scholarly journals Real-Life Management of Patients with Retinal Vein Occlusion Using I-Macula Web Platform

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Massimo Nicolò ◽  
Monica Bonetto ◽  
Raffaella Rosa ◽  
Donatella Musetti ◽  
Maria Musolino ◽  
...  

Aim.Real-lifeevaluation in the management of patients affected by macular edema secondary to retinal vein occlusion.Material and Methods. A retrospective, observational study using theI-Macula Webplatform.Results. Thirty-five patients (37 eyes; 15 females and 20 male) affected by RVO were analysed. At 12 months, there was a statistically significant improvement of best-corrected visual acuity (p=0.0235) and central macular thickness (p<0.0001). The mean change in visual acuity was 8.9 letters. Twenty-seven eyes underwent DEX implant (n=62; mean: 2.29) only. Of these, 8, 4, 14, and 1 eyes underwent 1, 2, 3, and 4 DEX implants, respectively. The remaining 10 eyes were also injected with ranibizumab (n=49; mean: 4.9). At 12 months, 12 eyes (32.5%) presented a dry macula, whereas the remaining 25 eyes (67.5%) still had macular edema. Mean interval between the first and second treatment (T1) and between the second and third treatment (T2) were 5.15 and (T2) 3.7 months, respectively. Where only DEX implants were received, T1 and T2 was 5.1 and 4.9 months, respectively.Conclusions. This study confirms that DEX implants and/or anti-VEGF drugs improve visual acuity and central macular thickness in patients affected by RVO.

2018 ◽  
Vol 4 (2) ◽  
pp. 110
Author(s):  
Citra Rahmadani ◽  
Nur Khoma Fatmawati ◽  
Rahmat Bakhtiar

Retinal vein occlusion is the second most common cause of blindness in retinal vascular disease after diabetic retinopathy and may lead to complications of macular edema. Bevacizumab is an influential treatment as an anti vascular endothelial growth factor (VEGF). This study aims to determine the difference of visual acuity and macular thickness before and after treatment of Bevacizumab. This is a quasi experimental study in patients with secondary macular edema retinal vein occlusion who meets the inclusion criteria. Visual acuity and macular thickness were evaluated after one month of treatment. This study was conducted for two months since May-June 2017 by collecting secondary data from medical record at SMEC Samarinda from January 2016 – June 2017. Data were analyzed using Wilcoxon. Sixteen eyes from 16 patients were diagnosed with macular edema secondary retinal vein occlusion given bevacizumab treatment. The mean visual acuity before therapy was 1.106 LogMAR ± 0.509 and increased to 0.889 logMAR ± 0.608 (p = 0.116) after treatment while the mean macular thickness before therapy was 504.06 μm ± 301.273 and decreased to 348.81 μm ± 181.17 (p = 0.017) after treatment. There was a significant effect on the decrease in macular thickness but no significant effect on visual acuity improvement in patients with macular edema secondary retinal vein occlusion at SMEC Samarinda.  Keywords: Retinal vein occlusion, macular edema, bevacizumab


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.


2020 ◽  
Vol 36 (3) ◽  
Author(s):  
Hussain Ahmad Khaqan ◽  
Usman Imtiaz ◽  
Hasnain Muhammad Buksh ◽  
Hafiz Ateeq Ur Rehman ◽  
Raheela Naz

Purpose:  To study the safety and efficacy of intravitreal Ziv-Aflibercept vs. Bevacizumab for the management of edema caused by different retinal pathologies. Study Design:  Comparative interventional study. Place and Duration of Study:  Lahore General Hospital, Lahore, from July 2018 to June 2019. Material and Methods:  Patients with resistant, center involving macular edema due to diabetes, retinal vein occlusion and age related macular degeneration were recruited. Complete ocular examination was performed. All the patients were randomly grouped into two i.e. IVZ (intravitreal Ziv-Aflibercept) and IVB (intravitreal bevacizumab). Each eye underwent intravitreal injection of 0.05 ml of fresh filtered ziv-aflibercept (1.25 mg) or 0.05 ml of fresh filtered Bevacizumab. Outcome was measured in terms of variation in central macular thickness (CMT) and also best corrected visual acuity (BCVA) at 3 months. Results:  Total of 156 eyes of 136 patients completed whole duration of study and were included in the results. The mean baseline CMT was 510 μm (± 94 μm) in the IVB group and 493μm (±102 μm) in the IVZ group (P = 0.94). The mean baseline BCVA (log MAR) was 0.78 (Snellen's equivalent 6/36) in the IVZ and 0.70 (Snellen's equivalent 6/30) in the IVB group (P = 0.78). Central macular thickness was significantly reduced at 1st, 2nd and 3rd month in the IVZ group and IVB group (P < 0.001). Conclusion:  Intravitreal Ziv-Aflibercept is safe and more effective than Bevacizumab for the treatment of edema caused by diabetes mellitus, retinal vein occlusion and wet age related macular degeneration.


2016 ◽  
Vol 236 (2) ◽  
pp. 67-73 ◽  
Author(s):  
Yoshito Koyanagi ◽  
Shigeo Yoshida ◽  
Yoshiyuki Kobayashi ◽  
Yuki Kubo ◽  
Muneo Yamaguchi ◽  
...  

Purpose: To compare the effectiveness of intravitreal ranibizumab (IVR) for diabetic macular edema (DME) between eyes with and without previous vitrectomy. Procedures: We prospectively assessed the best-corrected visual acuity (BCVA) and central macular thickness (CMT) after IVR for 6 months. Results: There were no significant differences in the baseline BCVA and CMT between both groups. In the nonvitrectomized group (n = 15), the mean changes of BCVA and CMT from baseline to month 6 were significant (p < 0.01). In the vitrectomized group (n = 10), the improvement appeared to be slower, and the mean BCVA improvement was not significant (p = 0.5), although the mean CMT decrease was significant (p < 0.05). There were no significant differences in the mean changes of BCVA and CMT between both groups at 6 months. Conclusions: The difference in the effectiveness of IVR between both groups was not significant. IVR can be a treatment option even for vitrectomized DME eyes.


2014 ◽  
Vol 2014 ◽  
pp. 1-10 ◽  
Author(s):  
Keiji Inagaki ◽  
Kishiko Ohkoshi ◽  
Sachiko Ohde ◽  
Gautam A. Deshpande ◽  
Nobuyuki Ebihara ◽  
...  

To assess the efficacy of subthreshold micropulse diode laser photocoagulation (SMDLP) for persistent macular edema secondary to branch retinal vein occlusion (BRVO), including best-corrected visual acuity (BCVA) > 20/40, thirty-two patients (32 eyes) with macular edema secondary to BRVO were treated by SMDLP. After disease onset, all patients had been followed for at least 6 months prior to treatment. Baseline Snellen visual acuity was used to categorize the eyes as BCVA ≤ 20/40 (Group I) or BCVA > 20/40 (Group II). Main outcome measures were reduction in central macular thickness (CMT) in optical coherence tomography (OCT) and BCVA at 6 months. In the total subject-pool at 6 months, BCVA had not changed significantly but CMT was significantly reduced. Group I exhibited no significant change in CMT at 3 months but exhibited significant reductions at 6 and 12 months. Group II exhibited a marginally significant reduction in CMT at 3 months and a significant reduction at 6 months. In patients with persistent macular edema secondary to BRVO, SMDLP appears to control macular edema with minimal retinal damage. Our findings suggest that SMDLP is an effective treatment method for macular edema in BRVO patients with BCVA > 20/40.


2018 ◽  
Vol 7 (3) ◽  
pp. 89-93
Author(s):  
Kiran Shakya ◽  
Ram Prasad Pokhrel ◽  
Om Krishna Malla

Background: Macular edema is the common sight-threatening condition following branch retinal vein occlusion. Objective: To find spectral domain optical coherence tomography characteristics of macular involvement and visual acuity in the patients with branch retinal vein occlusion Methodology: This is a cross-sectional study; consecutive new cases of branch retinal vein occlusion diagnosed at the ophthalmology department of Kathmandu Medical College, Kathmandu were carried out from November 2016 to October 2017. All subjects were divided three groups with normotensive/controlled hypertension, stage 1 hypertension (systolic pressure >140 mm Hg or diastolic pressure >90mm Hg) and Stage 2 hypertension (systolic pressure >160 mm Hg or diastolic pressure >100 mm Hg).The macular edema was evaluated by taking best corrected visual acuity and spectral domain optical coherence tomography for measurement of central foveal thickness. Results: Forty patients with forty eyes were enrolled. Mean age was 58.5 years SD ± 9.98 years. Stage 1 and stage 2 hypertensive groups had significantly worse best corrected visual acuity and more thickness of central foveal thickness than normotensive/controlled group (p<0.001). The best corrected visual acuity and central foveal thickness were successively worse among normotensive group, stage 1 hypertensive group and stage 2 hypertensive group (between normotensive/controlled group and stage 1 hypertensive group, p = 0.032 and 0.002 respectively and between stage I hypertensive group and stage 2 hypertensive group, p= 0.013 and 0.09 respectively). Conclusion: Control of hypertension could be a main contributing measure to lower incidence of branch retinal vein occlusion and the severity of macular edema.


2020 ◽  
Vol 9 (8) ◽  
pp. 2360
Author(s):  
Yusuke Arai ◽  
Hidenori Takahashi ◽  
Satoru Inoda ◽  
Shinichi Sakamoto ◽  
Xue Tan ◽  
...  

Purpose: To assess the efficacy and safety of a modified treat-and-extend (mTAE) regimen of aflibercept for macular edema (ME) due to branch retinal vein occlusion (BRVO). Methods: This prospective multicentre intervention study evaluated 50 eyes of 50 patients enrolled from October 2016 to September 2017. The patients received intravitreal aflibercept (IVA) injections on an mTAE regimen for a total of 12 months. The main outcome measures were best-corrected visual acuity (BCVA) and central subfield thickness (CST) at 12 months. Results: The baseline BCVA and CST were 0.33 (0.27) and 488 (171) µm (mean (standard deviation)), respectively. The BCVA and CST were significantly improved at month 12 (0.067 (0.19) LogMAR and 295 (110) µm; both p < 0.0001, paired t-test). The mean number of clinic visits and IVA injections was 6.71 (1.41) and 4.26 (0.71), respectively. The time to first recurrence from the first injection was most frequently 3 months. Conclusion: The mTAE regimen of IVA injections for ME due to BRVO effectively improved BCVA and reduced CST, and thus might be an effective therapy to reduce the number of injections and visits.


2018 ◽  
Vol 28 (6) ◽  
pp. 697-705 ◽  
Author(s):  
Francesco Bandello ◽  
Albert Augustin ◽  
Adnan Tufail ◽  
Richard Leaback

Purpose: Dexamethasone intravitreal implant and intravitreal ranibizumab are indicated for the treatment of macular edema secondary to retinal vein occlusion. This non-inferiority study compared dexamethasone with ranibizumab in patients with branch retinal vein occlusion. Methods: In this randomized, 12-month head-to-head comparison, subjects with branch retinal vein occlusion were assigned to dexamethasone 0.7 mg at day 1 and month 5 with the option of retreatment at month 10 or 11, or ranibizumab 0.5 mg at day 1 and monthly through month 5 with subsequent as-needed injections at month 6–month 11. The primary efficacy outcome was the mean change from baseline in best-corrected visual acuity at month 12; secondary outcomes included average change in best-corrected visual acuity, proportion of eyes with ≥10- and ≥15-letter gain/loss, change in central retinal thickness, and change in Vision Functioning Questionnaire-25 score. Results: In all, 307 of a planned 400 patients were enrolled in the study and received (mean) 2.5 dexamethasone injections (n = 154) and 8.0 ranibizumab injections (n = 153) over 12 months. The mean change from baseline in best-corrected visual acuity at month 12 was 7.4 letters for dexamethasone versus 17.4 letters for ranibizumab (least-squares mean difference (dexamethasone minus ranibizumab), −10.1 letters; 95% confidence interval, −12.9, −7.2; p = 0.0006). Conclusion: Dexamethasone and ranibizumab improved best-corrected visual acuity and anatomical outcomes; however, dexamethasone did not show non-inferiority to ranibizumab in this under-powered study. Dexamethasone was associated with an increased risk of intraocular pressure elevation and cataract progression, but a lower injection burden, compared to ranibizumab.


2018 ◽  
Vol 28 (6) ◽  
pp. 690-696 ◽  
Author(s):  
Yelda Buyru Özkurt ◽  
Sezen Akkaya ◽  
Sibel Aksoy ◽  
Mert Hakan Şimşek

Purpose: To compare the effects of intravitreal ranibizumab injection and yellow (577 nm) subthreshold micropulse laser treatment in patients with macular edema following non-ischemic branch retinal vein occlusion. Methods: The medical records of 51 patients who underwent intravitreal ranibizumab (0.5 mg) injection or subthreshold micropulse laser for the treatment of macular edema due to branch retinal vein occlusion were retrospectively reviewed. Subthreshold micropulse laser was administered with a 10% duty cycle, 100 μm spot diameter, 200 ms exposure time. The patients received an injection or laser treatment at baseline and were, then, retreated as needed and were followed for 12 months. The mean best corrected visual acuity changes over the follow-up and the decrease in the mean central macular thickness were evaluated. Results: A total of 27 and 24 patients were assigned to intravitreal ranibizumab and subthreshold micropulse laser subgroups, respectively. The mean number of treatment was 3.81 of intravitreal ranibizumab group and 1.5 of subthreshold micropulse laser group (p < 0.05). The subgroups were similar with regard to the mean score of best corrected visual acuity at baseline, at 1, 6, and 12 months (p > 0.05). The decrease in the mean central macular thickness was significant in both intravitreal ranibizumab and subthreshold micropulse laser groups at 1, 6, and 12 months than that of values at baseline (p < 0.05). No new ocular or systemic adverse events were observed. Conclusion: Our study results showed that intravitreal ranibizumab or yellow subthreshold micropulse laser treatment for macular edema due to branch retinal vein occlusion was not found to be superior to each other for reducing macular thickness and increasing visual acuity for 1-year period. Based on these results, subthreshold micropulse laser may be a useful alternative approach in the treatment of macular edema secondary to branch retinal vein occlusion.


Author(s):  
Andrea Radotma Silitonga ◽  
Sindy Boru Sembiring ◽  
Christina Josephina Bangun ◽  
Heri Purwoko

Introduction: Central retinal vein occlusion (CRVO) and branch retinal vein occlusion (BRVO) caused sudden visual decrease that most often treatable. This paper aims to describe clinical characteristic and outcome using bevacizumab for macular edema caused by retinal vein occlusion in real-life practice. Methods: This retrospective study included 91 treatment-naïve eyes with macular edema due to CRVO (55 eyes) and BRVO (36 eyes), who were treated with intravitreal bevacizumab (IVB) in pro re nata (PRN) regimen. Best corrected visual acuity (BCVA) and central macular thickness (CMT) before and after treatment were evaluated. Result: The mean age of patients was 60.3 + 11.2 years for CRVO and 55.7 + 8.2 years for BRVO. The mean baseline BCVA in the CRVO group was 1.41 + 0.55 logMAR. There was statistically significant improvement in BCVA after intravitreal bevacizumab compared to baseline (p < 0.001) in CRVO and BRVO group. Twenty six (47.3%) eyes with CRVO had BCVA > 1.0 logMAR (Snellen 20/200) at the last follow-up. In the BRVO group, the mean baseline BCVA was 0.93 + 0.48 logMAR. At the end of the follow up, 19 eyes (52.8%) with BRVO had BCVA > 0.3 logMAR (Snellen 20/40). There was also statistically significant improvement in CMT between all time points and baseline (p < 0.001) in both groups. At the end of the follow up, 26 (47.3%) eyes with CRVO and 25 eyes (69.4%) in BRVO group presented resolution of macular edema (CMT < 300). Conclusion: Intravitreal bevacizumab resulted in significant anatomical and functional improvement in macular edema associated with CRVO and BRVO, although outcome in CRVO group was sub-optimal.


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