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Gisela Barcat Angelelli, Miranda Buckle, Robert Johnston; Real-world visual acuity outcomes of ranibizumab treatment for retinal vein occlusion (RVO) in a well-defined region of the United Kingdom (UK). Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):3740.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate visual acuity outcomes up to 12 months in eyes with central, hemi and branch RVO treated with ranibizumab within a single UK centre.
A standardised dataset defined before first data entry was collected prospectively as a by-product of routine clinical care using an electronic medical record system (EMR). Data collection at each visit included: Early Treatment Diabetic Retinopathy Study visual acuity letter score (VA), Optical Coherence Tomography central 1 mm retinal thickness and injection episodes. The centre uses a pro re nata re-treatment posology at intended monthly follow up visits following a loading phase of 3 monthly injections. Hemiretinal vein occlusion was included within the central RVO group for analysis.
156 eyes were treated between May 2008 and Nov 2014, 81 eyes for central/hemi RVO and 75 eyes for branch RVO. There was a mean gain of 14.9 letters respectively at 12 months in each group. Lower baseline VA was associated with greater mean letter gain: for patients with baseline VA<55 letters, there was mean gain of 16.15 and 15.9 letters for the central/hemi and branch RVO groups respectively. For patients with baseline VA>55 letters, there was a mean gain of 4.05 and 2.65 letters respectively. Mean VA at 12 months was 59.0 and 63.7 letters and the percentage achieving VA > 70 letters was 2.5% and 10.7% in patients treated for central/hemi and branch RVO respectively. Mean central retinal thickness (CRT) at baseline was 605.1µm and 551.6µm for central and branch RVO respectively with a mean reduction of 319.4µm and 222.1µm respectively at 12 months.The median number of injections was 5.0 and 5.5 in the first 12 months for central and branch RVO respectively and the median number of clinic visits in each group was 9.
The results of this real-world study show that the mean letter gains and reduction in CRT following ranibizumab treatment for RVO in this centre are comparable with the landmark randomised controlled clinical trials. The inclusion of patients with poor baseline vision, previous RVO and other comorbidities, that would have been excluded from clinical trials, and lack of refracted acuities may explain the lower percentage of eyes achieving VA>70 letters at 1 year.
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