scholarly journals Bevacizumab Treatment and Treatment Regimes in Branch Retinal Vein Occlusion and Macular Edema

2019 ◽  
pp. 99-103
Keyword(s):  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Branch Retinal Vein Occlusion ◽  
Vascular Endothelial ◽  
Steroid Injections ◽  
Treatment Regimes ◽  
Vein Occlusion ◽  
Bevacizumab Treatment ◽  
Endothelial Growth Factor ◽  
Retinal Vein Occlusions

Macular edema secondary to retinal vein occlusions is a significant complication affecting the vision. Medical treatment of retinal vein occlusions first started with intraocular steroid injections and then enriched with intraocular Anti-VEGF (Vascular Endothelial Growth Factor) injections. But till now the length and frequency of therapy have not been defined clearly. In this review, the use of bevacizumab in the treatment of branch retinal vein occlusion and macular edema will be summarized in light of the current literature.

Intraocular Injections of Ranibizumab in Patients with Macular Edema Following Branch Retinal Vein Occlusion

2020 ◽  
pp. 127-132
Author(s):  
Alan D. Penman ◽  
Kimberly W. Crowder ◽  
William M. Watkins
Keyword(s):  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Branch Retinal Vein Occlusion ◽  
Controlled Trial ◽  
Phase Iii ◽  
Vascular Endothelial ◽  
Vein Occlusion ◽  
Endothelial Growth Factor ◽  
First Line Treatment

The Ranibizumab for Macular Edema following Branch Retinal Vein Occlusion (BRAVO) study was a 6-month, phase III, randomized, injection-controlled trial, with an additional 6 months of follow-up (total 12 months), to evaluate the safety and efficacy of intraocular injections of 0.3 mg and 0.5 mg ranibizumab (an anti–vascular endothelial growth factor [VEGF] agent) in patients with macular edema following branch retinal vein occlusion (BRVO). The study showed that intraocular injections of 0.3 mg or 0.5 mg ranibizumab provided rapid, effective treatment for macular edema following BRVO with low rates of ocular and nonocular adverse events. This study led to a paradigm shift toward anti-VEGF agents as the first-line treatment for macular edema secondary to BRVO.

scholarly journals OCT angiography features associated with macular edema recurrence after intravitreal bevacizumab treatment in branch retinal vein occlusion

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Kwang-Eon Choi ◽  
Cheolmin Yun ◽  
Jaehyung Cha ◽  
Seong-Woo Kim
Keyword(s):  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Branch Retinal Vein Occlusion ◽  
Intravitreal Bevacizumab ◽  
Intravitreal Bevacizumab Injection ◽  
Vein Occlusion ◽  
Anti Vegf ◽  
Bevacizumab Treatment ◽  
Capillary Plexus ◽  
Endothelial Growth Factor

Abstract We aimed to evaluate the relationship between the capillary abnormalities including nonperfusion area (NPA) in optical coherence tomography angiography (OCTA) images and the recurrence of macular edema (ME) secondary to branch retinal vein occlusion (BRVO) after intravitreal injection of anti-vascular endothelial growth factor (anti-VEGF; bevacizumab). The records of 40 patients who underwent intravitreal bevacizumab injection for ME secondary to BRVO and had at least six months of follow-up were reviewed. Central retinal thickness (CRT; μm) and macular edema type were evaluated prior to treatment. After ME resolution, nonperfusion areas in the 1 mm (NPA1) and 1–3 mm (NPA3) zones on the Early Treatment Diabetic Retinopathy Study (ETDRS) circle within the superficial capillary plexus (SCP) and deep capillary plexus (DCP) were measured using OCTA images. Furthermore, other microvascular abnormalities in the both SCP and DCP were compared between groups. ME recurred in 25 of 40 (62.5%) eyes. The NPA1 of the SCP and DCP (p = 0.002, 0.004, respectively), NPA3 of the SCP and DCP (p = 0.002, 0.008, respectively), and initial CRT (p = 0.022) differed significantly between eyes with and without ME recurrence. In multivariate logistic regression analyses, the NPA1 of the DCP (OR: 344.718; p = 0.029) and NPA3 of the SCP (OR: 4.072; p = 0.018) were significantly associated with ME recurrence. Other microvascular abnormalities were not significantly different between two groups. The central NPA and parafoveal NPA of the SCP in OCTA images correlated strongly with ME recurrence in BRVO patients after intravitreal anti-VEGF injection.

Change of cytokines after intravitreal ranibizumab in patients with recurrent branch retinal vein occlusion and macular edema

2019 ◽  
pp. 112067211988505 ◽  
Author(s):  
Hidetaka Noma ◽  
Kanako Yasuda ◽  
Masahiko Shimura
Keyword(s):  
Vascular Endothelial Growth Factor ◽  
Growth Factor ◽  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Branch Retinal Vein Occlusion ◽  
Growth Factor Receptor ◽  
Vascular Endothelial ◽  
Intravitreal Ranibizumab ◽  
Vein Occlusion ◽  
Endothelial Growth Factor

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.

scholarly journals Intravitreal Aflibercept Injection and Treatment Regimens in Macular Edema due to Branch Retinal Vein Occlusion

2019 ◽  
pp. 92-98
Keyword(s):  
Growth Factor ◽  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Branch Retinal Vein Occlusion ◽  
Vascular Endothelial ◽  
Treatment Regimens ◽  
Vein Occlusion ◽  
Anti Vegf ◽  
Intravitreal Aflibercept ◽  
Endothelial Growth Factor

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.

scholarly journals Outcome of Switching Anti-VEGF Agents at Fixed Intervals to Treat Eyes With Macular Edema Secondary to Branch Retinal Vein Occlusion

2021 ◽  
Author(s):  
Tsuyoshi Mito ◽  
Takeshi Kobayashi ◽  
Atsushi Shiraishi
Keyword(s):  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Branch Retinal Vein Occlusion ◽  
Retinal Thickness ◽  
Vascular Endothelial ◽  
Vein Occlusion ◽  
Injection Interval ◽  
One Year ◽  
The One ◽  
Endothelial Growth Factor

Abstract ObjectiveTo determine whether switching intravitreal injections of ranibizumab or aflibercept to the other will affect the interval of subsequent injections in patients with macular edema secondary to branch retinal vein occlusion (BRVO).ResultsThe medical charts of 16 eyes of 16 patients were reviewed. After injections of ranibizumab or aflibercept for >3 times/year, the type of anti-vascular endothelial growth factor agent was switched. A comparison was made of the average injection interval for the one year before switching and the interval of the first two injections post-switching. In the group that switched from ranibizumab to aflibercept (R to A group, n=8), the interval before was 85.4±6.6 days which was significantly increased to 125.9±23.2 days post-switching (P=0.0013). In the A to R group (n=8), a significant shortening from 103.9±11.8 days before to 85.9±12.6 days was observed (P=0.007). In the R to A group, the central retinal thickness at a recurrence was 522.1±79.6 µm which decreased significantly to 419.3±64.5 µm post-switching (P=0.005). The results suggest that the intervals can be different between ranibizumab and aflibercept in patients with macular edema secondary to BRVO who required repeat injections.

scholarly journals Cytokines and the Pathogenesis of Macular Edema in Branch Retinal Vein Occlusion

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Hidetaka Noma ◽  
Kanako Yasuda ◽  
Masahiko Shimura
Keyword(s):  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Branch Retinal Vein Occlusion ◽  
Vascular Endothelial ◽  
Intraocular Injection ◽  
Vein Occlusion ◽  
Anti Vegf ◽  
Lifestyle Related Diseases ◽  
Endothelial Growth Factor

Branch retinal vein occlusion (BRVO) is a very common retinal vascular problem in patients with lifestyle-related diseases, such as hypertension and arteriosclerosis. In patients with BRVO, development of macular edema is the main cause of visual impairment. BRVO is still a controversial condition in many respects. Over the years, various methods such as laser photocoagulation have been tried to treat macular edema associated with BRVO, but the results were not satisfactory. After vascular endothelial growth factor (VEGF) was found to have an important role in the pathogenesis of macular edema in BRVO patients, treatment of this condition was revolutionized by development of anti-VEGF therapy. Although macular edema improves dramatically following intraocular injection of anti-VEGF agents, repeated recurrence and resistance of edema is a major problem in some BRVO patients. This suggests that factors or cytokines other than VEGF may be associated with inflammation and retinal hypoxia in BRVO and that the pathogenesis of macular edema is complicated. The present review assesses the role of various factors and cytokines in the pathogenesis of macular edema associated with BRVO. We present a mechanism that is not only plausible but should also be useful for developing new therapeutic strategies.

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