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

Campochiaro, Peter A.; Hafiz, Gulnar; Mir, Tahreem A.; Scott, Adrienne W.; Solomon, Sharon D.; Zimmer-Galler, Ingrid; Sodhi, Akrit; Duh, Elia J.; Ying, Howard S.; Wenick, Adam S.; Shah, Syed Mahmood; Diana, V.; Nguyen, Quan Dong; Kherani, Saleema; Sophie, Raafay

doi:10.1016/j.ophtha.2015.04.006

Cited by 103 publications

(82 citation statements)

References 22 publications

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“…12 Scatter PRP exacerbated the macular edema and did not decrease it as would be expected. Another small prospective study by Spaide showed similar findings.…”

Section: Alternate Treatment Regimensmentioning

confidence: 63%

“…Also, in a recent study (RELATE) a cohort of chronic CRVO patients were injected with either a 0.5-mg dose and a 2.0-mg dose of ranibizumab. 12 The study showed that there was no significant difference between both groups with regards to visual outcome, although the 2.0-mg dose showed significant improvement with regards to central foveal thickness (CFT). Whether such an effect can be seen in patients with acute CRVO has yet to be seen.…”

Section: Ranibizumabmentioning

confidence: 92%

“…29 Although the cohort in the RELATE study was mainly chronic CRVO patients (mean of 15 months duration), the authors suggested that because of the exacerbation of edema post laser that conducting a trial on acute patients may not be warranted. 12 …”

Section: Alternate Treatment Regimensmentioning

confidence: 99%

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Central retinal vein occlusion: modifying current treatment protocols

Ashraf

Souka

Singh

2016

Eye

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Central retinal vein occlusion (CRVO) is a common retinal vascular disorder that can result in severe visual acuity loss. The randomized control study, CRUISE, helped establish anti-VEGFs as the standard of care in cases with CRVO. The extension studies for CRUISE; HORIZON and RETAIN showed that not all visual gains are maintained beyond the first year. In addition, patients showed different behavior patterns; with some patients showing complete response with few recurrences, whereas others showed partial or even no response with multiple recurrences. Long-term follow-up demonstrated that patients responding poorly to anti-VEGFs tended to do so early in the course of treatment. It also demonstrated the effectiveness of a pro re nata (PRN) protocol for improving vision and maintaining these gains over long-term follow-ups. The SHORE study further illustrated this point by demonstrating that there were minimal differences in visual outcomes between patients receiving monthly injections and patients being treated PRN. In this review we analyzed the data from the major randomized clinical trials (RCT) that looked at anti-VEGFs as the primary treatment modality in patients with CRVO (CRUISE and the extension studies HORIZON and RETAIN for ranibizumab as well as GALILEO and COPERNI-CUS for aflibercept). In addition, we looked at SCORE and GENEVA to help determine whether there is a place for steroids as a first line therapy in current treatment practice. We then explored alternative treatment regimens such as laser therapy and switching between anti-VEGF agents and/or steroids for non or partially responding patients. Finally, we propose a simplified modified treatment algorithm for patients with CRVO for better long-term outcomes in all types of responders.

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“…12 Scatter PRP exacerbated the macular edema and did not decrease it as would be expected. Another small prospective study by Spaide showed similar findings.…”

Section: Alternate Treatment Regimensmentioning

confidence: 63%

Section: Ranibizumabmentioning

confidence: 92%

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Central retinal vein occlusion: modifying current treatment protocols

Ashraf

Souka

Singh

2016

Eye

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“…Similarly, the RELATE trial evaluated higher dose of ranibizumab (2.0mg) and laser therapy in the management of macular edema in retinal vein occlusions. The results showed that higher dose of ranibizumab and laser therapy offered no additional benefits in eyes with retinal vein occlusions [9]. A number of newer agents are being studied for the management of retinal vein occlusions.…”

Section: Future Directionsmentioning

confidence: 99%

New Concepts in the Management of Retinal Vein Occlusions

Sabia

Agarwal

Ram

2017

AOVS

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“…Apart from that, panretinal laser photocoagulation was not found to reduce the total VEGF load in BRVO eyes. 20 However, a recent study indicated that the addition of scatter photocoagulation to ranibizumab may reduce progression of retinal nonperfusion in patients with BRVO. 19 To summarise, the achievement of a potential synergistic effect by combination of different interventions requires further study.…”

mentioning

confidence: 99%

Branch Retinal Vein Occlusion – Update on Treatment Options

Michels¹,

Wirth²

2016

European Ophthalmic Review

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The advent of new pharmacotherapeutic options and diagnostic methods have led to a revolution in the management of branch retinal vein occlusion over the past few years. Despite the variety of treatment options, we are confronted with several questions: which drug should we use? Is switching between or combining treatment options beneficial? What is the recommended treatment regimen? When should we start treatment and for how long should we continue it? Should we still use retinal laser therapy? The wide range of possibilities and emerging treatment choices not only aids, but also challenges clinicians striving for evidence-based management. KeywordsBranch retinal vein occlusion, macular oedema, anti-vascular endothelial growth factor (VEGF)

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

Cited by 103 publications

References 22 publications

Central retinal vein occlusion: modifying current treatment protocols

Central retinal vein occlusion: modifying current treatment protocols

New Concepts in the Management of Retinal Vein Occlusions

Branch Retinal Vein Occlusion – Update on Treatment Options

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