Bevacizumab treatment of macular edema in CRVO and BRVO: long-term follow-up (BERVOLT study: bevacizumab for RVO long-term follow-up)

Intravitreal Dexamethasone Implant Has Better Retinal Perfusion than Anti-Vascular Endothelial Growth Factor Treatment for Macular Edema Secondary to Retinal Vein Occlusion: A Five-Year Real-World Study

PURPOSE

The purpose of the study was to investigate the long-term effect of intravitreal dexamethasone (DEX) implant and anti-vascular endothelial growth factor (VEGF) injection on macular edema (ME) secondary to retinal vein occlusion (RVO) in a real-world setting.

METHODS

The medical records of RVO-ME cases, with intravitreal injections and followed up for at least 5 years, were retrospectively reviewed. Changes in best-corrected visual acuity (BCVA) and central macular thickness (CMT) were primary outcomes. Images of fluorescence angiography and swept-source optical coherence tomography angiography were analyzed. Foveal avascular zone (FAZ) metrics and perfusion density at the last visit were also compared between the two treatments.

RESULTS

A total of 16 patients were recruited, 8 in the anti-VEGF group and 8 in the DEX group. At the 5th year, the BCVA and the CMT in the DEX group were not different from those in the anti-VEGF group (0.69 ± 0.36 LogMAR vs. 0.57 ± 0.30 LogMAR, p = 0.574; 183.25 ± 97.31 µm vs. 195.38 ± 40.92 µm, p = 0.442). Compared with the anti-VEGF group, the DEX group had higher FAZ circularity index (0.57 ± 0.14 vs. 0.68 ± 0.14, p = 0.130) and higher retinal perfusion density (0.45 ± 0.02 vs. 0.39 ± 0.03, p = 0.001), especially in the deep capillary plexus.

CONCLUSION

DEX implant and anti-VEGF injection had comparative long-term effects on RVO-ME. Compared with the anti-VEGF treatment, the DEX treatment had advantages in maintaining retinal perfusion in patients with RVO.

Clinical characteristics of branch retinal vein occlusion with increased retinal haemorrhage during treatment for macular oedema

This study was performed to evaluate clinical characteristics of branch retinal vein occlusion (BRVO) patients with increased retinal haemorrhage during macular oedema (MO) treatment. Patients were divided into increased and non-increased retinal haemorrhage groups. The former group was sub-divided based on the degree of increase: < 50% or ≥ 50%. Baseline characteristics, clinical data, and best vision achieved before and after increased retinal haemorrhage were assessed. Sixty-eight eyes of 68 patients were included. Forty-six eyes were non-increased, 11 eyes experienced < 50% increase in retinal haemorrhage, and 11 eyes had ≥ 50% increase. Ischaemic BRVO was related to increased haemorrhage based on the multivariate analysis. The ≥ 50% increase group exhibited higher baseline central subfield macular thickness (CSMT), poorer baseline best corrected visual acuity (BCVA), and longer mean periods between the final intravitreal injections and the time increased retinal haemorrhages were observed, compared to the < 50% group. The best vision achieved before and after increased haemorrhage was significantly worse in the ≥ 50% group. In conclusion, the ischaemic type of BRVO is related to increased retinal haemorrhage during MO treatment, and a ≥ 50% increase in haemorrhages is associated with higher CSMT and poorer BCVA at baseline, with poor visual gain.

Short-term effect of intravitreal conbercept injection on major and macular branch retinal vein occlusion

OBJECTIVE

To evaluate the effectiveness of intravitreal conbercept injection on major and macular branch retinal vein occlusion (BRVO).

METHODS

This retrospective analysis involved 43 patients with BRVO (major BRVO n = 24; macular BRVO, n = 19) who were diagnosed by fluorescein fundus angiography (FFA) and injected with intravitreal conbercept. The following outcomes were measured at baseline and follow-up (1-6 months): best-corrected visual acuity (BCVA), central foveal thickness (CFT), total retinal volume in a 6-mm diameter section of the macula, choroidal thickness under the central fovea of the macula, relative area of retinal hemorrhage, complications, and times when repeated injection was performed.

RESULTS

There were significant differences between the two groups in terms of BCVA, CFT, and total retinal volume in a 6-mm diameter section of the macula at 6 months after treatment. Choroidal thickness under the central fovea of the macula and relative area of retinal hemorrhage showed no significant differences between the two groups at 6 months after treatment; however, they significantly differed from baseline measurements.

CONCLUSION

In general, intravitreal injection of conbercept may have a better short-term effect in patients with macular BRVO than in patients with major BRVO.