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Cajal Patel, Robert N Frank; Frequency of Anti-VEGF Injections in Retinal Vein Occlusions. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3864.
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Anti-VEGF injections are often used to manage macular edema. In the DRCR.net Protocol 1 study on ranibizumab in the treatment of diabetic macular edema (DME), researchers found that those randomized to treatment with ranibizumab with or without concomitant laser had significant improvements in visual acuity and macular thickness, compared to the laser only and laser with intravitreal triamcinolone groups. The subjects were followed using a standard protocol for 3 years, during which time the frequency of injections needed to maintain acuity and macular thickness declined. The BRAVO and CRUISE studies showed that those with macular edema secondary to vein occlusion were also able to achieve gains in acuity with Anti-VEGF injections. We conducted this study to determine if the frequency of injections also declines in patients with vein occlusions comparable to the DRCR.net study on DME.
Data were collected retrospectively. Patients with a history of vein occlusion were separated into 2 groups. One group of 18 included those with past central retinal vein occlusion (CRVO) and the second group of 22 subjects had past hemi or branch retinal vein occlusion (BRVO). Patients without documentation in our EMR or with incomplete records were excluded.
The number of injections was averaged over 6 month intervals. Graphs A and B reflect the results for CRVO and BRVO respectively. The data points represent observations at each interval and the lines represent the best-fitting line plotted by least-squares analysis.
Based on our analysis, the frequency of injections showed a slight decline. Initially, a decreasing trend was noted. Later, there was a flattening of the curve. Considering the initial trend, it’s possible that in a prospective standardized study more information could be elicited regarding the frequency of injections needed to maintain acuity. This could provide more information on the long term benefits of anti-VEGF injections.
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