June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Factors Contributing to Persistent Macular Edema in Retinal Vein Occlusion
Author Affiliations & Notes
  • Tahreem Aman Mir
    Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, United States
  • Gulnar Hafiz
    Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, United States
  • Sidra Zafar
    Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, United States
  • Adrienne W. Scott
    Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, United States
  • Ingrid E Zimmer-Galler
    Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, United States
  • Adam Wenick
    Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, United States
  • Sharon Solomon
    Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, United States
  • Syed Mahmood Ali Shah
    Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, United States
  • Christopher Brady
    Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, United States
  • Catherine Meyerele
    Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, United States
  • Akrit Sodhi
    Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, United States
  • Saleema Kherani
    Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, United States
  • Peter A Campochiaro
    Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, United States
  • Footnotes
    Commercial Relationships   Tahreem Mir, None; Gulnar Hafiz, None; Sidra Zafar, None; Adrienne Scott, Allergan (C), Thromogenics Inc (F); Ingrid Zimmer-Galler, None; Adam Wenick, Alcon Research Ltd (F); Sharon Solomon, None; Syed Mahmood Shah, None; Christopher Brady, None; Catherine Meyerele, None; Akrit Sodhi, None; Saleema Kherani, None; Peter Campochiaro, Genentech/Roche (F), Genentech/Roche (C)
  • Footnotes
    Support  Study drug and Financial Support was provided by Genentech
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 1545. doi:
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      Tahreem Aman Mir, Gulnar Hafiz, Sidra Zafar, Adrienne W. Scott, Ingrid E Zimmer-Galler, Adam Wenick, Sharon Solomon, Syed Mahmood Ali Shah, Christopher Brady, Catherine Meyerele, Akrit Sodhi, Saleema Kherani, Peter A Campochiaro; Factors Contributing to Persistent Macular Edema in Retinal Vein Occlusion. Invest. Ophthalmol. Vis. Sci. 2017;58(8):1545.

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

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Abstract

Purpose : We performed a post-hoc analysis of a randomized controlled trial (RELATE Study) to identify factors that contribute to persistent macular edema (ME) in retinal vein occlusion (RVO)

Methods : Forty-two BRVO and 39 CRVO subjects were included. Subjects not able to achieve a 3-month edema free period as determined by spectral domain optical coherence tomography (SD-OCT) throughout the 36 month trial were categorized as Persistent ME (group 1) whereas those with at least one 3-month edema-free period were Intermittent ME (group 2). Factors that could contribute to persistent ME, such as microvascular changes (microaneurysms; MAs), age and disease duration, as well as visual and anatomic outcomes and treatment burden were compared between the 2 groups.

Results : Forty-six percent of BRVO and 38% of CRVO subjects had persistent ME. For BRVO, age, disease duration, central subfield thickness (CST, µm) and best-corrected visual acuity (BCVA, ETDRS letters) were balanced at baseline (BL), but there were more patients with MAs in group 1 (60% vs 27.3%, p=0.03). At month (M) 6, BCVA was significantly lower in group 1 vs group 2 (58.9+2.5 vs 69.4+3.2, p=0.01), but was comparable at all other time points. CST (all time points) and number of anti-VEGF injections were comparable. The greater number of group 1 patients with MAs persisted at M6 (73.3% vs 23.8%, p=0.003) and M12 (81.3% vs 26.3%, p=0.001), but not at later time points.
For CRVO, age, disease duration, CST, and patients with MAs were balanced between the 2 groups, but group 1 patients had significantly lower BCVA (38.6+3.0 vs 53.9+2.7, p=0.001) at BL, which was maintained at M6 (51.8+3.7 vs 70.3+2.95, p<0.001), M12 (50.3+4.9 vs 69.8+3.4, p=0.003) and M24 (53.5+4.9 vs 69.2+3.52, p=0.02). Group 1 patients had a significantly greater CST at M6 (363.4+37.1 vs 281.6+17.4, p=0.04), M12 (458.1+50.3 vs 317.6+22.0, p=0.02) and M24 (369.3+36.6 vs 285.8+20.8, p=0.04), but not M36. The number of patients with MAs was comparable in the 2 groups at BL and early time points, but was significantly greater in group 1 at M36 (83.3% vs 41.7%, p=0.05). Patients in group 1 received significantly more anti-VEGF injections (22.2+2.3 vs 16.0+1.3, p=0.02).

Conclusions : MAs are associated with persistent ME in patients with BRVO and CRVO, which may increase treatment burden. Poor vision at BL in patients with CRVO may predict persistent ME which is associated with poor visual and anatomic outcomes

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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