April 2011
Volume 52, Issue 14
Free
ARVO Annual Meeting Abstract  |   April 2011
Association Between Duration of Macular Edema and Clinical Outcomes in Patients with Retinal Vein Occlusion Following Treatment With Dexamethasone Intravitreal Implant
Author Affiliations & Notes
  • Wei-Shi D. Yeh
    Global Health Outcomes Strategy Res,
    Allergan, Irvine, California
  • Julia A. Haller
    Ophthalmology, Wills Eye Institute, Philadelphia, Pennsylvania
  • Baruch D. Kuppermann
    Gavin Herbert Eye Inst Dept Ophthalmolog, Univ of California Irvine, Irvine, California
  • Paul Mitchell
    Dept of Ophthalmology, Univ of Sydney, Sydney, Australia
  • Paolo Lanzetta
    Dept of Ophthalmology, Univ of Udine, Udine, Italy
  • Scott M. Whitcup
    R & D,
    Allergan, Irvine, California
  • Tien Y. Wong
    Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
  • Jonathan W. Kowalski
    Glbl Hlth Outcomes Strat Res,
    Allergan, Irvine, California
  • Footnotes
    Commercial Relationships  Wei-Shi D. Yeh, Allergan (E); Julia A. Haller, Allergan, Genentech (C); Baruch D. Kuppermann, Allergan, CoMentis, Genentech, Glaukos, Neovista, Novagali, SurModics, TareGen, Ophthotech, OPKO Health, Vitreoretinal Technologies (C); Paul Mitchell, None; Paolo Lanzetta, Allergan (F), Neovista, Novartis (C); Scott M. Whitcup, Allergan (E); Tien Y. Wong, None; Jonathan W. Kowalski, Allergan (E)
  • Footnotes
    Support  Allergan, Inc.
Investigative Ophthalmology & Visual Science April 2011, Vol.52, 3965. doi:
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      Wei-Shi D. Yeh, Julia A. Haller, Baruch D. Kuppermann, Paul Mitchell, Paolo Lanzetta, Scott M. Whitcup, Tien Y. Wong, Jonathan W. Kowalski; Association Between Duration of Macular Edema and Clinical Outcomes in Patients with Retinal Vein Occlusion Following Treatment With Dexamethasone Intravitreal Implant. Invest. Ophthalmol. Vis. Sci. 2011;52(14):3965.

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Abstract

Purpose: : To evaluate the effect of duration of macular edema on visual and anatomic outcomes in patients with vision loss due to macular edema (ME) following either branch or central retinal vein occlusion (RVO).

Methods: : This post hoc analysis includes 690 RVO patients enrolled in the GENEVA trials treated with a dexamethasone intravitreal (DEX) implant. Using logistic regression models, the relationship between a patient’s duration of ME at the time of initial DEX treatment and the likelihood of gaining ≥ 15 letters in best-corrected visual acuity (BCVA) or ≥ 200 µm reduction in optical coherence tomography (OCT) 180 days post treatment was assessed. Duration of ME was defined as the time (months) between diagnosis of ME and initial DEX treatment. Age, gender, type of RVO, OCT central subfield thickness at treatment, and BCVA at treatment were adjusted for in the analyses.

Results: : Controlling for all other variables, ME duration at initial DEX treatment was a significant predictor for both BCVA and OCT outcomes 180-days post treatment. Each month increase in duration of ME was associated with a significantly lower odds of achieving ≥ 15-letter improvement in BCVA (OR = 0.88, 0.83-0.94, P < .001) or ≥ 200-µm reduction in OCT (OR = 0.91, 0.86-0.97, P < .01).

Conclusions: : A longer duration of ME at time of DEX treatment is associated with a significantly lower likelihood of achieving ≥ 15 letter BCVA improvement or ≥ 200 µm reduction in OCT post-treatment. Therefore, physicians may consider advising patients with RVO that early DEX treatment may result in improved visual and anatomic outcomes compared to delaying onset of treatment.

Clinical Trial: : http://www.clinicaltrials.gov 00168298 & 00168324

Keywords: vascular occlusion/vascular occlusive disease • visual acuity • corticosteroids 
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