July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Two year results of intravitreal ranibizumab injection using a treat and extend regimen to treat macular edema due to branch retinal vein occlusion
Author Affiliations & Notes
  • Mika Hosogi
    Okayama University Hospital, Okayama city, Japan
  • Yuki Morizane
    Okayama University Hospital, Okayama city, Japan
  • Shuhei Kimura
    Okayama University Hospital, Okayama city, Japan
  • Mio Hosokawa
    Okayama University Hospital, Okayama city, Japan
  • Hirano Masayuki
    Okayama University Hospital, Okayama city, Japan
  • Shinichiro doi
    Okayama University Hospital, Okayama city, Japan
  • Shinji Toshima
    Okayama University Hospital, Okayama city, Japan
  • Kosuke Takahashi
    Okayama University Hospital, Okayama city, Japan
  • Yuki Kanzaki
    Okayama University Hospital, Okayama city, Japan
  • Atsushi Fujiwara
    Okayama University Hospital, Okayama city, Japan
  • Fumio Shiraga
    Okayama University Hospital, Okayama city, Japan
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 4268. doi:
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      Mika Hosogi, Yuki Morizane, Shuhei Kimura, Mio Hosokawa, Hirano Masayuki, Shinichiro doi, Shinji Toshima, Kosuke Takahashi, Yuki Kanzaki, Atsushi Fujiwara, Fumio Shiraga; Two year results of intravitreal ranibizumab injection using a treat and extend regimen to treat macular edema due to branch retinal vein occlusion. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4268.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : The most effective injection protocol of for vascular endothelial growth factor inhibitors to treat macular edema (ME) due to branch retinal vein occlusion (BRVO) remains controversial. We retrospectively evaluated the therapeutic efficacy of intravitreal ranibizumab injection (IVR) for BRVO using a treat and extend regimen (TER) for two years and explored the predictive factors for the recurrence of ME.

Methods : Thirty-two eyes of 32 patients (14 men, 18 women; mean age ± SD, 71.3 ± 11.2 years) with ME due to BRVO were treated with IVR using a TER for two years. We initiated IVR at a 4-week interval, and we continued this until a central retinal thickness (CRT) of 300 μm or less was achieved. If the CRT was ≤ 300 μm, the treatment interval was extended by 4 weeks to a maximum of 12 weeks. If the CRT was > 300 µm, the treatment interval was reduced by 2 weeks. For patients whose treatment interval was extended to 12 weeks, the treatment protocol was switched from the TER to a pro re nata regimen. The main outcome measures were changes in best corrected visual acuity (BCVA) and CRT as well as total number of injections. We also investigated the predictive factors for the recurrence of ME.

Results : The mean BCVA (logarithm of the minimal angle of resolution, logMAR) improved significantly from 0.40 ± 0.34 at baseline to 0.10 ± 0.22 and 0.07 ± 0.19 at year 1 and 2, respectively (all p < 0.001, Tukey test). The mean CRT decreased significantly from 448.6 ± 115.1 μm at baseline to 272.3 ± 70.5 μm and 252.9 ± 36.3 μm at year 1 and 2, respectively (all p < 0.001, Tukey test). The mean number of injections significantly decreased from 6.0 ± 2.2 in year 1 to 3.2 ± 2.9 in year 2. Univariate analyses showed that lower visual acuity (p = 0.004, unpaired t-test), older age (p = 0.014, unpaired t-test), and occlusion of a major vein (p = 0.01, Fisher’s exact test) were predictive factors for the recurrence of ME.

Conclusions : IVR using a TER was effective for improving and maintaining both BCVA and CRT for 2 years in BRVO patients. Baseline BCVA, age, and occlusion site of the retinal vein were predictive for the recurrence of ME.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

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