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5 year clinical and angiographic outcomes of intravitreal vascular endothelial growth factor antagonisms in patients with retinal vein occlusion

Session Details

Session Title: Vascular Diseases II

Session Date/Time: Friday 27/09/2013 | 11:00-12:30

Paper Time: 11:48

Venue: Hall F (Level 2)

First Author: S.Rezar AUSTRIA

Co Author(s):    S. Sacu   K. Eibenberger   R. Blum   M. Georgopoulos     

Abstract Details

Purpose:

To evaluate long-term effects of intraocular antagonism of vascular endothelial growth factor (VEGF) in patients with macular edema secondary to branch retinal vein occlusion.

Setting:

This cross-sectional study including 28 patients was performed at the Department of Ophthalmology and Optometry, Medical University of Vienna.

Methods:

From case series with 54 patients concerning macula edema secondary to branch retinal vein occlusion (BRVO) 28 were included into this study after a mean time of 5 years. The 54 patients were treated with either intravitreal Ranibizumab (IVR, n=25) or Bevacizumab (IVB, n=29). Primary outcome measures were mean change in best-corrected visual acuity (BCVA) from initial treatment and change in central retinal thickness (CRT). Secondary outcomes were wide-field angiographic outcomes using Optos Optomap and retinal sensitivity (CRS).

Results:

28 of the original 54 patients were successfully recruited to the study. The mean follow-up was 6±1.0 years in the IVB group and 4±0.8 in the IVR group. Mean time between onset of RVO and initial treatment was 188±141 days in the IVB group (n=14, 48%) and 51±31 days In IVR group (n=14, 56%). In the IVB group mean of 9±5.4 injections were admistered. The average visual acuity increased by 6 letters with no statistical significance (p=0.3) while CRS improved by 3.1dB (p=0.01) and CRT decreased by 162 µm (p=0.02). In the IVR group, visual acuity and CRS increased significantly (27 letters; 4.6dB) (p<0.001) and the CRT decreased 229 µm (p<0.001). IVR group received a mean of 6±5.6 injections. 6 patients in the IVB group and 4 patients in IVR group received additional sector laser photocoagulation due to retinal ischemia. In 14 eyes (50%), ultra-wide-field fluorescein angiography demonstrated nonperfusion in the peripheral retina in both groups.

Conclusions:

Our results show long-term benefit of intraocular antagonisms with anti-vascular endothelial growth factor agents in patients with macular edema secondary to branch retinal vein occlusion. Early treatment with anti-VEGF agents showed better visual recovery in our patients. Often frequent injections and long aftercare with continuous evaluation is required in patients with macula edema due to branch retinal vein occlusion. Wide-field angiography seems to give new insights in the monitoring and treatment of retinal vein occlusions.

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