Abstract
PurposeTo investigate the long-time outcome of patients with branch vein occlusion (BRVO) and central vein occlusion (CRVO) treated with anti-VEGF injections compared to the dexamethasone (DEX) implant.MethodsThis retrospective real-life study included all 492 patients presenting with retinal vein occlusion (RVO) during 2012–2013 at St. Erik Eye Hospital. Maximum follow-up was 5 years.ResultsThe mean time of follow-up for patients treated for macular edema was 33.2±17.7 and 34.3±18.1 months in the BRVO and CRVO groups, respectively. At the end of follow-up, the best-corrected visual acuity improved +9.8±20.4 Early Treatment Diabetic Retinopathy Study letters in BRVO patients receiving anti-VEGF therapy while patients treated with the DEX implant lost −2.1±23.4 letters (p<0.05). CRVO patients treated with anti-VEGF therapy improved +0.2±27.6 letters while patients receiving a DEX implant lost −9.7±32.6 letters (p=0.11). Overall, in RVO patients treated with anti-VEGF injections, the central retinal thickness decreased to 322±174μm compared to 398±174 μm in patients treated with the DEX implant (p<0.05).ConclusionsIn a clinical setting, a substantial part of patients is still in follow-up a long time after presentation. The visual and anatomical outcomes were better in patients treated with anti-VEGF agents compared to subjects receiving a DEX implant.
Highlights
Retinal vein occlusion (RVO) is a common retinal vasculopathy that may cause significant visual impairment [1, 2]
In RVO patients treated with anti-vascular endothelial growth factor (VEGF) injections, the central retinal thickness decreased to 322±174μm compared to 398±174 μm in patients treated with the DEX implant (p
In the branch vein occlusion (BRVO) group, the central retinal thickness (CRT) decreased in subjects receiving anti-VEGF injections from 547±212 to 321±124 μm compared to a reduction from 531±170 to 391±177 μm in patients treated with the DEX implant (p
Summary
Retinal vein occlusion (RVO) is a common retinal vasculopathy that may cause significant visual impairment [1, 2]. During this second year of follow-up, the patients received between 2.0 (BRVO) and 3.8 (CRVO) additional ranibizumab injections. The RETAIN study investigated prospectively the outcome of 66 RVO patients after 4 years They showed a BCVA improvement of +20 and +14 letters for BRVO and CRVO patients, respectively, at the end of follow-up while receiving 14.8 ranibizumab injections (BRVO) and 19.2 injections (CRVO) during this time span [9]. How this data translates into a daily clinical setting with a non-selected patient population is not clear. In the BERVOLT study including 152 eyes treated with bevacizumab, the BCVA increased by 0.25 Log MAR in the BRVO group and decreased by −0.118 Log MAR in the CRVO group after 2 years [11]
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