Predictive factors for functional improvement following intravitreal bevacizumab injections after central retinal vein occlusion

Januschowski, Kai; Feltgen, Nicolas; Pielen, Amelie; Spitzer, Bernhard; Rehák, Matúš; Spital, Georg; Dimopoulos, Spyridon; Meyer, Carsten H.; Szurman, Gesine B.

doi:10.1007/s00417-016-3471-2

Cited by 12 publications

(4 citation statements)

References 25 publications

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“…The comparison between the two groups shows that the cured group is younger, has a shorter disease duration, has a greater proportion of BRVO, and has lower values of baseline CMT and baseline BCVA when compared with the uncured group. This is consistent with previous studies investigating the baseline indexes to predict the long-term efficacy in RVO-ME (26)(27)(28)(29)(30). Scott et al (31) have treated RVO-ME patients with anti-VEGF treatments for six consecutive (once a month) months, and the univariate regression analysis shows that the baseline BCVA and the baseline CMT are significantly correlated with 6-month BCVA.…”

Section: ) (E)supporting

confidence: 89%

“…The anti-VEGF drugs have been widely used in ocular diseases such as exudative age-related macular degeneration, diabetic macular edema, choroidal neovascularization, and RVO-ME, and have shown good safety and efficacy. Previous retrospective and prospective studies have shown that the anti-VEGF treatment for RVO-ME in real-word has achieved significant retinal structure improvement and visual function recovery ( 5 , 17 , 29 , 33 , 37 , 38 ). The patients included in this study are divided into the mAb group (ranibizumab injection) and the Fc group (injection of conbercept or aflibercept) according to their mechanism of action.…”

Section: Discussionmentioning

confidence: 99%

“…has achieved significant retinal structure improvement and visual function recovery (5,17,29,33,37,38). The patients included in this study are divided into the mAb group (ranibizumab injection) and the Fc group (injection of conbercept or aflibercept) according to their mechanism of action.…”

Section: ) (E)mentioning

confidence: 99%

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Two-Week Central Macular Thickness Reduction Rate >37% Predicts the Long-Term Efficacy of Anti-vascular Endothelial Growth Factor Treatment for Macular Edema Secondary to Retinal Vein Occlusion

Zhou

et al. 2022

Front. Med.

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ObjectiveTo determine if the early response assessments can predict the long-term efficacy of anti-vascular endothelial growth factor (VEGF) treatment for macular edema secondary to retinal vein occlusion (RVO-ME).MethodsA retrospective study of patients with diagnosis of RVO-ME and intravitreal anti-VEGF treatment was conducted. Clinical characteristics including age, gender, disease subtype and disease duration were recorded at baseline. The best corrected visual acuity (BCVA and logMAR), intraocular pressure (IOP), and central macular thickness (CMT) were recorded at baseline, 2 weeks, and every month (months 1–6) after injection. Further, we compared the early response assessments between the cured group (6-month CMT ≤ 250 μm) and the uncured group (6-month CMT > 250 μm).ResultsA total of 164 eyes in 164 patients (77 male and 87 female) were included. At each post-injection time point, both BCVA and CMT are significantly decreased from baseline (all P < 0.001). Spearman’s test showed that 2-week CMT reduction rate after the first injection was negatively correlated with BCVA at 6 months (r = −0.359, P < 0.001). Compared with the uncured group (47 cases), the cured group (117 cases) was younger (59.53 ± 11.68 vs. 65.19 ± 13.10 years old, P < 0.01), had more BRVO patients (76.1% vs. 44.7%, P < 0.01), a shorter disease duration (1.92 ± 2.43 vs. 5.05 ± 4.32 months, P < 0.01), lower baseline CMT (527.09 ± 154.95 vs. 768.96 ± 287.75 μm, P < 0.01), and lower baseline BCVA (0.86 ± 0.44 vs. 1.31 ± 0.51, P < 0.01). At each post-injection time point, the cured group had lower CMT and BCVA values when compared to the uncured group (all P < 0.01), and the 2-week CMT reduction rate was identified as the earliest response time to predict the long-term treatment efficacy. Moreover, ROC curve analysis indicated that a 2-week CMT reduction rate >37% yielded the best cut-off point for predicting the long-term cure of anti-VEGF treatment at 6 months (P < 0.001). Multivariable logistic regression confirmed that the 2-week CMT reduction rate >37% was independently associated with the 6-month cured rate (OR = 9.639, 95% Cl = 1.030–90.227, P = 0.047).ConclusionAge, disease duration, baseline CMT, and baseline BCVA are associated with visual outcomes at 6-month of anti-VEGF treatment for RVO-ME. The “2-week CMT reduction rate >37%” after the first injection is an independent factor to predict better long-term outcomes.

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Section: ) (E)supporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

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Two-Week Central Macular Thickness Reduction Rate >37% Predicts the Long-Term Efficacy of Anti-vascular Endothelial Growth Factor Treatment for Macular Edema Secondary to Retinal Vein Occlusion

Zhou

et al. 2022

Front. Med.

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“…13 Januschowski et al treated patients with bevacizumab and looked at multiple baseline patient characteristics in a diagnosis of CRVO and found that a low BVA and high CRT were indicative of greater visual improvement at weeks 24 to 48. 14 These findings may be due to the increased capacity for recovery in patients with initially low BVA and high CRT.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Outcomes of Anti-VEGF Therapy in Patients With Macular Edema Secondary to Retinal Vein Occlusion

Young

Wai

Silva

et al. 2017

Journal of VitreoRetinal Diseases

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To evaluate long-term visual and anatomical outcomes of anti-vascular endothelial growth factor (VEGF) therapy for macular edema (ME) secondary to retinal vein occlusion (RVO) in routine clinical practice. Methods: Patients with ME secondary to hemi-RVO (HRVO), central RVO (CRVO), or branch RVO (BRVO) after initiating anti-VEGF therapy were followed for at least 36 months. Main outcomes were change in best visual acuity (BVA) and mean absolute change in central subfield thickness (CST) at 12, 24, 36, and 48 months. Results: Patients with BRVO showed significant increases in BVA that were maintained after 12, 24, 36, and 48 months (þ11.03, þ12.06, þ10.71, and þ9.26 letters, respectively; P < .05). CST significantly decreased after 12, 24, 36, and 48 months (À83.51, À67.93, À97.52, À127.85 mm, respectively; P < .05). In patients with CRVO/HRVO, significant improvements in BVA were seen at 12 and 24 months (þ9.39 and þ8.54 letters, respectively; P ¼ .023). At 36 and 48 months, the visual gain was not significant (þ2.64 and þ3.42 letters, respectively; P > .05). For CST changes, there were significant decreases at 12, 24, and 36 months (À146.23, À149.54, and À166.44 mm, respectively; P < .05). At 48 months (À97.66 mm, P ¼ .130), changes in CST were not significant. Conclusions: In routine clinical practice, visual and anatomical benefits of anti-VEGF agents in patients with BRVO were sustained at 36 and 48 months. For patients with CRVO/HRVO, anatomical improvements were maintained for 36, but not 48 months, while visual improvements were no longer maintained by 36 months.

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