Recurrence of macular edema associated with branch retinal vein occlusion after intravitreal bevacizumab

Hanada, Narihisa; Iijima, Hiroyuki; Sakurada, Yoichi; Imasawa, Mitsuhiro

doi:10.1007/s10384-011-0113-4

Cited by 23 publications

(16 citation statements)

References 27 publications

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“…Although IVB has a rapid and promising effect, the majority of patients require retreatment for ME after IVB because of the short duration of the therapeutic effect [17, 18]. In this study, the rate of retreatment was 58.9%, which is similar to rates reported in previous studies [19, 20]. As to treatment for the recurrence of ME, recent studies have shown that repeated injections with IVB are required to maintain good visual acuity [12, 21].…”

Section: Discussionsupporting

confidence: 85%

Intravitreal Bevacizumab Alone or Combined with Macular Laser Photocoagulation for Recurrent or Persistent Macular Edema Secondary to Branch Retinal Vein Occlusion

Hirashima

Chihara

Bun

et al. 2014

Journal of Ophthalmology

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Background. To evaluate the efficacy of intravitreal bevacizumab (IVB) injection with or without macular laser photocoagulation (MLP) for recurrent or persistent macular edema (ME) secondary to branch retinal vein occlusion (BRVO). Methods. Thirty-four eyes underwent IVB injection for ME secondary to BRVO as a primary treatment. Twenty of the 34 eyes experienced recurrent or persistent ME after the first IVB. Nine of the 20 eyes (Group 1) were retreated with IVB combined with MLP. The remaining 11 eyes (Group 2) were retreated with IVB alone. Results. In Group 1, the postoperative best corrected visual acuity (BCVA) improved compared with the preoperative value at all follow-up visits, although no statistically significant improvement was observed at 6 months. In contrast, BCVA significantly improved from 0.53 to 0.40 at 6 months (P < 0.05) in Group 2. Conclusion. Combined therapy tended to have a smaller effect on visual acuity compared with IVB monotherapy.

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Section: Discussionsupporting

confidence: 85%

Intravitreal Bevacizumab Alone or Combined with Macular Laser Photocoagulation for Recurrent or Persistent Macular Edema Secondary to Branch Retinal Vein Occlusion

Hirashima

Chihara

Bun

et al. 2014

Journal of Ophthalmology

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“…Although previously randomized clinical trials have reported the efficacy of ranibizumab for BRVO, 1 , 2 several case series have reported frequent recurrences of macular edema even after multiple injections of the drug. 16 – 18 In addition, the appropriate duration of anti-VEGF therapy remains to be elucidated. Photocoagulation therapy, in contrast to drug therapy, might be expected to have a long-term effect; however, the detailed mechanism of grid photocoagulation is not fully understood.…”

Section: Discussionmentioning

confidence: 99%

Direct photocoagulation to leakage points to treat chronic macular edema associated with branch retinal vein occlusion: a pilot study

Sakimoto¹,

Kamei²,

Sakaguchi³

et al. 2014

OPTH

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Summary statementDirect photocoagulation reduces the central foveal thickness (CFT) in cases with chronic branch retinal vein occlusion (BRVO) of longer than 12 months duration. Photo-coagulation might be effective for chronic macular edema due to branch retinal vein occlusion.BackgroundThe aim was to investigate the effect of direct photocoagulation for treating chronic macular edema associated with BRVO.MethodsThis study was a noncomparative, pilot interventional case series. We examined the CFT and best-corrected visual acuity over 6 months in patients with BRVO treated with direct photocoagulation.ResultsSixteen eyes of 16 patients had been treated with direct photocoagulation (mean follow-up period, 20.5 months). The mean CFT decreased significantly (P<0.001) between the baseline (465 μm) and the final visit (304 μm). The mean (logarithm of the minimum angle of resolution equivalent) best-corrected visual acuity at the baseline was 0.39 and improved significantly (P<0.001) to 0.20 at the final visit.ConclusionDirect photocoagulation to leakage points is beneficial for treating chronic macular edema associated with chronic BRVO of longer than 12 months duration.

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“…However, it has been reported that most RVO patients (approx. 80%) show recurrence of macular oedema after 1 dose of IVB [26,27]. In the present study, inflammatory factors other than VEGF did not reach a plateau after 1 dose of IVB, suggesting that inflammation can persist following a single dose of bevacizumab.…”

Section: Discussionmentioning

confidence: 42%

Cytokine Kinetics after Monthly Intravitreal Bevacizumab for Retinal Vein Occlusion Associated with Macular Oedema

et al. 2016

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Purpose: To investigate changes of cytokines after intravitreal anti-vascular endothelial growth factor (VEGF) therapy in patients with branch retinal vein occlusion (BRVO) or central retinal vein occlusion (CRVO). Methods: Monthly doses of intravitreal bevacizumab (IVB) were administered for 6 months to treat macular oedema associated with BRVO or CRVO. Aqueous humour levels of 11 factors were measured using samples obtained from 24 patients during IVB treatment (16 BRVO patients and 8 CRVO patients). Levels of VEGF, placental growth factor (PlGF), soluble VEGF receptor (sVEGFR)-1, sVEGFR-2, soluble intercellular adhesion molecule (sICAM)-1, monocyte chemoattractant protein (MCP)-1, platelet-derived growth factor (PDGF)-AA, interleukin (IL)-6, IL-8, IL-12 (p70), and IL-13 were measured by suspension array. Results: Vision and macular oedema improved significantly after monthly IVB. Furthermore, there was a significant decrease in sVEGFR-1, VEGF, PDGF-AA, MCP-1, and IL-8 after monthly IVB. On the other hand, there were no significant changes of sVEGFR-2, PlGF, sICAM-1, or IL-6 after monthly IVB. After 1 dose of bevacizumab, changes of VEGF, visual acuity, and optical coherence tomography parameters almost occurred in parallel. Conclusions: These findings suggest an important role of the cytokine network in both BRVO and CRVO, and may contribute to a new strategy for macular oedema associated with retinal vein occlusion.

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Recurrence of macular edema associated with branch retinal vein occlusion after intravitreal bevacizumab

Abstract: Although retreatment with IVB because of recurrence of macular edema is common, in this study, the probability of retreatment with IVB was approximately 70% after each individual IVB injection, indicating that 4 injections is maximum for three-quarters of eyes with BRVO macular edema.

Cited by 23 publications

References 27 publications

Intravitreal Bevacizumab Alone or Combined with Macular Laser Photocoagulation for Recurrent or Persistent Macular Edema Secondary to Branch Retinal Vein Occlusion

Intravitreal Bevacizumab Alone or Combined with Macular Laser Photocoagulation for Recurrent or Persistent Macular Edema Secondary to Branch Retinal Vein Occlusion

Direct photocoagulation to leakage points to treat chronic macular edema associated with branch retinal vein occlusion: a pilot study

Cytokine Kinetics after Monthly Intravitreal Bevacizumab for Retinal Vein Occlusion Associated with Macular Oedema

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