Ranibizumab for Macular Edema Secondary to Central and Branch Retinal Vein Occlusion in Patients Younger Than 50 Years of Age.

Maurizio Battaglia Parodi,Francesco Romano,Alessandro Franceschi,Stefano Mercuri,Alessandro Arrigo,Francesco Bandello

doi:10.1155/2020/4747696

Maurizio Battaglia Parodi, Francesco Romano + Show 4 more

Open Access

https://doi.org/10.1155/2020/4747696

Copy DOI

Abstract

Background To determine the effectiveness of intravitreal ranibizumab (IVR) approach over 1-year follow-up in patients younger than 50 years old with central and branch retinal vein occlusion (RVO) complicated by macular edema (ME). Methods Prospective, open-label case series. Patients initiating IVR injections from January 2015 to May 2017 were consecutively recruited. Each patient underwent monthly ophthalmic examination and structural OCT over 12 months. A single IVR injection was administered at baseline, followed by a PRN regimen. Outcome measures are best-corrected visual acuity (BCVA); central foveal thickness (CFT); number of IVR injections; subretinal fluid (SRF); epiretinal membrane; and outer retinal layer (ORL) status. Results Thirty-eight patients (27 males) were included in the study. At follow-up, mean BCVA improved from 0.40 ± 0.17 to 0.10 ± 0.10 LogMAR in patients with central RVO and from 0.39 ± 0.19 to 0.19 ± 0.07 LogMAR in those with branch RVO, with 20 eyes gaining ≥3 ETDRS lines. In addition, mean CFT significantly decreased in both subgroups at the end of follow-up. All patients with SRF at baseline (9) disclosed complete resolution after 1 year. Likewise, ORL appeared reconstituted in most cases. At 12 months, 3.6 ± 2.4 and 4.4 ± 2.4 IVR injections were required for central and branch RVO, respectively, with only 5 eyes showing ME persistence. Conclusions Our study indicates that IVR injections can be a valid therapeutic option in patients under 50 years of age with ME secondary to RVO.

Highlights

Retinal vein occlusion (RVO) in patients younger than 50 years of age represents a distinct subgroup of the disease, probably related to different pathogenetic mechanisms [1,2,3,4,5,6]
The natural history of this retinal vein occlusion (RVO) subtype is believed to be more favourable with respect to older patients, as spontaneous improvement occurs in about one-fourth of cases in central RVO (CRVO) [10], with no specific study available instead for branch RVO (BRVO)
Positive effects were shown by a single study based on dexamethasone implant in a subset of CRVO patients with best-corrected visual acuity (BCVA) better than 20/400 Snellen equivalents [11]

Summary

Introduction

Retinal vein occlusion (RVO) in patients younger than 50 years of age represents a distinct subgroup of the disease, probably related to different pathogenetic mechanisms [1,2,3,4,5,6]. The natural history of this RVO subtype is believed to be more favourable with respect to older patients, as spontaneous improvement occurs in about one-fourth of cases in central RVO (CRVO) [10], with no specific study available instead for branch RVO (BRVO). To determine the effectiveness of intravitreal ranibizumab (IVR) approach over 1-year follow-up in patients younger than 50 years old with central and branch retinal vein occlusion (RVO) complicated by macular edema (ME). Outcome measures are best-corrected visual acuity (BCVA); central foveal thickness (CFT); number of IVR injections; subretinal fluid (SRF); epiretinal membrane; and outer retinal layer (ORL) status. At 12 months, 3:6 ± 2:4 and 4:4 ± 2:4 IVR injections were required for central and branch RVO, respectively, with only 5 eyes showing ME persistence. Our study indicates that IVR injections can be a valid therapeutic option in patients under 50 years of age with ME secondary to RVO

Methods

Results

Conclusion