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Karen M Wai, Jason Young, Fabiana Queiroga de Paula Araujo Silva, Sunil K Srivastava, Justis Ehlers, Aleksandra V Rachitskaya, Peter K Kaiser, Andrew Schachat, Amy Shrader Babiuch, Alex Yuan, Rishi P Singh; Long-Term Outcomes of Anti-VEGF Treatment in Patients with Macular Edema Secondary to Retinal Vein Occlusions. Invest. Ophthalmol. Vis. Sci. 2017;58(8):1541.
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Few studies have examined the long-term outcomes of anti-VEGF use in the treatment of macular edema secondary to retinal vein occlusion (RVO). This retrospective study examines the long-term visual and anatomical outcomes of anti-VEGF therapy for RVOs in a routine clinical setting.
This study identified treatment naïve patients with macular edema secondary to hemi-retinal vein occlusions (HRVO), central retinal vein occlusions (CRVO), or branch retinal vein occlusions (BRVO) treated with anti-VEGF agents and had follow-up visits for at least 36 months after therapy initiation at a single institution. Exclusion criteria included prior intravitreal injection or confounding ocular disease. Main outcomes measured were change in best-corrected visual acuity (BCVA) and mean absolute change in central subfield thickness (CST) at 12, 24, 36, and 48 months, if applicable.
Twenty-seven BRVO patients were followed for 36 months; 11 patients had 48 months of follow-up. BRVO patients showed significant increases in BCVA from baseline that were maintained after 12 months (+11.03 letters, p<0.001), 24 months (+12.06 letters, p<0.001), 36 months (+10.71 letters, p<0.001), and 48 months (+9.26 letters, p=0.022) of therapy. CST significantly decreased from baseline after 12 months (-83.51µm, p<0.001), 24 months (-67.93µm, p=0.006), 36 months (-97.52µm, p<0.001), and 48 months (-127.85µm, p<0.001).Twenty-five CRVO/HRVO patients were followed for 36 months; 9 patients had 48 months of follow up. Significant improvements in BCVA were seen at 12 months (+9.39 letters, p=0.013) and 24 months (+8.54 letters, p=0.023). At 36 months (+2.64 letters, p=0.480) and 48 months (+3.42 letters, p=0.300), the visual gain was no longer significant. For CST changes, there were significant decreases at 12 months (-146.23µm, p=0.002), 24 months (-149.54µm, p=0.002), and 36 months (-166.44µm, p<0.001) from baseline. At 48 months (-97.66µm, p=0.130), changes in CST were no longer significant.
In routine clinical practice, visual and anatomical benefits of anti-VEGF agents in patients with BRVO were sustained at 36 and 48 months. For patients with CRVO/HRVO, anatomical improvements were maintained for 36 but not 48 months, while visual changes were no longer maintained by 36 months.
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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