Sustained Benefits of Ranibizumab with or without Laser in Branch Retinal Vein Occlusion

Tadayoni, Ramin; Waldstein, Sebastian M.; Boscia, Francesco; Gerding, H.; Gekkieva, Margarita; Barnes, Elizabeth H; Gupta, Ayan Das; Wenzel, Andreas; Pearce, Ian

doi:10.1016/j.ophtha.2017.06.027

Cited by 97 publications

(118 citation statements)

References 14 publications

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“…In the RETAIN study, which examined the long-term outcomes after IVR injection in eyes with a BRVO, the final visual acuity was not significantly different between the eyes with resolved macular oedema and eyes with unresolved macular oedema after 4 years 8. In addition, the BRIGHTER study reported that the presence of macular ischaemia did not affect the BCVA outcome after 2 years 9. It was found that the anti-VEGF therapy for macular oedema is effective and can decrease the damages of the photoreceptors 27–29.…”

Section: Discussionmentioning

confidence: 99%

Correlation between reduction in macular vessel density and frequency of intravitreal ranibizumab for macular oedema in eyes with branch retinal vein occlusion

et al. 2018

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Section: Discussionmentioning

confidence: 99%

Correlation between reduction in macular vessel density and frequency of intravitreal ranibizumab for macular oedema in eyes with branch retinal vein occlusion

et al. 2018

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“…; Tadayoni et al. ), early treatment with VEGF inhibitors resulted in better treatment outcome than deferred treatment. Thus, early initiation of treatment with VEGF inhibitors should probably be a preference when treating MO induced by BRVO.…”

Section: Discussionmentioning

confidence: 98%

Is there still a role of macular laser treatment in branch retinal vein occlusion in the era of intravitreal injections?

Stenner

Frederiksen

Grauslund

2019

Acta Ophthalmologica

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We aimed to evaluate whether macular laser still has a role in the treatment of macular oedema (MO) caused by branch retinal vein occlusion (BRVO) and provide an overview of recent studies on commonly available treatment options. A literature search was last conducted in PubMed on 26 February 2019, limited to human randomized controlled trials published in English since 2008. Seventeen articles addressing 13 trials were included in this assessment. In trials evaluating intravitreal corticosteroid and macular laser, triamcinolone was non-inferior to laser in regard to visual acuity (VA) and central retinal thickness (CRT) outcomes. Combination treatment of dexamethasone and laser resulted in better VA and lower CRT after 6 months. In trials evaluating vascular endothelial growth factor (VEGF) inhibitors versus macular laser treatment, or sham and rescue laser, better VA and CRT of VEGF inhibition treatment was consistently reported. Results of combination treatment versus VEGF inhibition monotherapy were inconsistent, with four of six studies reporting comparable outcomes and injection burden. Study comparison was affected by considerable differences in study design and inadequate reporting of laser protocol and rescue laser. Studies evaluating angiostatic treatment as monotherapy largely report the use of rescue laser, indicating that some patients would benefit from supplemental laser treatment even in the era of intravitreal therapy. Thus, we suggest further studies on optimal design of combination therapy prioritizing longer follow-up time to sufficiently evaluate the delayed effect of laser.

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“…Scatter photocoagulation has been added in the treatment of RVO to reduce the burden of intravitreal anti-VEGF injections due to retinal ischemia and the high VEGF levels. However, some studies including the RELATE study revealed that adding laser did not result in the better visual and anatomical outcomes or reduce the need for frequent anti-VEGF injections [49][50][51]. In terms of the treatment regimen, the anti-VEGF therapy was frequently initiated with monthly scheduled injections for six doses, and then the monthly asneeded regimen was usually applied to maintain an optimum level of visual function and macular thickness.…”

Section: Expert Commentarymentioning

confidence: 99%

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

Sangroongruangsri

Ratanapakorn

et al. 2018

Expert Review of Clinical Pharmacology

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Anti-vascular endothelial growth factor (VEGF) therapy has become the most commonly used treatment for macular edema secondary to retinal vein occlusion (RVO). Although its superior efficacy as compared to other interventions has been proven, there is a lack of evidence for relative efficacy among anti-VEGF drugs. Areas covered: This work systematically reviewed and compared the efficacy of intravitreal bevacizumab, ranibizumab, and aflibercept for treating macular edema due to RVO. PubMed, EMBASE, and the Cochrane Library were searched from their inception until October 2017. Eleven randomized controlled trials (18 articles; 1830 adult patients) were identified. The proportion of patients who gained at least 15 letters in best-corrected visual acuity (BCVA), mean change from baseline in BCVA, and mean change from baseline in central macular thickness (CMT) were reported and these efficacy outcomes at 6 months were analyzed in network meta-analysis. Expert commentary: Apparently, bevacizumab, ranibizumab, and aflibercept were significantly superior to sham injection in terms of BCVA improvement and CMT reduction and had good safety profiles. However, there were no statistically significant differences in any outcomes among anti-VEGF drugs. In selecting an anti-VEGF drug for individual patients, other factors including affordability, drug availability, and patient characteristics should be considered.

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Sustained Benefits of Ranibizumab with or without Laser in Branch Retinal Vein Occlusion

Cited by 97 publications

References 14 publications

Correlation between reduction in macular vessel density and frequency of intravitreal ranibizumab for macular oedema in eyes with branch retinal vein occlusion

Correlation between reduction in macular vessel density and frequency of intravitreal ranibizumab for macular oedema in eyes with branch retinal vein occlusion

Is there still a role of macular laser treatment in branch retinal vein occlusion in the era of intravitreal injections?

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

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