Twelve-month outcomes in patients with retinal vein occlusion treated with low-frequency intravitreal ranibizumab

Abstract

PurposeThe purpose of this study was to determine the clinical efficacy of low-frequency intravitreal ranibizumab to treat macular edema due to retinal vein occlusion (RVO).Patients and methodsThis was a retrospective examination of cases that received intravitreal ranibizumab for untreated RVO over a period of 12 months. Instead of the conventional three monthly injections, injections were given once during the introductory period. If the recurrence of macular edema was diagnosed during the monthly visit, additional injections were given as needed. There were 21 eyes of 21 patients with branch RVO (BRVO) and ten eyes of ten patients with central RVO (CRVO). The parameters examined included the number of injections over the 12-month period, improvements in best-corrected visual acuity (BCVA), and the central macular thickness (CMT). For BRVO, preinjection parameters that had an effect on the prognosis of BCVA after the 12-month period were also examined.ResultsThe total mean number of injections over the 12-month period was 3.4 for CRVO and 2.1 for BRVO. For CRVO, the BCVA in log minimum angular resolution changed from a preinjection value of 0.80 to 0.55 at 12 months. For BRVO, the change was from 0.51 to 0.30. For all diseases, BCVA improved after 12 months compared with the preinjection values (P<0.05). There was improvement in the CMT, and the CRVO changed from 765.0 μm at preinjection to 253.5 μm 12 months later. BRVO changed from 524.1 to 250.1 μm, and pre-injection BCVA was associated with a prognosis of visual acuity after 12 months of the initial injection (P=0.0485).ConclusionEven with a low number of injections during the introductory period, there were still improvements in both visual acuity and CMT in RVO patients after 12 months, indicating that it was an effective treatment.

Real-Life Clinical Effectiveness of Razumab® (the World’s First Biosimilar of Ranibizumab) in Retinal Vein Occlusion: A Subgroup Analysis of the Pooled Retrospective RE-ENACT Study

“…Another retrospective, observational, multicenter (n = 200) study showed a significant decrease in CMT at 6 months after ranibizumab treatment [37]. Similarly, a significant reduction in CMT was observed in BRVO (n = 21) and CRVO (n = 10) patients after ranibizumab treatment [38]. Overall, the subgroup analysis demonstrates effects of the ranibizumab biosimilar in functional and anatomical visual improvements in BCVA and CMT, and the degree of improvement was similar to that reported in several studies with ranibizumab administration.…”

Ranibizumab versus Aflibercept in Macular Edema Secondary to Retinal Vein Occlusion in Real Life: A Retrospective Case Control Study

“…At conclusion of the follow-up period, the 2 groups had similar results in visual outcomes. Skanishi et al evaluated low frequency IVR treatment in ME secondary to RVO, and after a follow-up of 12 months, they reported that patients received mean of 3.4 injections in CRVO group, and 2.1 in BRVO group, which was, again, very low in comparison to multicenter studies (16). Although number of injections was very low, change in VA from baseline to month 6 was reported to be 2.8 lines, and 2.5 lines at month 12 in CRVO group, and 1.8 lines at month 6, and 2.1 lines at month 12 in BRVO group, which were comparable outcomes to aforementioned studies ( Figure 3) (9-13, 16).…”

“…Subsequently, various treatment regimens were pursued (9)(10)(11)(12)(13).Loading phase of anti-VEGF drugs has been investigated in some studies, and low-frequency ranibizumab treatment was found to be effective (15). It is worth recalling here that in real-life setting, it is not always possible to conform to strict follow-up and treatment criteria (14)(15)(16)(17)(18)(19)(20). Low visit and injection frequency observed in real life usually leads to decrease in visual and anatomical outcomes in the patients with neovascular age-related macular degeneration (nAMD) or diabetic macular edema (DME) (18,19).…”

“…However, it is usually not possible to replicate these strict criteria in real-life practice (14)(15)(16). Number of injections, especially, has been found to be very low in real-life studies in comparison with multicenter research (14)(15)(16). In this study, efficacy of ranibizumab and aflibercept in real-life practice were compared.…”

“…In pivotal multicenter studies in which strict follow-up and treatment criteria were observed, successful treatment outcomes have been reported (9)(10)(11)(12)(13). However, it is usually not possible to replicate these strict criteria in real-life practice (14)(15)(16). Number of injections, especially, has been found to be very low in real-life studies in comparison with multicenter research (14)(15)(16).…”