Early peripheral laser photocoagulation of nonperfused retina improves vision in patients with central retinal vein occlusion (Results of a proof of concept study)

Rehák, Matúš; Tilgner, Eric; Franke, Annegret; Rauscher, Franziska G.; Brosteanu, Oana; Wiedemann, Peter

doi:10.1007/s00417-013-2528-8

Cited by 37 publications

(30 citation statements)

References 22 publications

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“…In another small study, patients with CRVO with a duration of 8 months or less and an area of retinal nonperfusion between 1 and 10 disc areas were randomized to ranibizumab plus laser (n ¼ 10) or ranibizumab (n ¼ 12). 22 At baseline, patients in the ranibizumab group had an injection of 0.5 mg ranibizumab and patients in the ranibizumab plus laser group had an injection of 0.5 mg ranibizumab plus scatter photocoagulation to all areas of retinal nonperfusion outside the temporal arcade vessels identified by wide-angle fluorescein angiography. In both groups, repeat ranibizumab injections were mandated at the week 4 and week 8 visits and were administered at the week 12, 16, and 20 visits only if re-treatment criteria were met.…”

Section: Discussionmentioning

confidence: 99%

Scatter Photocoagulation Does Not Reduce Macular Edema or Treatment Burden in Patients with Retinal Vein Occlusion

Campochiaro¹,

Hafiz²,

Mir³

et al. 2015

Ophthalmology

103

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Section: Discussionmentioning

confidence: 99%

Scatter Photocoagulation Does Not Reduce Macular Edema or Treatment Burden in Patients with Retinal Vein Occlusion

Campochiaro¹,

Hafiz²,

Mir³

et al. 2015

Ophthalmology

103

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“…We considered that short-pulse grid laser photocoagulation for capillary nonperfusion in the macula successfully modulated overproduced VEGF, thus resolving foveal edema in a manner similar to panretinal photocoagulation to decreased neovascularization in the retina and iris by suppressing VEGF overproduction [12, 22, 23]. MA formation in the foveal capillaries was earlier evoked by high intraocular VEGF in an animal model [24].…”

Section: Discussionmentioning

confidence: 99%

Effect of Leaking Foveal Microaneurysms on the Treatment of Center-Involving Diabetic Macular Edema: A Pilot Study

et al. 2018

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Purpose: Evaluate the effect of foveal leaking microaneurysms (MAs) on the required number of intravitreal ranibizumab (IVR) injections in the treatment of center-involving diabetic macular edema (DME) when treated with focal/grid laser. Design: A pilot study of prospective, nonrandomized, multicenter clinical trial. Methods: This study enrolled 21 eyes with DME for which pro re nata IVR injections were combined with short-pulse focal/grid laser. At 12 months, best-corrected visual acuity (BCVA), central subfield macular thickness (CMT), and the required number of IVRs to maintain CMT < 300 µm were compared between eyes with or without foveal leaking MAs, termed the MA(+) and MA(–) groups, respectively. Results: Significant CMT improvements (p < 0.0001) and increased BCVA of 4.0 ± 8.5 letters were observed at 12 months. The MA(–) group required significantly fewer IVRs than did the MA(+) group (mean: 4.9 ± 3.0 vs. 8.6 ± 3.0; p = 0.0306). In the latter 6 months of the 1-year follow-up, 50% (4/8) of MA(–) eyes did not require any IVR administration to sustain CMT < 300 µm. Conclusions: A combination therapy of short-pulse focal/grid laser and reduced IVR injections appeared noninferior to previous reports of IVR monotherapy. Further large-scale investigations are warranted.

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“…There is evidence that early peripheral laser photocoagulation of non-perfused retinal areas improves visual acuity and leads to less recurrence ofmacular edema in patients with CRVO [9] . 22 patients with CRVO < 8 months, and an area of non-perfusion between 1 and 10 optic disc areas were randomized into two groups.…”

Section: Ischemic Crvomentioning

confidence: 99%

“…During the course of the disease ischemia must be repeatedly evaluated to detect conversion from non-ischemic to ischemic RVO. Recent investigations show that the combination of anti-VEGF with targeted laserphotocoagulation of avascular peripheral retina may improve patients' prognosis and lead to a reduced number of injections [8,9] . In this article we review up-to-date information on intravitreal anti-VEGF therapy in RVO, international guidelines, safety and efficacy of treatment.…”

Section: Introductionmentioning

confidence: 99%

Anti-VEGF Therapy for Retinal Vein Occlusion

Danzmann¹,

Pielen²,

Bajor³

2016

International Journal of Ophthalmic Research

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Current recommendations for treatment of macular edema secondary to BRVO or CRVO favour intravitreal anti-VEGF agents compared to intravitreal steroids. An upload of 3 injections is reasonable to address intravitreal VEGF levels. Prognosis for visual improvement is good and time to treatment is crucial. There is evidence that an early targeted laser photocoagulation of ischemic areas may lead to additional treatment effects, less injections and improved prognosis if administered early after RVO. In the course of the disease patients must be frequently monitored for recurrence of edema to initiate re-treatment and for conversion to ischemic RVO. Ischemia, proliferations and rubeosisiridis must not be treated with intravitreal anti-VEGF alone. Laser treatment of peripheral retina remains the standard-of-care to treat ischemia. In this article we review up-to-date information on intravitreal anti-VEGF therapy in RVO, international guidelines, safety and efficacy of treatment. We discuss new insights on factors that may improve prognosis or burden of intravitreal treatment. And we discuss the role of ischemia in RVO.

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Early peripheral laser photocoagulation of nonperfused retina improves vision in patients with central retinal vein occlusion (Results of a proof of concept study)

Abstract: The selective laser photocoagulation of peripheral areas of nonperfusion seems to lead to additional visual improvement in patients with CRVO. A larger replication trial is necessary to confirm the results of this proof of concept study.

Cited by 37 publications

References 22 publications

Scatter Photocoagulation Does Not Reduce Macular Edema or Treatment Burden in Patients with Retinal Vein Occlusion

Scatter Photocoagulation Does Not Reduce Macular Edema or Treatment Burden in Patients with Retinal Vein Occlusion

Effect of Leaking Foveal Microaneurysms on the Treatment of Center-Involving Diabetic Macular Edema: A Pilot Study

Anti-VEGF Therapy for Retinal Vein Occlusion

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