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

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Takafumi Hirashima ◽  
Tomoyuki Chihara ◽  
Toshitaka Bun ◽  
Takao Utsumi ◽  
Miou Hirose ◽  
...  

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.

Folia Medica ◽  
2019 ◽  
Vol 61 (2) ◽  
pp. 240-248
Author(s):  
Prashant Kumar ◽  
Yog Raj Sharma ◽  
Parijat Chandra ◽  
Rajvardhan Azad ◽  
Girish Gulab Meshram

Abstract Background: There is an ambiguity regarding the therapy of choice for patients with macular edema following branch retinal vein occlusion (BRVO). Aim: The purpose of the study was to compare the efficacy and safety of ranibizumab (3 injections 0.5 mg) versus ranibizumab (1 injection 0.5 mg) with laser photocoagulation (LP) versus dexamethamethasone intravitreal (IVT) implant (0.7 mg) with or without LP in patients with macular edema following BRVO. Materials and methods: 60 eyes of 60 patients were divided into 4 groups. Group 1 received IVT ranibizumab (3 injections 0.5 mg), Group 2 received IVT ranibizumab (1 injection 0.5 mg) + LP, Group 3 received dexamethasone IVT implant (0.7 mg), and Group 4 received dexamethasone IVT implant (0.7 mg) + LP. The endpoints were the difference in mean changes in best corrected visual acuity (BCVA), central macular thickness (CMT), and inter-group differences in contrast sensitivity (CS), retinal sensitivity (RS), and intraocular pressure (IOP). Results: BCVA gains in Group 1 (18.00±8.51) patients were significantly (p < 0.05) higher than patients in Groups 2 (10.00±10.26), 3 (9.50±9.60), and 4 (10.50±10.97), after 6 months of therapy. No significant inter-group variation was found in the CMT, CS, and RS. Conclusions: Ranibizumab (3 injections 0.5 mg) showed significantly higher BCVA gains at 6 months post-therapy. Improvements in the BCVA, CMT, CS, and RS were comparable initially in all the therapies.


2015 ◽  
Vol 68 (9-10) ◽  
pp. 295-300
Author(s):  
Jelena Karadzic ◽  
Igor Kovacevic ◽  
Jelena Ljikar ◽  
Zorka Grgic ◽  
Gordana Devecerski

Introduction. Macular edema is the main cause of visual loss in patients with branch retinal vein occlusion. Macular edema is initially reversible, but over time, permanent loss of vision occurs from structural damage to the macula. For this reason, there is a need for more rapid and effective treatments than laser photocoagulation which has been established as a gold standard. There are several pharmacologic agents which have changed the management of macular edema. Material and Methods. Twenty eyes of 20 consecutive patients of the Department of Eye Diseases, Clinical Center of Vojvodina, in Novi Sad, were enrolled in this prospective, randomized and consecutive study conducted from January 2012 to January 2013. The patients were randomly assigned into two treatment groups, and they were given an intravitreal injection of bevacizumab 1.25 mg/0.05 mL (Avastin?), or triamcinolone acetonid injection 4 mg/0.1mL (Kenalog?). Reinjections were performed according to the following retreatment criteria a loss of visual acuity or increase in central retinal thickness. Results. Both intravitreal bevacizumab and triamcinolonacetonid were very effective in reducing macular edema and improving visual acuity in the eyes with macular edema secondary to retinal vein occlusion. The effect of the treatment was more pronounced if it started early after the onset of macular edema. The reported temporary effects of intravitreal triamcinolon- acetonide and bevacizumab could be explained by their clearance from the eye. Conclusion. The short-term results of our clinical trial showed that pharmacological intravitreal agents, such as bevacizumab and triamcinolon-acetonid, lead to rapid resolution of macular edema and significant improvement of visual acuity.


2021 ◽  
Author(s):  
Gengmin Tong ◽  
Yishan Hu ◽  
Dawei Wang ◽  
Yanhua Jin

Abstract Background: To evaluate the efficacy of intravitreal injection of conbercept (IVC) with or without laser photocoagulation for recurrent macular edema secondary to branch retinal vein occlusion (BRVO). Methods: 82 patients (82 eyes) with recurrent macular edema secondary to BRVO were collected. The central macular thickness (CMT) and best corrected visual acuity (BCVA) were recorded. Results: The BCVA in both groups was significantly superior to that before treatment (P<0.05). Compared with initial values, CMT was reduced significantly in both groups (P<0.05). But at 1 month to 6 month after treatment, there are no significant difference was observed between the two groups (P>0.05). In the combined therapy group for Hemispheric Retinal Vein Occlusion, we observed a lower number of reinjections during follow-up. Conclusion: Conbercept with or without retinal photocoagulation can effectively improve the visual acuity and reduce the CMT.


2020 ◽  
Vol 2 (3) ◽  
pp. 36-44
Author(s):  
Eman Abo Taleb ◽  
Altaf Alsowaidi

Aim To compare the efficacy of combined anti-VGEF (IVB) with steroids versus pure anti-VEGF for the treatment of macular edema secondary to retinal vein occlusion (RVO). Methods In this prospective study, 51 eyes were randomized into 2 groups according to treatment of clinically identified macular edema secondary to retinal vein occlusion within 4 weeks of onset: Group 1 (19 eyes) was given intravitreal Bevacizumab (IVB) (1.25mg/.05ml) + Triamcinolone (IVTA) (2mg/.05ml); Group 2 (22 eyes) was given pure intravitreal Bevacizumab (IVB) (1.25mg/.05ml) at baseline, at month 1, and at month 2. The outcome of the study represented the EDRTS letters gain, IOP change and (CRT) by using Spectral domain optical coherence tomography (OCT) at month 1, 2, 3 and 6 in each group. Both central retinal vein occlusion (CRVO) and branch retinal vein occlusion (BRVO) patients with at least 6 months FU were enrolled in the study. Results EDRTS letters gain was (20.37±15.28, 28.05±16.68, 35.16±17.12, 36.47±18.17) in group1 and (14.50±14.56, 18.41±14.56, 20.59±16.13, 21.06±15.72) in group2 at month 2,3 and 6 p value (0.18, .04, 0.004, 0.002). Mean IOP pre-injection (14.00±2.67) in group 1 and (13.5±5.89) in group 2. Group 1 has transient increase in IOP at month 1 and then return to baseline over 6 months. CRT from baseline to final FU decrease by 264.82 (µm) ±147.66 in group 1 and 308.42(µm) ±226.78 in group 2 with no significant difference between two group p value 0.57. There was no significant difference in EDRTS letters gain between CRVO patients and BRVO patients at month 1, 2, 3 and 6 p values (0.83, 0.23, 0.29, 0.13). Conclusion Early treatment macular edema in RVO patients by combined anti-VGEF+ steroid effectively improve functional outcome better than pure anti-VGEF injection.


2019 ◽  
Vol 35 (1) ◽  
Author(s):  
Imran Ahmad, Mubashir Rehman, Mir Ali Shah, Irfan Aslam Khattak

Purpose: To evaluate the effect of intra-vitreal bevacizumab in macular edema caused by branch retinal vein occlusion. Study Design: Interrupted time series study. Place and Duration of Study: Department of Ophthalmology Hayatabad Medical Complex, Peshawar and department of Ophthalmology Lady Reading Hospital Peshawar from 1st July 2016 to 31st December 2016. Material and Methods: There were 60 patients included in the study. All patients with macular edema due to BRVO visible clinically and evident on SD-OCT and visual acuity of less than 6/9 were included in the study. Patients who used other intra-vitreal drug for macular edema, those with surgery in the same eye and those with macular laser for macular edema were excluded from the study. All patients were given intra-vitreal 0.05 ml bevacizumab injection every month for 6 months. After 6 months OCT was repeated. At each monthly visit VA was measured and fundoscopy was done. Follow up of all patients was at six months. Results: Our study included 60 patients with mean age of 54.42 ± 9.19 years. The mean baseline central macular thickness was 427.06 µ with SD ± 63.54 µ. After 6 months significant improvement in visual acuity was documented. Also marked reduction in central macular thickness was noted after six months with mean of 327.44 µ with SD ± 55.55 µ. Conclusion: Intra-vitreal bevacizumab is an effective treatment for macular edema caused by BRVO in terms of both anatomic and visual improvement. Key words: Branch retinal vein occlusion, bevacizumab, macular edema.


2011 ◽  
Vol 21 (4) ◽  
pp. 434-439 ◽  
Author(s):  
Angel Salinas-Alamán ◽  
Javier Zarranz-Ventura ◽  
Jose M. Caire González-Jauregui ◽  
Luis M. Sádaba-Echarri ◽  
Jesús Barrio-Barrio ◽  
...  

2019 ◽  
Vol 30 (2) ◽  
pp. 370-375
Author(s):  
Seoung Hyun An ◽  
Woo Jin Jeong

Purpose: To investigate the effect of early-scatter laser photocoagulation on the formation of collateral vessels in branch retinal vein occlusion. Methods: The medical records of 40 cases (40 patients) of branch retinal vein occlusion with macular edema were retrospectively reviewed. Of them, 23 patients were treated with intravitreal bevacizumab injection and 17 patients underwent intravitreal bevacizumab injection with additional laser treatment. Early-scatter laser photocoagulation was applied for capillary non-perfusion areas, regardless of retinal neovascularization. Collateral vessel presence, recurrence rate of macular edema, and number of intravitreal bevacizumab injections were compared between the groups. Results: During the follow-up period, collateral vessel formation was noted in 10/23 eyes (43.5%) in the intravitreal bevacizumab injection group and 15/17 eyes (88.2%) in the laser combined treatment group ( p = 0.004). The recurrence rate of macular edema was lower in the laser combined treatment group (29.4%) than in the intravitreal bevacizumab injection group (65.2%); this difference was statistically significant ( p = 0.025). The average numbers of intravitreal bevacizumab injections were 3.57 ± 3.23 in the intravitreal bevacizumab group and 2.14 ± 2.26 in the laser combined treatment group ( p = 0.044). Conclusion: Early-scatter laser photocoagulation promotes collateral vessel formation; the presence of collateral vessels seemed to affect the course of macular edema in branch retinal vein occlusion. Combined early-scatter laser photocoagulation treatment after intravitreal bevacizumab injection lowered the recurrence rate of macular edema and number of intravitreal bevacizumab injections in the cases of branch retinal vein occlusion.


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