Predictive factors for recurrence of macular edema after successful intravitreal bevacizumab therapy in branch retinal vein occlusion

Yamada, Rika; Nishida, Akihiro; Shimozono, Masataka; Kameda, Takuro; Miyamoto, Noriko; Mandai, Michiko; Kurimoto, Yasuo

doi:10.1007/s10384-015-0412-2

Cited by 22 publications

(17 citation statements)

References 30 publications

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“…However, CME due to BRVO has a relatively high rate of recurrence. Only 30%–34% of IVB-effective eyes can achieve persistent resolution of CME, whereas most need additional treatments to optimize visual acuity [104–106]. The duration from symptom onset to initial IVB could affect the CME recurrence rate but not the efficacy rate after a single IVB injection [104].…”

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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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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“…Several factors have been reported to be associated with the recurrences of the macular edema after the injection of an anti-VEGF agent, e.g., initial central retinal thickness (CRT), age, and several other factors 14–19 . However, it is still difficult to predict the number of recurrences even with knowledge of these factors.…”

Section: Introductionmentioning

confidence: 99%

Correlation between macular vessel density and number of intravitreal anti-VEGF agents for macular edema associated with branch retinal vein occlusion

Tomita

Iwase

Goto

et al. 2019

Sci Rep

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We evaluated whether the reduction of macular vessel density was correlated with the number of intravitreal injections of anti-vascular endothelial growth factor (VEGF) agents in eyes with a branch retinal vein occlusion (BRVO). The mean vessel density was determined by optical coherence tomography angiography in 29 eyes with macular edema associated with a BRVO. Our results showed that the mean vessel density in the group that had a resolution of the macular edema after one anti-VEGF injection was significantly higher than group that had a recurrence of the macular edema (P = 0.028). Single regression analysis showed that the number of intravitreal injections was significantly correlated with the reduction of the modified vessel density (r = −0.421, P = 0.023) and systemic hypertension (r = 0.377, P = 0.044). Multiple stepwise regression analysis showed that the reduction of the modified vessel density (β = −0.442, P = 0.009) and hypertension (β = 0.403, P = 0.016) were independent factors associated with the number of intravitreal injections. We conclude that the vessel density reduction can be used to predict whether recurrences of the macular edema will develop after the initial anti-VEGF injection in eyes with macular edema associated with a BRVO.

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“…Results of all pivotal trials on anti-VEGF treatment showed that gain in BCVA was limited initially as well as on the long-term, if treatment was deferred by 6-month sham treatment [ 4 , 5 , 8 , 11 , 14 ]. There is evidence that early anti-VEGF treatment may reduce the risk and frequency of recurrent macular edema [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

Switch of Intravitreal Therapy for Macular Edema Secondary to Retinal Vein Occlusion from Anti-VEGF to Dexamethasone Implant and Vice Versa

Pielen

Bühler

Heinzelmann

et al. 2017

Journal of Ophthalmology

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Purpose To evaluate the anatomical and functional outcome of intravitreal dexamethasone implant for macular edema secondary to central (C) or branch (B) retinal vein occlusion (RVO) in patients with persistent macular edema (ME) refractory to intravitreal antivascular endothelial growth factor (VEGF) treatment compared to treatment naïve patients and to dexamethasone-refractory eyes switched to anti-VEGF. Methods Retrospective, observational study including 30 eyes previously treated with anti-VEGF (8 CRVO, 22 BRVO, mean age 69 ± 10 yrs), compared to 11 treatment naïve eyes (6 CRVO, 5 BRVO, 73 ± 11 yrs) and compared to dexamethasone nonresponders (2 CRVO, 4 BRVO, 69 ± 12). Outcome parameters were change in best-corrected visual acuity (BCVA) and central foveal thickness (CFT) measured by spectral-domain optical coherence tomography. Results Mean BCVA improvement after switch to dexamethasone implant was 4 letters (p = 0.08), and treatment naïve eyes gained 10 letters (p = 0.66), while we noted no change in eyes after switch to anti-VEGF (p = 0.74). Median CFT decrease was most pronounced in treatment naïve patients (−437 μm, p = 0.002) compared to anti-VEGF refractory eyes (−170 μm, p = 0.003) and dexamethasone-refractory eyes (−157, p = 0.31). Conclusions Dexamethasone significantly reduced ME secondary to RVO refractory to anti-VEGF. Functional gain was limited compared to treatment naïve eyes, probably due to worse BCVA and CFT at baseline in treatment naïve eyes.

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Predictive factors for recurrence of macular edema after successful intravitreal bevacizumab therapy in branch retinal vein occlusion

Abstract: Early IVB treatment against BRVO may suppress ME recurrence.

Cited by 22 publications

References 30 publications

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

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

Correlation between macular vessel density and number of intravitreal anti-VEGF agents for macular edema associated with branch retinal vein occlusion

Switch of Intravitreal Therapy for Macular Edema Secondary to Retinal Vein Occlusion from Anti-VEGF to Dexamethasone Implant and Vice Versa

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