June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Long-Term Outcomes of Anti-VEGF Treatment in Patients with Macular Edema Secondary to Retinal Vein Occlusions
Author Affiliations & Notes
  • Karen M Wai
    Cole Eye Institute , Cleveland Clinic, Saratoga, California, United States
    Case Western Reserve University School of Medicine, Cleveland, Ohio, United States
  • Jason Young
    Cole Eye Institute , Cleveland Clinic, Saratoga, California, United States
  • Fabiana Queiroga de Paula Araujo Silva
    Cole Eye Institute , Cleveland Clinic, Saratoga, California, United States
  • Sunil K Srivastava
    Cole Eye Institute , Cleveland Clinic, Saratoga, California, United States
  • Justis Ehlers
    Cole Eye Institute , Cleveland Clinic, Saratoga, California, United States
  • Aleksandra V Rachitskaya
    Cole Eye Institute , Cleveland Clinic, Saratoga, California, United States
  • Peter K Kaiser
    Cole Eye Institute , Cleveland Clinic, Saratoga, California, United States
  • Andrew Schachat
    Cole Eye Institute , Cleveland Clinic, Saratoga, California, United States
  • Amy Shrader Babiuch
    Cole Eye Institute , Cleveland Clinic, Saratoga, California, United States
  • Alex Yuan
    Cole Eye Institute , Cleveland Clinic, Saratoga, California, United States
  • Rishi P Singh
    Cole Eye Institute , Cleveland Clinic, Saratoga, California, United States
  • Footnotes
    Commercial Relationships   Karen Wai, None; Jason Young, None; Fabiana Silva, None; Sunil Srivastava, Allergan (R), Bausch and Lomb (C), Bioptigen (P), Synergetics (P); Justis Ehlers, Alcon (C), Alcon (F), Alimera (C), Allergan (C), Bausch and Lomb (P), Bioptigen (C), Bioptigen (P), Genentech (C), Genentech (F), Leica (C), Leica (P), Regeneron (F), Santen (C), Synergetics (P), Thrombogenics (C), Thrombogenics (F), Zeiss (C); Aleksandra Rachitskaya, Allergan (C); Peter Kaiser, Allergan (C), Bayer (C), Novartis (C), Regeneron (C); Andrew Schachat, None; Amy Babiuch, Allergan (R); Alex Yuan, None; Rishi Singh, Alcon (F), Apellis (F), Genentech (C), Genentech (F), Optos (C), Regeneron (C), Regeneron (F), Shire (C), Zeiss (C)
  • Footnotes
    Support  Prevent Blindness Young Investigator Student Fellowship Awards for Female Scholars in Vision Research
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 1541. doi:
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    • Get Citation

      Karen M Wai, Jason Young, Fabiana Queiroga de Paula Araujo Silva, Sunil K Srivastava, Justis Ehlers, Aleksandra V Rachitskaya, Peter K Kaiser, Andrew Schachat, Amy Shrader Babiuch, Alex Yuan, Rishi P Singh; Long-Term Outcomes of Anti-VEGF Treatment in Patients with Macular Edema Secondary to Retinal Vein Occlusions. Invest. Ophthalmol. Vis. Sci. 2017;58(8):1541.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Few studies have examined the long-term outcomes of anti-VEGF use in the treatment of macular edema secondary to retinal vein occlusion (RVO). This retrospective study examines the long-term visual and anatomical outcomes of anti-VEGF therapy for RVOs in a routine clinical setting.

Methods : This study identified treatment naïve patients with macular edema secondary to hemi-retinal vein occlusions (HRVO), central retinal vein occlusions (CRVO), or branch retinal vein occlusions (BRVO) treated with anti-VEGF agents and had follow-up visits for at least 36 months after therapy initiation at a single institution. Exclusion criteria included prior intravitreal injection or confounding ocular disease. Main outcomes measured were change in best-corrected visual acuity (BCVA) and mean absolute change in central subfield thickness (CST) at 12, 24, 36, and 48 months, if applicable.

Results : Twenty-seven BRVO patients were followed for 36 months; 11 patients had 48 months of follow-up. BRVO patients showed significant increases in BCVA from baseline that were maintained after 12 months (+11.03 letters, p<0.001), 24 months (+12.06 letters, p<0.001), 36 months (+10.71 letters, p<0.001), and 48 months (+9.26 letters, p=0.022) of therapy. CST significantly decreased from baseline after 12 months (-83.51µm, p<0.001), 24 months (-67.93µm, p=0.006), 36 months (-97.52µm, p<0.001), and 48 months (-127.85µm, p<0.001).
Twenty-five CRVO/HRVO patients were followed for 36 months; 9 patients had 48 months of follow up. Significant improvements in BCVA were seen at 12 months (+9.39 letters, p=0.013) and 24 months (+8.54 letters, p=0.023). At 36 months (+2.64 letters, p=0.480) and 48 months (+3.42 letters, p=0.300), the visual gain was no longer significant. For CST changes, there were significant decreases at 12 months (-146.23µm, p=0.002), 24 months (-149.54µm, p=0.002), and 36 months (-166.44µm, p<0.001) from baseline. At 48 months (-97.66µm, p=0.130), changes in CST were no longer significant.

Conclusions : In routine clinical practice, visual and anatomical benefits of anti-VEGF agents in patients with BRVO were sustained at 36 and 48 months. For patients with CRVO/HRVO, anatomical improvements were maintained for 36 but not 48 months, while visual changes were no longer maintained by 36 months.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

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