Abstract
Purpose:
Ranibizumab has been shown to be an effective treatment for retinal vein occlusions (RVO) in the BRAVO and CRUISE studies in a treatment naïve cohort. We carried out a retrospective case series of patients with treatment refractory macular oedema secondary to RVO treated in Frimley Park Hospital, England.
Methods:
All patients had persistent macular oedema that was refractory to treatment with Bevacizumab, Ozurdex or both. All patients received three monthly Ranibizumab (0.5mg) doses followed by monthly OCT-guided Ranibizumab treatment as required. Best corrected visual acuity (BCVA) and central macular thickness (CMT) were measured monthly for 12 months.
Results:
Seventy-eight patients were followed up for a maximum of 12 months (mean follow up 7.7 months). Mean number of injections required over 12 months was 8.4 (n=15) with a range of 4-12 injections. BCVA and CMT were improved significantly from baseline at month 1 (p=<0.001 and p=<0.001 respectively, n=78). CMT remained significantly reduced at month 9 (p=<0.001, n=35) and reduced at month 12 (p=0.054, n=14). BCVA remained significantly improved from baseline at month 9 (8.8 letters, p=0.002, n=36) and improved at 12 months (3.7 letters p=0.280, n=14). Only one patient had a reduction of vision greater than 15 letters at month 12. Twenty-one percent of patients (n=3/14) maintained 6/12 (driving) vision in the effected eye. No serious systemic adverse events were recorded.
Conclusions:
Ranibizumab may be an effective treatment for patients with macular oedema secondary to RVO that is refractory to treatment with Bevacizumab, Ozurdex or both. Improvements in BCVA and CMT were maintained over 12 months.