Long-term outcomes of anti-VEGF treatment of retinal vein occlusion

Spooner, Kimberly; Fraser‐Bell, Samantha; Hong, Thomas; Wong, James; Chang, Andrew

doi:10.1038/s41433-021-01620-z

Cited by 25 publications

(15 citation statements)

References 20 publications

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“…In a subsequent study, the same study group confirmed the maintenance of a 3-lines of vision gain after 8 years from the commencing of anti-VEGF therapy in 221 patients affected by RVO. 32…”

Section: Discussionmentioning

confidence: 99%

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: 99%

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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“…This did not lead, as mentioned in the results section, to any relevant cases of adverse events including endophthalmitis. www.nature.com/scientificreports/ Since it is known that anti-VEGF therapy has a positive impact on the course and final outcome of CME after RVO 37,38 , it is, however, not a prerequisite that every patient will benefit from this treatment. This is the main point why determining possible baseline characteristics or predictors is important in order to make an early switching and thus avoid additional unnecessary injections.…”

Section: Discussionmentioning

confidence: 99%

Choroidal thickness as a possible predictor of non-response to intravitreal bevacizumab for macular edema after retinal vein occlusion

Al-Jundi

Gradinger

Langenbucher

et al. 2023

Sci Rep

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To evaluate outcomes of intravitreal bevacizumab (IVB) treating macular edema (ME) after retinal vein occlusion (RVO) following pro re nata (PRN) regimen and investigate potential predictors of non-response. Retrospective analysis of 126 treatment-naive eyes with ME after RVO. Eyes were treated initially with IVB of 1.25 mg/ml. Therapy was switched in case of non-response. Outcome measures included best-corrected visual acuity (BCVA) and central macular thickness (CMT), which were recorded over 4 years of treatment. BCVA improved significantly during first 2 years. CMT decreased significantly during the 4-year follow-up period. Switching was required in 42 eyes (33%). 34 eyes (26.9%) were switched to steroids, while 8 eyes (6.3%) were switched to other anti-VEGF due to diagnosed glaucoma. Switching occurred after 12.4 ± 8.3 months and an average of 8 ± 4.1 IVBs. Compared with the treatment-responsive group, the treatment-unresponsive group had significantly worse BCVA, higher CMT and subfoveal choroidal thickness (SFCT) at baseline. Treatment IVB following PRN regimen showed significant functional and anatomic improvement in patients with ME after RVO. Switching was required in more than one third of eyes. Higher baseline SFCT could be considered as predictor for non-response to such therapy and thus an indicator of early switching.

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“…Since it is known that anti-VEGF therapy has a positive impact on the course and nal outcome of CME after RVO 34,35 , it is, however, not a prerequisite that every patient will bene t from this treatment. This is the main point why determining possible baseline characteristics or predictors is important in order to make an early switching and thus avoid additional unnecessary injections.…”

Section: Discussionmentioning

confidence: 99%

Choroidal thickness as a possible predictor of non-response to intravitreal bevacizumab for macular edema after retinal vein occlusion

Al-Jundi

Gradinger

Langenbucher

et al. 2022

Preprint

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To evaluate outcomes of intravitreal bevacizumab treating macular edema (ME) after retinal vein occlusion (RVO) following PRN (pro re nata) regimen and investigate potential predictors of non-response. Retrospective analysis of 126 treatment-naive eyes with ME after RVO. Eyes were treated initially with bevacizumab intravitreal injections (IVIs) of 1.25 mg/ml. Therapy was switched in case of non-response. Outcome measures included best-corrected visual acuity (BCVA) and central macular thickness (CMT), which were recorded over 4 years of treatment. BCVA improved significantly during first 2 years. CMT decreased significantly during the 4-year follow-up period. Switching was required in 42 eyes (33%). 34 eyes (26.9%) were switched to intravitreal steroids, while 8 eyes (6.3%) were switched to other anti-VEFG due to diagnosed glaucoma. Switching occurred after 12.4±8.3 months after an average of 8±4.1 bevacizumab IVIs. Compared with the treatment-responsive group, the treatment-unresponsive group had significantly worse BCVA, higher CMT and subfoveal choroidal thickness (SFCT) at baseline. Treatment with intravitreal bevacizumab following PRN regimen showed significant functional and anatomic improvement in patients with ME after RVO. A therapy switching was required in more than one third of eyes. Higher SFCT at baseline could be considered as predictor for non-response to such therapy.

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Long-term outcomes of anti-VEGF treatment of retinal vein occlusion

Cited by 25 publications

References 20 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

Choroidal thickness as a possible predictor of non-response to intravitreal bevacizumab for macular edema after retinal vein occlusion

Choroidal thickness as a possible predictor of non-response to intravitreal bevacizumab for macular edema after retinal vein occlusion

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