scholarly journals The effects of intravitreally injected dexamethasone implant and anti-VEGF on macular edema due to retinal vein occlusion

2021 ◽  
Vol 12 (06) ◽  
Keyword(s):  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Dexamethasone Implant ◽  
Vein Occlusion ◽  
Anti Vegf

scholarly journals The Role of Steroids in the Management of Macular Edema from Retinal Vein Occlusion

2019 ◽  
Vol 16 (1) ◽  
pp. 95-101
Author(s):  
M. V. Budzinskaya ◽  
A. V. Shelankova ◽  
A. A. Plukhova ◽  
N. M. Nuriyeva ◽  
A. S. Sorokin
Keyword(s):  
Macular Edema ◽  
Intravitreal Injection ◽  
Retinal Vein Occlusion ◽  
Intravitreal Injections ◽  
Ophthalmological Examination ◽  
Dexamethasone Implant ◽  
Duration Of Treatment ◽  
Vein Occlusion ◽  
Anti Vegf ◽  
Group 1

Aim: To analyze the effectiveness of intravitreal injection of an anti-VEGF agent (ranibizumab) and an dexametazon implant for the intravitreal injection, in real clinical life.Patients and Methods. 137 patients with MO due to retinal venous occlusion were included in the study. Patients were retrospectively divided into groups: patients who received monotherapy with ranibizumab 94 people; and monotherapy with dexamethasone implant — 15 patients; patients who initially were injected with a dexamethasone implant, but due the study transferred to ranibizumab 15 patients; patients who initially received ranibizumab, but then transferred to the dexamethasone implant -13. For the treatment of macular edema were used an anti-VEGF agent — ranibizumab (Lucentis) 0.05 ml (0.5 mg) manufactured by Novartis (Switzerland) or glucocorticosteroid — dexamethasone implant for intravitreal injection of 0.7 mg (Ozurdex) manufactured by Allergan Pharmaceutical Ireland (Ireland). The injections were administered on a pro re nata basis (the presence of macular edema). Standard ophthalmological examination and fluorescent angiography (PAG), optical coherent tomography (OCT), optical coherence tomography angiography (OCT-A) were used. Visual acuity changes (BCVA), central retinal thickness (CRT) and intraocular pressure (IOP) were analyzed depending on the study group (group 1–4), the duration of treatment and the number of injections. Results: In group 1, from 1 to 8 IVVs were performed in 24 months, an average of 3.77. In group 2, from 1 to 4 intravitreal injections were performed in 24 months, an average of 1.37. In group 3, from 1 to 2 of intravitreal injections Ozurdex and from 1 to 4 intravitreal injections of ranibizumab for 24 months. In group 4, from 1 to 4 intravitreal injections of anti-VEGF drug and from 1 to 4 intravitreal dexamethasone implant were performed in 24 months of follow-up. Monotherapy with the Ozurdex drug (12 months) had the most stable effect, with a relapse of the process, repeated injections were required, conducted only in 3 out of 15 patients. Conclusion: In real clinical practice, the dexamethasone implant showed a good safety profile and high efficacy in the resorption of macular edema in patients with retinal vein occlusion, which corresponds to the clinical trials that was made earlier. 

scholarly journals Switch of Intravitreal Therapy for Macular Edema Secondary to Retinal Vein Occlusion from Anti-VEGF to Dexamethasone Implant and Vice Versa

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Amelie Pielen ◽  
Anima Desiree Bühler ◽  
Sonja Ute Heinzelmann ◽  
Daniel Böhringer ◽  
Thomas Ness ◽  
...  
Keyword(s):  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Dexamethasone Implant ◽  
Intravitreal Therapy ◽  
Foveal Thickness ◽  
Central Foveal Thickness ◽  
Vein Occlusion ◽  
Anti Vegf ◽  
Treatment Naïve ◽  
Intravitreal Dexamethasone

Purpose. To evaluate the anatomical and functional outcome of intravitreal dexamethasone implant for macular edema secondary to central (C) or branch (B) retinal vein occlusion (RVO) in patients with persistent macular edema (ME) refractory to intravitreal antivascular endothelial growth factor (VEGF) treatment compared to treatment naïve patients and to dexamethasone-refractory eyes switched to anti-VEGF. Methods. Retrospective, observational study including 30 eyes previously treated with anti-VEGF (8 CRVO, 22 BRVO, mean age 69 ± 10 yrs), compared to 11 treatment naïve eyes (6 CRVO, 5 BRVO, 73 ± 11 yrs) and compared to dexamethasone nonresponders (2 CRVO, 4 BRVO, 69 ± 12). Outcome parameters were change in best-corrected visual acuity (BCVA) and central foveal thickness (CFT) measured by spectral-domain optical coherence tomography. Results. Mean BCVA improvement after switch to dexamethasone implant was 4 letters (p=0.08), and treatment naïve eyes gained 10 letters (p=0.66), while we noted no change in eyes after switch to anti-VEGF (p=0.74). Median CFT decrease was most pronounced in treatment naïve patients (−437 μm, p=0.002) compared to anti-VEGF refractory eyes (−170 μm, p=0.003) and dexamethasone-refractory eyes (−157, p=0.31). Conclusions. Dexamethasone significantly reduced ME secondary to RVO refractory to anti-VEGF. Functional gain was limited compared to treatment naïve eyes, probably due to worse BCVA and CFT at baseline in treatment naïve eyes.

scholarly journals Retinal venous pressure is decreased after anti-VEGF therapy in patients with retinal vein occlusion–related macular edema

2021 ◽  
Author(s):  
Teruyo Kida ◽  
Josef Flammer ◽  
Katarzyna Konieczka ◽  
Tsunehiko Ikeda
Keyword(s):  
Macular Edema ◽  
Intravitreal Injection ◽  
Retinal Vein Occlusion ◽  
Venous Pressure ◽  
Decisive Role ◽  
Retinal Venous Pressure ◽  
Vein Occlusion ◽  
Anti Vegf ◽  
Significant Difference ◽  
Endothelial Growth Factor

Abstract Purpose The pathomechanism leading to retinal vein occlusion (RVO) is unclear. Mechanical compression, thrombosis, and functional contractions of veins are discussed as the reasons for the increased resistance of venous outflow. We evaluated changes in the retinal venous pressure (RVP) following intravitreal injection of anti-vascular endothelial growth factor (VEGF) agent to determine the effect on RVO-related macular edema. Methods Twenty-six patients with RVO-related macular edema (16 branch RVOs [BRVOs] and 10 central RVOs [CRVOs], age 72.5 ± 8.8 years) who visited our hospital were included in this prospective study. Visual acuity (VA), intraocular pressure (IOP), central retinal thickness (CRT) determined by macular optical coherence tomography, and RVP measured using an ophthalmodynamometer were obtained before intravitreal injection of ranibizumab (IVR) and 1 month later. Results Comparison of the BRVOs and CRVOs showed that VA was significantly improved by a single injection in BRVOs (P < 0.0001; P = 0.1087 for CRVOs), but CRT and RVP were significantly decreased without significant difference in IOP after the treatment in both groups (P < 0.0001). Conclusion The anti-VEGF treatment resulted in a significant decrease in the RVP, but the RVP remained significantly higher than the IOP. An increased RVP plays a decisive role in the formation of macula edema, and reducing it is desirable.

scholarly journals The Effect of Antivascular Endothelial Growth Factor Therapy on the Development of Neovascular Glaucoma after Central Retinal Vein Occlusion: A Retrospective Analysis

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Christina L. Ryu ◽  
Adrian Elfersy ◽  
Uday Desai ◽  
Thomas Hessburg ◽  
Paul Edwards ◽  
...  
Keyword(s):  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Central Retinal Vein Occlusion ◽  
Significant Risk ◽  
Case Series ◽  
Neovascular Glaucoma ◽  
Vein Occlusion ◽  
Anti Vegf ◽  
Central Retinal Vein

Purpose. Ischemic central retinal vein occlusion (CRVO) eyes are at high risk of developing neovascular glaucoma (NVG). Our purpose is to investigate the effect of anti-VEGF therapy for macular edema after CRVO on the development of neovascular glaucoma (NVG) in ischemic CRVO eyes.Methods. This is a retrospective case series of 44 eyes from 44 patients with CRVO treated with anti-VEGF therapy for macular edema. The primary outcome was the development of NVG.Results. Of the 44 eyes, 14 eyes had ischemic CRVO, and 30 eyes had nonischemic CRVO. Nonischemic eyes received a mean of 8.4 anti-VEGF doses, over mean follow-up of 24 months. One nonischemic eye (3.3%) developed NVD but not NVG. The 14 ischemic eyes received a mean of 5.6 anti-VEGF doses, with mean follow-up of 23 months. Of these 14 ischemic eyes, two eyes (14%) developed iris neovascularization and 3 eyes (21%) developed posterior neovascularization. Three of these 5 eyes with neovascularization progressed to NVG, at 19.7 months after symptom onset, on average.Conclusion. Anti-VEGF therapy for macular edema may delay, but does not prevent, the development of ocular NV in ischemic CRVO. Significant risk of NVG still exists for ischemic CRVO eyes.

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