Anti‐VEGF treatment in branch retinal vein occlusion: a real‐world experience over 4 years. (24th June 2015)

• Record Type: Journal Article
• Authors: Rezar, Sandra; Eibenberger, Katharina; Bühl, Wolf; Georgopoulos, Michael; Schmidt‐Erfurth, Ursula; Sacu, Stefan
• Is Part Of: Acta ophthalmologica. Volume 93:Number 8(2015)
• Page Start: 719
• Page End: 725
• Publication Date: 2015-06-24
• Subjects: antivascular endothelial growth factor -- branch retinal vein occlusion -- long‐term outcome -- macular oedema; Ophthalmology -- Periodicals; 617.7005
• DOI: 10.1111/aos.12772
• Languages: English
• ISSNs: 1755-375X

Abstract

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.