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Anti‐ VEGF treatment in branch retinal vein occlusion: a real‐world experience over 4 years
Author(s) -
Rezar Sandra,
Eibenberger Katharina,
Bühl Wolf,
Georgopoulos Michael,
SchmidtErfurth Ursula,
Sacu Stefan
Publication year - 2015
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/aos.12772
Subject(s) - medicine , branch retinal vein occlusion , ranibizumab , visual acuity , ophthalmology , occlusion , retinal , central retinal vein occlusion , macular edema , bevacizumab , retinal vein , surgery , chemotherapy
Abstract Purpose To determine long‐term outcome of intraocular antagonism of vascular endothelial growth factor ( VEGF ) in macular oedema (ME) secondary to branch retinal vein occlusion ( BRVO ). Methods A total of 28 consecutive patients were treated with either intravitreal bevacizumab ( IVB ) or intravitreal ranibizumab ( IVR ) in the first series and were evaluated after a mean follow‐up of 5 years for their functional and anatomical outcome. Results Time between onset of macular oedema and initial treatment was 5.2 ± 0.4/0.1 ± 0.1 ( IVB / IVR ) months. A mean of 4 intravitreal injections were given per patients in the first 6 months. In months 7–12 intravitreal injections decreased to 2 and further decreased in the second year (months 13–18: 1.14; months 19–24: 0.5) and third year (months 25–30: 0.4; months 31–36: 0.2). After the fourth year, only two of the 28 patients received further treatment. Average visual acuity ( VA ) increased by 16 letters after 1 year (p < 0.01) and although not statistically significantly, by a mean of 5 letters (p = 0.3) at long‐term evaluation ( IVB ‐group). However, after mean of 5 years, central retinal sensitivity ( CRS ) improved by 3.6 dB (p = 0.01) and central retinal thickness ( CRT ) decreased by 161 μ m (p = 0.02). In the IVR ‐group, VA and CRS increased significantly (31 letters and respectively 4.4 dB, p < 0.001) and CRT decreased by 229 μ m (p < 0.001) after long‐term follow‐up. Final functional results were significantly better in patients with treatment initiation <3 months (79 versus 55 letters, p = 0.01). Microvascular abnormalities were detected in 88% (21 of 24 patients), hyperfluorescence in 42% (10 of 24 patients) on wide‐field fluorescein angiography in both groups. Conclusions Inhibition of VEGF provides substantial long‐term benefits for patients with ME secondary to BRVO . Early treatment with anti‐ VEGF agents and extended therapeutic surveillance was associated with improved visual recovery.