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Lawrence J. Singerman, Dianne R. Himmelman, Burton Singerman, Akshay Thomas, Lucy Newman, Joseph M. Coney, Jerome P. Schartman, Michael A. Novak; Impact of Lucentis on Psychological Morbidity in Patients with Macular Edema and Neovascularization Secondary to Retinal Vein Occlusion. Invest. Ophthalmol. Vis. Sci. 2012;53(14):5466.
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The purpose of this prospective, single-center, non-randomized study was to assess the impact of intravitreally administered ranibizumab (Lucentis) treatment on vision-related functioning and emotional well-being in subjects with central or branch retinal vein occlusion.
Thirty consecutive patients with retinal vein occlusion (RVO) and macular edema were given intravitreal ranibizumab at each of 6 consecutive visits at 4-week intervals. Ophthalmology status was assessed with examination, refraction, OCT, and FA. Psychological status was assessed with the Visual Function Questionnaire (VFQ25), which was subdivided into the 9-question general mental health questions (VFQ9, mental health); the Patient Health Questionnaire (PHQ9); and the General Health Questionnaire (GHQ12). A comparison group of 15 patients with inactive RVO not treated with any anti-VEGF agent was assessed with the same questionnaires in the same 24-week period.
The change in the PHQ-9 score was not statistically different between the treatment and comparison groups. The mean change in GHQ12 score was a reduction of 2.6 (SD 4.25) for the treatment group and a gain of 0.33 (SD 4.13) for the comparison group. The mean change in score was statistically significant between the groups (p =.034). The mean change in the VFQ-9 score for the treatment group was +7.8; for the comparison group, -4.6. The mean change in VFQ-9 score was statistically significant between the groups (p <.0001). Patients receiving intravitreal Lucentis injections gained an average of 14.3 letters (median 15, SD 16.5) and had a mean reduction in central retinal thickness of 283.6 microns (median 261, SD 324) at the end of the 24-week study.
In subjects with RVO, Lucentis treatment was associated with significant improvement in psychological status by both the well-validated GHQ12 and the VFQ9 mental health, both of which assess probability of mental health morbidity. This occurred even though most subjects had near-normal vision in the uninvolved eye and thus did not have much psychological distress at the start of the study. Lucentis-treated subjects had significant improvement in vision in the involved eye, with reduction in macular edema.
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