scholarly journals Evaluation of the Effectiveness of Treatment with Dexamethasone Intravitreal Implant in Cystoid Macular Edema Secondary to Retinal Vein Occlusion

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Simone Donati ◽  
Carlo Gandolfi ◽  
Simona Maria Caprani ◽  
Jennifer Cattaneo ◽  
Laura Premoli ◽  
...  

Purpose. To evaluate retinal functional improvement by means of visual acuity and retinal sensibility examination after intravitreal dexamethasone implant in patients affected by cystoid macular edema secondary to retinal vein occlusion. Methods. Twenty-six consecutive patients affected by retinal vein occlusion complicated by cystoid macular edema were enrolled in this prospective interventional study. All patients underwent a baseline complete ophthalmological evaluation as well as retinal angiography, OCT examination, and microperimetry evaluation. Each patient was treated with intravitreal injection of a long-term steroid implant (Ozurdex, Allergan). Follow-up evaluations were performed at months 1, 3, and 6 and completed by OCT and MP1 examination. Clinical data underwent statistical analysis. Results. Baseline functional evaluation showed mean visual acuity of 0,63±0,42 LogMAR and retinal sensitivity of 7,93±4,73 dB (mean±standard deviation); after treatment, at day 30 we found, respectively, 0,43±0,38 LogMAR (p<0.05, compared to baseline) and 10,15±4,410 dB (p<0.05); at day 90, we found 0,44±0,32 (p<0.05) and 9.61±4,29 dB (p<0.05); at day 180, we found 0,41±0,31 (p<0.05) and 9,95±3,79 dB (p<0.05). Fixation pattern improved significantly (p<0.05), showing a stable fixation in 30% of patients at baseline, increasing to 77% of patients at day 180. Baseline morphological evaluation showed a central retinal thickness (CRT) of 398,21±181,65 μm after treatment; we found a CRT of 222,64±95,21 μm at day 30 (p<0.05, compared to baseline), 307,50±120,25 μm (p<0.05) at day 90, and 294,93±135,86 μm (p<0.05) at day 180. About 15,3% patients showed already at month 3 a recurrence of macular edema. They underwent a retreatment before month 6 as for treatment guidelines. Conclusion. Our detailed analysis showed the significative increase in retinal function in the early phases of the follow-up. Retinal sensibility showed a stronger correlation than VA in macular edema reabsorption, better underlying the progressive functional recovery and increase in quality of vision and life for the patients. This trial is registered with ClinicalTrials.gov NCT03559491.

2019 ◽  
Vol 236 (04) ◽  
pp. 547-550
Author(s):  
Georgios Panos ◽  
Vassileios Kostakis ◽  
Grazyna Porter

Abstract Purpose The purpose of this study was to report the efficiency and safety of intravitreal aflibercept for the treatment of cystoid macular edema (CME) secondary to central retinal vein occlusion (CRVO). Methods This is a retrospective cohort study. Ten naive eyes of ten patients with CME secondary to CRVO were included. All eyes received a loading dose of 3 monthly aflibercept injections followed by as-needed injections at monthly follow-up visits. Best corrected visual acuity (BCVA) and central retinal thickness (CRT) were evaluated at baseline and at the end of the follow-up period. Results The median follow-up period was 6 months (range: 6 – 9). The median number of injections was 4 (range: 3 – 5). Median BCVA improved from 1.05 LogMAR units (range: 0.7 – 1.6) at baseline to 0.65 (range: 0.4 – 1.6) at the end of the follow-up period (p = 0.02). Median CRT improved from 690 µm (range: 561 – 1235) at baseline to 243 µm (range: 207 – 531) at the end of the follow-up period (p = 0.002). The power of all statistical tests was greater than 0.8. No adverse effects or complications were documented. Conclusion Intravitreal aflibercept treatment for CME secondary to CRVO significantly improved both macular anatomy and visual acuity without adverse effects.


Retina ◽  
2012 ◽  
Vol 32 (4) ◽  
pp. 792-798 ◽  
Author(s):  
Yumiko Kurashige ◽  
Akitaka Tsujikawa ◽  
Tomoaki Murakami ◽  
Kazuaki Miyamoto ◽  
Ken Ogino ◽  
...  

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.


2018 ◽  
Vol 2 (5) ◽  
pp. 289-296 ◽  
Author(s):  
Atalie C. Thompson ◽  
Akshay S. Thomas ◽  
Adam L. Rothman ◽  
Duncan Berry ◽  
Sharon Fekrat

Purpose: To investigate the longitudinal relationship between subfoveal choroidal thickness (CT) and central retinal vein occlusion (CRVO). Methods: Retrospective cohort of 104 subjects with enhanced-depth imaging optical coherence tomography for unilateral CRVO. Mean CT and best-corrected visual acuity (BCVA) were compared in eyes with and without CRVO and in eyes with CRVO with and without cystoid macular edema (CME). Results: CT was thicker in eyes with CRVO-related CME than uninvolved contralateral eyes at baseline (263.9 ± 86.9 versus 230.2 ± 87.9 µm; P < .001) and final follow-up (261.1 ± 94.7 versus 222.3 ± 86.2 µm; P = .007). CRVO eyes treated with intravitreal antivascular endothelial growth factor with or without steroid therapy showed a significant reduction in CT at final follow-up (256.3 ± 90.7 versus 236.9 ± 85.9 µm; P = .004). Subjects with CRVO who were not treated with intravitreal injections also showed a significant but more modest decline in CT over time (234.4 ± 94.2 versus 221.5 ± 97.1 µm; N = 31; P = .02). However, contralateral uninvolved eyes without CRVO did not show a significant change in CT over time (233.3 ± 87.9 versus 219.5 ± 90.6 µm; N = 71; P = .40). Persistent CME at final follow-up was associated with thicker baseline (277.6 ± 96.4 versus 235.1 ± 86.5 µm; P = .02) and final CT (265.7 ± 93.4 versus 215.0 ± 82.1 µm; P = .005). Change in CT was not related to change in BCVA ( P > .05). Conclusions: CT was greater in eyes with CRVO-related CME compared to eyes with CRVO but no CME and compared to uninvolved contralateral eyes. CT decreased in eyes with CRVO over time both among eyes that received intravitreal injections and among eyes that did not receive injections. CT may be a prognosticator of treatment response in CRVO-related CME.


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.


2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Young Hwan Bae ◽  
Seong Mi Kim ◽  
Jin Young Kim ◽  
So Hyun Bae ◽  
Hakyoung Kim ◽  
...  

Purpose. To evaluate whether treatment with intravitreal corticosteroid and anti-vascular endothelial growth factor (VEGF) injections alternately can improve treatment outcomes of macular edema (ME) caused by retinal vein occlusion (RVO). Methods. This dual-center retrospective study included 112 eyes with treatment-naïve ME secondary to RVO that were alternately treated with intravitreal corticosteroid and anti-VEGF injections (33 eyes, alternate group) or treated only with intravitreal anti-VEGF injections (79 eyes, anti-VEGF group) on a pro re nata basis. Results. During the 12-month follow-up period, the alternate group achieved a visual acuity gain of 0.39 logMAR, while the anti-VEGF group achieved a gain of 0.21 logMAR ( P = 0.042 ). The alternate group demonstrated a reduction in the central macular thickness of 229.9-μm, while the anti-VEGF group achieved a reduction of 220.1 μm ( P = 0.887 ). The alternate group required an average of 5.2 injections, while the anti-VEGF received 4.2 injections ( P < 0.001 ). In a propensity score-matched cohort to compensate for the differences in the injection numbers between the two groups, the alternate group achieved a better visual acuity gain than the anti-VEGF group at month 12 (0.39 logMAR vs. 0.17 logMAR, P = 0.048 ). Conclusions. In ME secondary to RVO, treatment with intravitreal corticosteroid and anti-VEGF injections alternately resulted in a more favorable visual outcome compared with intravitreal anti-VEGF monotherapy.


Retina ◽  
2014 ◽  
Vol 34 (9) ◽  
pp. 1743-1749 ◽  
Author(s):  
Baruch D. Kuppermann ◽  
Julia A. Haller ◽  
Francesco Bandello ◽  
Anat Loewenstein ◽  
Jenny Jiao ◽  
...  

2020 ◽  
Vol 12 (2) ◽  
pp. 281-289
Author(s):  
Anil Parajuli ◽  
Purushottam Joshi ◽  
Prabha Subedi ◽  
Chandni Pradhan

Introduction: The most common cause of vision loss in cases of Retinal vein occlusion (RVO) is due to macular edema. This study was conducted to examine the effect of intravitreal bevacizumab (IVB) in the treatment of macular edema secondary to RVO. Materials and methods: The authors conducted a retrospective study of 94 eyes (N) of 92 patients with macular edema associated with decreased visual acuity secondary to RVO who were treated with IVB. Patients received IVB at baseline, 1 month and 2 months. At each follow up patients were evaluated and re-injected if necessary. Results: The mean age of the patients was 56.6 ±11.51 years. The average number of injections per eye was 2.1 ± 0.87. The baseline median central macular thickness (CMT) and best-corrected visual acuity (BCVA) in LogMAR was 465.00μm (Min 254μm, Max 1218μm) and 1.00 (Min 0.30, Max 2.28), respectively. The median CMT at one month following first, second and third dose of IVB was 258μm (N=94, Z= -7.64, p <0.001), 261μm (N=63, Z= -0.17, p=0.86), and 292μm (N=41, Z= -0.21, p= 0.83), respectively. The median LogMAR BCVA at one month following first, second and third dose of IVB was 0.60 (N=94, Z= -5.70, p < 0.001), 0.60 (N=63, Z= -1.69, p=0.09), and 0.60 (N=41, Z= -0.03, p=0.97), respectively. Pre-operative BCVA was the best predictor of the final visual outcome after IVB in cases of RVO. None of the patients developed any serious ocular or systemic complications due to IVB. Conclusion: IVB is an effective and safe treatment for macular edema associated with decreased visual acuity secondary to RVO. The most beneficial effect of IVB is seen at one month after the first dose. The efficacy of subsequent doses could not be established in this study


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