What are the effects of anti-vascular endothelial growth factor (anti-VEGF) for people with macular edema secondary to branch retinal vein occlusion?

2021 ◽  
Author(s):  
Sarah Anderson
2019 ◽  
pp. 112067211988505 ◽  
Author(s):  
Hidetaka Noma ◽  
Kanako Yasuda ◽  
Masahiko Shimura

Purpose: To investigate the relations of vascular endothelial growth factor, growth factors, soluble vascular endothelial growth factor receptors, and inflammatory factors to recurrence of macular edema after anti-vascular endothelial growth factor therapy in patients with branch retinal vein occlusion. Methods: This study retrospectively investigated 17 patients with branch retinal vein occlusion who received intravitreal ranibizumab injection three times within 6 months for recurrent macular edema. Aqueous humor samples were obtained from these patients at every recurrence. Levels of soluble vascular endothelial growth factor receptor-1, soluble vascular endothelial growth factor receptor-2, vascular endothelial growth factor, placental growth factor, platelet-derived growth factor-AA, soluble intercellular adhesion molecule-1, monocyte chemoattractant protein-1, interleukin-6, interleukin-8, interleukin-12(p70), and interleukin-13 were measured by the suspension array method. Aqueous flare values were measured with a laser flare meter and central macular thickness was determined by optical coherence tomography. Results: Mean best-corrected visual acuity and central macular thickness improved significantly over time after intravitreal ranibizumab injection, but the aqueous flare value at recurrence after intravitreal ranibizumab injection showed no significant change compared with baseline. Aqueous humor levels of soluble vascular endothelial growth factor receptor-1, soluble vascular endothelial growth factor receptor-2, vascular endothelial growth factor, platelet-derived growth factor-AA, monocyte chemoattractant protein-1, and interleukin-8 decreased significantly over time after intravitreal ranibizumab injection. However, there were no significant changes of the other five factors/cytokines (placental growth factor, soluble intercellular adhesion molecule-1, interleukin-6, interleukin-12, and interleukin-13) at recurrence after intravitreal ranibizumab injection compared with baseline. Conclusion: These findings suggest that persistent inflammation may influence the recurrence of macular edema in branch retinal vein occlusion patients, and that adding steroid therapy might be an effective strategy for preventing recurrence.


Branch retinal vein occlusion (BRVO) is the most common form of retinal vein occlusions (RVO), which is the second most common retinal vascular disease after diabetic retinopathy. The most common cause of visual loss in BRVO is macular edema. Since the vascular endothelial growth factor (VEGF) was detected in the pathogenesis of macular edema due to BRVO, studies have been made with available anti-VEGF agents and different treatment regimens. Those treatment regimens can be listed as; monthly / bi-monthly fixed interval, as needed (Pro Re Nata; PRN), treat and extend (T&E). Aflibercept acts as a decoy receptor that binds to VEGF-A, VEGF-B, and placental growth factor. There are publications indicating that this agent binds VEGF with a higher affinity than other anti-VEGF agents and thus provides a longer treatment efficacy. This review summarizes the studies about the use of aflibercept in different regimens for the treatment of macular edema due to BRVO.


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