Bevacizumab treatment of macular edema in CRVO and BRVO: long-term follow-up. (BERVOLT study: Bevacizumab for RVO long-term follow-up)

Kornhauser, Tom; Schwartz, Roy; Goldstein, Michaella; Neudorfer, Meira; Loewenstein, Anat; Barak, Adiel

doi:10.1007/s00417-015-3130-z

Cited by 30 publications

(25 citation statements)

References 18 publications

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“…Furthermore, better visual acuity was recorded in eyes with BRVO as compared to those with CRVO, at each time point. is confirms previous findings [17,19] and emphasizes that considerably more severe retinal damage may be caused by a more extensive impairment in retinal vein circulation. e adverse events found in our population were consistent with the well-established safety profile of Ranibizumab and dexamethasone.…”

Section: Discussionsupporting

confidence: 92%

Intravitreal Injections for Macular Edema Secondary to Retinal Vein Occlusion: Long-Term Functional and Anatomic Outcomes

Maggio

Mete

Maraone

et al. 2020

Journal of Ophthalmology

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Purpose. To report the long-term visual and anatomic outcomes of intravitreal injections for macular edema (ME) secondary to retinal vein occlusion (RVO) in a real-life clinical setting. Design. Retrospective interventional case series. Methods. A total of 223 consecutive eyes with ME secondary to RVO, treated with the first three intravitreal Ranibizumab or dexamethasone injections between August 2008 and September 2018, were enrolled in the study. Subsequent retreatment was guided by best-corrected visual acuity (BCVA) and central macular thickness (CMT) measurements, aimed at achieving macular fluid regression and BCVA stability. BCVA and CMT were recorded at baseline and at subsequent annual time points. The mean number of injections administered each year and the incidence of adverse events were recorded. Results. The mean BCVA and CMT at baseline were 0.79 logMar (SD 0.71) and 615.7 μm (SD 257.5), respectively. The mean follow-up (FU) period was 47.8 months (min 12–max 120). At 12 months, the mean BCVA and CMT had significantly improved to 0.62 logMar (SD 0.68; p<0.0001) and 401.04 μm (SD 183.8; p<0.0001). Improvements remained significant at the final FU visit. Eyes with BRVO and nonischemic RVO showed significantly better visual outcomes when compared to eyes with CRVO and ischemic RVO, over the entire FU period. An average of 4.08 (SD 2.1) Ranibizumab and 1.5 (SD 0.6) Ozurdex injections were administered over the first 12 months. The number of injections decreased thereafter progressively. One eye with CRVO developed endophthalmitis and one with BRVO developed an intraocular pressure increase that was refractory to topical medications and ultimately treated with trabeculectomy. Conclusion. Intravitreal Ranibizumab and/or dexamethasone injections were found to be effective at inducing a long-lasting improvement of BCVA and CMT in a real-life clinical setting. A safety profile similar to that already well-established in Ranibizumab and dexamethasone treatment was observed, as well as a steady decrease in the number of intraocular injections required. The results support intravitreal treatments for BRVO and CRVO in patient populations with similar characteristics in similar settings.

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Section: Discussionsupporting

confidence: 92%

Intravitreal Injections for Macular Edema Secondary to Retinal Vein Occlusion: Long-Term Functional and Anatomic Outcomes

Maggio

Mete

Maraone

et al. 2020

Journal of Ophthalmology

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“… Naive 23 55.4 (8) 47.8 Retrospective, – 12 Son et al [ 94 ] South Korea Bevacizumab 1.25 mg Three 6 weekly injections then PRN regimen. Unclear 56 60.7 (10.2) – Retrospective, single-centre 6 Kornhauser et al [ 52 ] Israel Bevacizumab 1.25 mg One to three monthly loading injections then 1–3 monthly PRN regimen. Unclear 87 72.9 (10.4) 58.6 Retrospective, – 24 Wang et al [ 53 ] Taiwan Bevacizumab 1.25 mg Single injection then monthly PRN regimen.…”

Section: Resultsmentioning

confidence: 99%

“…For intravitreal bevacizumab, 21 arms (58%) used a single injection followed by a PRN regimen, 7 arms (19%) used 3 loading injections followed by a PRN regimen, 2 arms (6%) used single or 3 loading injections followed by a PRN regimen, 2 arms (6%) used single injection only, while another 4 arms (11%) utilised had different and unique treatment regimens [ 47 , 49 , 51 , 52 ]. There were six intravitreal ranibizumab arms (46%) that used a single injection followed by a PRN regimen and seven arms (54%) used three loading injections followed by a PRN regimen.…”

Section: Resultsmentioning

confidence: 99%

A systematic review of real-world evidence of the management of macular oedema secondary to branch retinal vein occlusion

Ang

Ah-Moye

Kim

et al. 2020

Eye

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This review assessed the real-world evidence of the management of macular oedema secondary to branch retinal vein occlusion (BRVO). A meta-analysis of 2530 eyes from 48 real-world studies of therapies for macular oedema secondary to BRVO was conducted. Baseline characteristics, visual, anatomical and safety outcomes were recorded. The weighted mean and weighted estimates from random-effects models were calculated for visual acuity (VA) and central subfield thickness (CST) changes at 6, 12 and 24 months. Primary outcome was change in VA (logMAR letters) at 12 months. Study quality was assessed using the quality appraisal checklist for case series developed by Institute of Health Economics. The mean baseline VA for the pooled data was 54.0 (51.5, 56.5) letters and the mean baseline CST was 501.3 (483.5, 519.1) µm. The random-effects estimate for mean (95% CI) change in VA was 14.6 (12.5, 16.7) letters at 12 months ( n = 1727). The random-effects estimate for mean (95% CI) change in CST was −181.7 (−230.7, −132.7) µm at 12 months ( n = 1325). The quality of studies varied considerably. Ocular and systemic adverse events were discussed in 79% and 42% of treatment arms respectively, with possible under-reporting. Visual and anatomical gains achieved in the real-world for anti-VEGF therapy were not as impressive as seminal RCTs, possibly due to reduced injection frequency in the real world and differences in baseline characteristics. There is an urgent need for consensus on the minimum efficacy, treatment burden and safety data to collect to strengthen the real-world evidence base.

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“…The most commonly used anti-VEGF drugs at this time are bevacizumab (Avastin), aflibercept (Eylea), and ranibizumab (Lucentis). Selected clinical trials are collected in Table 1 [89–99]. …”

Section: Treatmentmentioning

confidence: 99%

“…Many studies have reported that visual acuity and macular edema improved significantly after intravitreal bevacizumab (IVB) treatment and also cause a significant decrease in sVEGFR-1, VEGF, PDGF-AA, MCP-1, and IL-8 [38, 89]. A recent study showed that after IVB treatment, there is an increase of retinal venous outflow that may possibly influence the resolution of macular edema [100].…”

Section: Treatmentmentioning

confidence: 99%

New Developments in the Classification, Pathogenesis, Risk Factors, Natural History, and Treatment of Branch Retinal Vein Occlusion

Paulus

Shuai

et al. 2017

Journal of Ophthalmology

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For years, branch retinal vein occlusion is still a controversial disease in many aspects. An increasing amount of data is available regarding classification, pathogenesis, risk factors, natural history, and therapy of branch retinal vein occlusion. Some of the conclusions may even change our impression of branch retinal vein occlusion. It will be beneficial for our doctors to get a deeper understanding of this disease and improve the treatment skills. The aims of this review is to collect the information above and report new ideas especially from the past a few years.

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Bevacizumab treatment of macular edema in CRVO and BRVO: long-term follow-up. (BERVOLT study: Bevacizumab for RVO long-term follow-up)

Abstract: Visual acuity outcomes in the CRVO group were poorer, especially in patients with low baseline BCVA.

Cited by 30 publications

References 18 publications

Intravitreal Injections for Macular Edema Secondary to Retinal Vein Occlusion: Long-Term Functional and Anatomic Outcomes

Intravitreal Injections for Macular Edema Secondary to Retinal Vein Occlusion: Long-Term Functional and Anatomic Outcomes

A systematic review of real-world evidence of the management of macular oedema secondary to branch retinal vein occlusion

New Developments in the Classification, Pathogenesis, Risk Factors, Natural History, and Treatment of Branch Retinal Vein Occlusion

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