuity occurred in six cases of the ITA group (cases 10,17,18,19,20,21) with an average of 226.50 ± 61.50 days (ranging from 133 to 295 days) postoperatively, and in seven cases of the IBe group (cases 1, 2, 5, 6, 7, 8, 13) with an average of 86.78±46.80 days (ranging from 35 to 168 days) postoperatively. Subsequently, all these six patients in the ITA group accepted a second injection of triamcinolone acetonide.…”

Section: Outcome Measuresmentioning

confidence: 99%

“…Recently, the effect of intravitreal injection of triamcinolone acetonide [10][11][12][13][14][15][16][17] and of anti-VEGF agents, such as bevacizumab 18 and ranibizumab, 19 has been widely discussed. They have been reported to be associated with short-term favourable anatomic and functional improvement in some patients with macular oedema due to CRVO.…”

Section: Introductionmentioning

confidence: 99%

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Intravitreal triamcinolone acetonide vs bevacizumab for treatment of macular oedema due to central retinal vein occlusion

2009

Eye

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Section: Discussionmentioning

confidence: 99%

Section: Outcome Measuresmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Intravitreal triamcinolone acetonide vs bevacizumab for treatment of macular oedema due to central retinal vein occlusion

2009

Eye

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“…1,2 Although the exact mechanism of ME in BRVO is not fully understood, ME is thought to be caused by the flux of fluid from the blood vessels to the tissue, because of breakdown of the blood-retinal barrier as a result of damage to the tight junctions of capillary endothelial cells, enhanced expression of inflammatory cytokines such as prostaglandins and interleukin 6, and increased secretion into the vitreous of vasopermeability factors such as vascular endothelial growth factor (VEGF) produced in the retina. [3][4][5][6][7] Several recent studies have reported that VEGF has an important role in the pathophysiology of ME by inducing blood-retinal barrier breakdown and increasing vascular permeability. [6][7][8][9] Elevated VEGF level in vitreous has been reported in patients with BRVO, and this elevation was correlated with the severity of ME and area of non-perfusion.…”

Section: Introductionmentioning

confidence: 99%

“…[3][4][5][6][7] Several recent studies have reported that VEGF has an important role in the pathophysiology of ME by inducing blood-retinal barrier breakdown and increasing vascular permeability. [6][7][8][9] Elevated VEGF level in vitreous has been reported in patients with BRVO, and this elevation was correlated with the severity of ME and area of non-perfusion. 7 These correlations prompted interest in the use of pharmacologic inhibition of VEGF for treatment of ME.…”

Section: Introductionmentioning

confidence: 99%

Combination therapy of intravitreal bevacizumab with single simultaneous posterior subtenon triamcinolone acetonide for macular edema due to branch retinal vein occlusion

Moon

Kim

Sagong

2016

Eye

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Purpose To evaluate efficacy and safety of combination therapy of intravitreal bevacizumab (IVB) with single simultaneous posterior subtenon triamcinolone acetonide (STA) for treatment of macular edema (ME) secondary to branch retinal vein occlusion (BRVO). Methods This was a prospective, randomized, interventional comparative study conducted in 45 eyes with ME secondary to BRVO who were treated primarily with IVB 1.25 mg (23 eyes, IVB group) or combination therapy of IVB 1.25 mg with a single simultaneous STA 40 mg (18 eyes, IVB/STA group). Reinjections were performed with IVB if optical coherence tomography (OCT) showed recurrent ME associated with decreased visual acuity. The main outcome measurement was the number of additional IVB injections, and changes of best-corrected visual acuity (BCVA) and central macular thickness (CMT) during a 6-month follow-up period were compared. Results BCVA showed significant improvement in two groups at 6 months. In addition, CMT showed significant decrease in two groups at 6 months. No significant differences in the change of BCVA and CMT at 6 months after injection (P = 0.973, P = 0.639) were observed between the two groups. A statistically significant difference was found regarding the number of additional IVB injections (IVB group 0.96 ± 0.83; IVB/STA group 0.44 ± 0.70, P = 0.034).Conclusion Although combination therapy of IVB with a single simultaneous STA for treatment of ME secondary to BRVO did not affect the visual outcomes compared with IVB monotherapy, it had a benefit of reducing the number of additional IVB injections.

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Anti-vascular endothelial growth factor for macular oedema secondary to central retinal vein occlusion

Braithwaite

Nanji²,

Lindsley

et al. 2014

Cochrane Database of Systematic Reviews

102

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Background Central retinal vein occlusion (CRVO) is a relatively common retinal vascular disorder in which macular oedema may develop, with a consequent reduction in visual acuity. Until recently there has been no treatment of proven benefit, but growing evidence supports the use of anti-vascular endothelial growth factor (anti-VEGF) agents. Objectives To investigate the effectiveness and safety of anti-VEGF therapies for the treatment of macular oedema secondary to CRVO. Search methods We searched CENTRAL (which contains the Cochrane Central Register of Controlled Trials (CENTRAL) and the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2013, Issue 10), Ovid MEDLINE (January 1950 to October 2013), EMBASE (January 1980 to October 2013), Latin American and Caribbean Health Sciences Literature Database (LILACS) (January 1982 to October 2013), Cumulative Index to Nursing and Allied Health Literature (CINAHL) (January 1937 to October 2013), OpenGrey, OpenSIGLE (January 1950 to October 2013), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), Clinical-Trials.gov (www.clinicaltrials.gov), the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en) and Web of Science Conference Proceedings Citation Index-Science (CPCI-S). There were no language or date restrictions in the electronic search for trials. The electronic databases and clinical trials registers were last searched on 29th October 2013. Selection criteria We considered randomised controlled trials (RCTs) that compared intravitreal anti-VEGF agents of any dose or duration to sham injection or no treatment. We focused on studies that included individuals of any age or gender and a minimum of six months follow-up. Data collection and analysis Two review authors independently assessed trial quality and extracted data. The primary outcome was the proportion of participants with a gain in best-corrected visual acuity (BCVA) from baseline of greater than or equal to 15 letters (3 lines) on the Early Treatment of Diabetic Retinopathy Study (ETDRS) chart. Secondary outcomes included the proportion of participants with a loss of 15 letters or more of BCVA, the mean change from baseline BCVA, the mean change in central retinal thickness (CRT), the number and type of complications or adverse outcomes, and the number of additional interventions administered. Where available, we also presented quality of life and economic data. Main results We found six RCTs that met the inclusion criteria after independent and duplicate review of the search results. These RCTs included 937 participants and compared outcomes at six months to sham injection for four anti-VEGF agents: aflibercept (VEGF Trap-Eye, Eylea), bevacizumab (Avastin), pegaptanib sodium (Macugen) and ranibizumab (Lucentis). Three trials were conducted in Norway, Sweden and the USA, and three trials were multicentre, one including centres in the USA, Canada, India, Israel, Argentina and Columbia, a second including centres in the US...

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Ranibizumab for Macular Edema Due to Retinal Vein Occlusions; Implication of VEGF as a Critical Stimulator

Cited by 58 publications

References 21 publications

Intravitreal triamcinolone acetonide vs bevacizumab for treatment of macular oedema due to central retinal vein occlusion

Intravitreal triamcinolone acetonide vs bevacizumab for treatment of macular oedema due to central retinal vein occlusion

Combination therapy of intravitreal bevacizumab with single simultaneous posterior subtenon triamcinolone acetonide for macular edema due to branch retinal vein occlusion

Anti-vascular endothelial growth factor for macular oedema secondary to central retinal vein occlusion

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