Time to Clinically Significant Visual Acuity Gains after Ranibizumab Treatment for Retinal Vein Occlusion

Thach, Allen B.; Yau, Linda; Hoang, Carol; Tuomi, Lisa

doi:10.1016/j.ophtha.2013.11.022

Cited by 89 publications

(75 citation statements)

References 23 publications

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“…There were 14 patients who received less than six total injections before the switch. Although the time for clinically significant VA gain in the CRUISE study was 5.2 months, 21 we decided to include patients in this study with a minimum of three prior injections of bevacizumab or ranibizumab based on the poor visual outcome of the early non-responders reported by Bhisitkul et al 8 The limitations of this study include the lack of standardized VA measurement, the lack of masking for the VA and OCT measurements, and the relatively small size of the study population. Its retrospective design naturally excludes a controlled environment for this cohort of patients as well as standardization of the treatment protocol.…”

Section: Discussionmentioning

confidence: 93%

Intravitreal aflibercept for macular oedema secondary to central retinal vein occlusion in patients with prior treatment with bevacizumab or ranibizumab

Papakostas

Lim

Zyl

et al. 2015

Eye

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Purpose To report the visual and anatomic outcomes in eyes with macular oedema (MO) secondary to central retinal vein occlusion (CRVO) that were switched from either intravitreal bevacizumab or ranibizumab to intravitreal aflibercept. Methods Two-center retrospective chart review. Eyes with MO secondary to CRVO that received a minimum of three intravitreal injections of bevacizumab or ranibizumab and were switched to intravitreal aflibercept for persistent or recurrent MO not responding to either bevacizumab and/or ranibizumab. Results In all 42 eyes of 42 patients were included in the study. The median visual acuity before the switch was 20/126, 1 month after the first injection of aflibercept 20/89 (P = 0.0191), and at the end of the follow-up 20/100 (P = 0.2724). The median CRT before the switch was 536 μm, 1 month after the first injection of aflibercept 293.5 μm (P = 0.0038), and at the end of the follow-up 279 μm (P = 0.0013 compared to before the switch). The median number of weeks between injections before the switch was 5.6 and after the switch was 7.6 (Po0.0001). Conclusion Converting eyes with refractory MO due to CRVO to aflibercept can result in stabilization of the vision, improved macular anatomy, and extension of the injection interval.

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Section: Discussionmentioning

confidence: 93%

Intravitreal aflibercept for macular oedema secondary to central retinal vein occlusion in patients with prior treatment with bevacizumab or ranibizumab

Papakostas

Lim

Zyl

et al. 2015

Eye

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“…For the treatment of cystoid macular oedema (CME) resulting from RVO, there are several options available like intravitreal injections of anti-vascular growth factor (anti-VEGF) substances such as ranibizumab, bevacizumab, and aflibercept in addition to retinal laser photocoagulation and intraocular corticosteroids [1, 2]. The BRAVO and CRUISE studies have shown a significant improvement of best corrected visual acuity (BCVA) after treatment with intravitreal ranibizumab [3-7]. In the RETAIN study, the visual acuity (VA) effect of ranibizumab was bigger in branch retinal vein occlusion (BRVO) than in central retinal vein occlusion (CRVO) after 4 years [8].…”

Section: Introductionmentioning

confidence: 99%

Spectral-Domain Optical Coherence Tomography-Driven Treat-and-Extend and Pro Re Nata Regimen in Patients with Macular Oedema due to Retinal Vein Occlusion: 24-Month Evaluation and Outcome Predictors

et al. 2018

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Purpose: To analyse the efficacy and outcome predictors of ranibizumab using a spectral-domain optical coherence tomography (SD-OCT)-driven treat-and-extend regimen (TER) versus SD-OCT-driven pro re nata regimen (PRN) in patients with cystoid macular oedema (CME) due to branch or central retinal vein occlusion (BRVO, CRVO). Methods: Retrospective, consecutive case series. Evaluation included best corrected visual acuity (BCVA), morphological parameters on SD-OCT, and treatment frequency. Results: From baseline to months 12, 18, and 24, BCVA improved by 16.6 ± 13.1, 15.5 ± 14.4, and 16.6 ± 15.8 letters, respectively, in TER (n = 45), compared to 11.3 ± 17.0, 11.0 ± 15.0, and 10 ± 20.5 letters in PRN (n = 31) (p = 0.152, p = 0.237, p = 0.172). The mean reduction in central retinal thickness was –261 ± 189, –272 ± 188, and –264 ± 158 μm, respectively, in TER, compared to –130 ± 196, –140 ± 210, and –166 ± 207 μm in PRN (p = 0.006, p = 0.017, p = 0.064). 59% (53%) of TER and 22% (17%) of PRN patients showed no intra- or subretinal fluid on SD-OCT at 12 (24) months. Using TER, the maximum recurrence-free treatment interval increased from 8.9 ± 2.3 weeks at 12 months to 9.8 ± 2.3 and 10.5 ± 2.7 weeks at 18 and 24 months, respectively. The number of injections was significantly higher in the TER than in the PRN group. Conclusions: In CME, due to BRVO/CRVO, TER provides better morphological outcome using more injections than PRN.

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“…But data from the Standard Care vs Corticosteroid for Retinal Vein Occlusion (SCORE) trail also demonstrade limited benefit for laser therapy at 12 months with the median gain of six letters at 12 months. Furthermore, poor vision persists despite photocoagulation treatment in many patients, and its use is not recommended until 3 months after development of BRVO [18,19,31,32] .…”

Section: Macular (Grid) Laser Photocoagulationmentioning

confidence: 99%

“…Laser photocoagulation had been used for additional treatment in some studies such as in BRAVO study patients not achieving sufficient improvements at month 3 could receive laser therapy, even according to BVOS the benefits of laser therapy are minimal within the first year of treatment thus possibly confounding the results from month 3 onwards [30][31][32] .…”

Section: Macular (Grid) Laser Photocoagulationmentioning

confidence: 99%

Laser Photocoagulation in Retinal Vein Occlusion

Altıntaş

2016

International Journal of Ophthalmic Research

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Retinal vein occlusion (RVO) is the second most common retinal vascular disease after diabetic retinopathy which is a frequently devastating cause of blindness in mainly in older patients over 60 years of age. Its prevalence changes according to studies in overall populations are from 5.2 to 16 per 1,000 [1][2][3][4] . People with end-organ damage caused by diabetes mellitus and hypertension have strongly increased risk for RVO. The majority of individual diagnosed with RVO defined more than one component of the systemic vascular and metabolic disease, such as the presence of Diabetes Mellitus, hyper tension and high serum lipids. Coexisting metabolic diseases are important factors for prognosis and laser treatment response [1][2][3][4][5] .There are mainly two types of RVO according to occlusion side branch retinal vein occlusion (BRVO) and central retinal vein occlusion (CRVO). In BRVO occlusion is located in the any branch of the retinal vein system, while occlusion located exactly in the central retinal vein in CRVO. Different researches shows that BRVO is 4-6 times more common than CRVO and it has been estimated that there are around 80 new cases of CRVO/million population/ year. Although CRVO most commonly affects one eye, in around 10% of patients the disease affects both eyes [2][3][4][5][6][7] . Even RVO was first recognized over a century ago, the exact pathogenesis is not completely nderstood and therefore exact treatment methods not found yet. The condition may be due to a combination of three systemic changes known as Virchow's triad: (1) hemodynamic changes such as venous stasis; (2) degenerative changes of the vessel wall; and (3) blood hypercoagulability [6,8,9] . According to clinical findings, fundus appearance, Fluorescein angiography and electrophisiological results Hayreh futher divided RVO into three types: (1) BRVO is divided further into major BRVO (a) and macular BRVO (b) according to localization; (2) CRVO is divided into ischemic and non-ischemic types due to presence or absence of ABSTRACTVisual acuity is primarily decreased secondary to macular edema, retinal ischemia and complications of neovascularisation in both BRVO and CRVO. Panretinal Laser photocoagulation or Focal photocoagulation is an effecting treatment for neovascularisation and prevention of complications of neovascularisation by ablating ischemic retina in either BRVO or CRVO. But Macular Laser photocoagulation can be use for treatment of non ischaemic macular oedema in only BRVO either alone or combination with other Anti-VEGF or Anti-inflammatory medication.

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Time to Clinically Significant Visual Acuity Gains after Ranibizumab Treatment for Retinal Vein Occlusion

Cited by 89 publications

References 23 publications

Intravitreal aflibercept for macular oedema secondary to central retinal vein occlusion in patients with prior treatment with bevacizumab or ranibizumab

Intravitreal aflibercept for macular oedema secondary to central retinal vein occlusion in patients with prior treatment with bevacizumab or ranibizumab

Spectral-Domain Optical Coherence Tomography-Driven Treat-and-Extend and Pro Re Nata Regimen in Patients with Macular Oedema due to Retinal Vein Occlusion: 24-Month Evaluation and Outcome Predictors

Laser Photocoagulation in Retinal Vein Occlusion

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