Age-related differences in presentation and outcomes of anti-VEGF treatment of retinal vein occlusion

Dewan, Karan S.; Hentati, Firas; Greenlee, Tyler; Conti, Thais F.; Chen, Andrew X.; Hom, Grant L; Singh, Rishi P.

doi:10.1016/j.jcjo.2020.09.004

Cited by 4 publications

(4 citation statements)

References 9 publications

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“…Our data are in agreement with the findings of the SCORE2 trial 33 and a recently published paper by Battaglia Parodi et al 34 Dewan and colleagues, by contrast, concluded that there was no relationship between age at presentation of RVO and outcomes with intravitreal injections. 35 However, it is not possible to compare our results with this paper as the age stratification and the outcomes are different.…”

Section: Discussionmentioning

confidence: 82%

Long-term outcomes of anti-VEGF treatment of macular oedema due to retinal vein occlusions

Corazza

D'Alterio

Savastano

et al. 2022

European Journal of Ophthalmology

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Purpose retinal vein occlusion (RVO) is classified as either branch (BRVO) or central (CRVO) RVO. The gold standard treatment for macular oedema (MO) secondary to RVO is intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections. Our study aimed to compare ranibizumab and aflibercept outcomes over a maximum follow-up of five years. Methods this retrospective study assessed treatment-naïve RVO patients. Active disease was treated with three loading injections followed by a pro-re-nata (PRN) regimen of an anti-VEGF agent. Visual outcomes and injection frequency were analyzed, with patients stratified according to RVO subtype, anti-VEGF agent used, baseline vision, and age. Results 316 CRVO-affected eyes and 467 BRVO-affected eyes were analysed. Visual benefits between different treatments did not significantly differ, except in year 1 in ranibizumab-treated BRVO eyes. However, aflibercept-treated CRVO and BRVO eyes required significantly fewer injections during the follow up period. Furthermore, our results confirm that younger patients achieve better visual outcomes with fewer intravitreal injections. Overall, half of our patients did not require further injections after 1 year from diagnosis. Conclusion the results demonstrate that anti-VEGF treatment of RVO benefits vision for up to 5 years. Our findings are the first to suggest that compared to ranibizumab, fewer aflibercept injections may be required over five years follow up. Prospective randomised trials are needed to confirm this, alongside further attention to OCT scan features and the effect of patient demographics on treatment outcomes.

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Section: Discussionmentioning

confidence: 82%

Long-term outcomes of anti-VEGF treatment of macular oedema due to retinal vein occlusions

Corazza

D'Alterio

Savastano

et al. 2022

European Journal of Ophthalmology

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“…In contrast, some studies have suggested poorer visual outcomes in young patients due to the lack of anti-VEGF therapy [69]. However, a study by Dewan et al showed that the BCVA and CRT after anti-VEGF therapy between elderly and young patients at the final follow-up were not significantly different [70]. Eah et al reported that compared with elderly patients, young patients had a better BCVA (logMAR 0.37 ± 0.57 vs. 0.93 ± 1.02), thinner CRT at the last follow-up (272.8 ± 111.5 vs. 420.5 ± 523.0 lm, P = 0.007), and SRF (0% vs.15.1%, P = 0.004) and CME (8.2% vs. 34.9%, P \ 0.001) accounted for a lower proportion [18].…”

Section: Differences In Prognosismentioning

confidence: 97%

Clinical Features of Central Retinal Vein Occlusion in Young Patients

et al. 2022

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Retinal vein occlusion (RVO) is the second most common retinal vascular disease. Central RVO (CRVO), in which obstruction occurs posterior to the lamina cribrosa due to various causes, manifests with extensive venous tortuosity, dilatation of blood vessels in the four quadrants, and retinal hemorrhage. The presence of macular edema decreases visual acuity in patients with CRVO, especially in elderly patients with hypertension, hyperlipidemia, and diabetes. In the last decade, treatment modalities for CRVO have improved, with antivascular endothelial growth factor agents being widely used as treatment. However, there are cases of refractory or recurrent macular edema. Moreover, CRVO also occurs in young patients. This article reviews previous studies and case reports and summarizes the differences in etiological factors, clinical manifestations, treatment, and prognosis between young and elderly patients. Due to the low incidence of CRVO in young patients, clinical data from these age groups are limited. Hence, further studies are warranted to explore the differences between age groups to improve individualization of treatment of young patients.

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“…Anti-VEGF is a powerful weapon of relieve ME and improve vision. [9] Neovascularization is a common pathological change of many common eye diseases, and VEGF is an important promoter in the process of neovascularization. In recent years, intravitreal injection of anti-VEGF drugs has opened up a new direction for the treatment of neovascular eye diseases, and achieved good results.…”

Section: Introductionmentioning

confidence: 99%

“…Intravitreal bevacizumab can effectively treat retinal vein occlusion and CRVO in the short term. Anti-VEGF is a powerful weapon of relieve ME and improve vision [9] …”

Section: Introductionmentioning

confidence: 99%

Comparative efficacy and safety of antivascular endothelial growth factors for central retinal vein occlusion

Liu

Wang

et al. 2021

Medicine

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Background: Central retinal vein occlusion (CRVO) is one of the most common retinal vascular diseases, which is closely related to systemic diseases like hypertension, diabetes and arteriosclerosis. Due of its blinding, it will seriously reduce the quality of life. Macular edema (ME) caused by CRVO is one of the serious complications of visual impairment. We found that the severity of ME in CRVO was positively associated with vascular endothelial growth factor (VEGF) in the anterior chamber. With the accelerated pace of modern life and the changed dietary structure, the incidence of this disease will continue to rise. Therefore, it is of great practical significance to seek effective treatment methods. Intraocular injection of anti-VEGF can effectively alleviate ME and improve visual acuity, showing excellent clinical application prospects. In recent years, there have been some new understandings and advances on the etiology and treatment methods of the present disease, such as the deepening into the molecular biology and gene level. Clinical studies on the efficacy of the disease have emerging. Therefore, a network meta-analysis (NMA) of anti-VEGF treatment for CRVO is particularly necessary to systematically compare its efficacy. Methods: The two reviewers will comprehensively retrieved electronic databases such as PubMed, The Cochrane Library, Wanfang database, Web of Science, Chinese Scientifific Journals Database, EMBASE, China National Knowledge Infrastructure, and China BioMedical Literature. A randomized controlled trial for CRVO against VEGF between January 2010 and June 2021 was included according to the relevant content of the study. In addition, 2 researchers will screen the literature to assess the risk bias for the included articles. We will evaluate the collected evidence and data using a Bayesian NMA method, and analyzed it with STATA and WinBUGS software. Results: Anti-VEGF is one of the effective methods for ME in CRVO patients, accordingly, this study will evaluate its efficacy and safety using a Bayesian NMA system. Conclusion: This study can provide an effective rationale for the clinical application of anti-VEGF for CRVO, contribute to the treatment of CRVO and patient condition rehabilitation in clinical work. Ethics and dissemination: Do not require. INPLASY registration number: INPLASY2021110073.

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Age-related differences in presentation and outcomes of anti-VEGF treatment of retinal vein occlusion

Cited by 4 publications

References 9 publications

Long-term outcomes of anti-VEGF treatment of macular oedema due to retinal vein occlusions

Long-term outcomes of anti-VEGF treatment of macular oedema due to retinal vein occlusions

Clinical Features of Central Retinal Vein Occlusion in Young Patients

Comparative efficacy and safety of antivascular endothelial growth factors for central retinal vein occlusion

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