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Annette Rasmussen, Michael Larsen, Henrik Lund-Andersen; Beyond two years of treatment with anti-vascular endothelial growth factor for patients with retinal vein occlusions.. Invest. Ophthalmol. Vis. Sci. 2018;59(9):5449.
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© ARVO (1962-2015); The Authors (2016-present)
To study the timespan beyond 2 years of anti-vascular endothelial growth factor (VEGF) treatment for patients with retinal vein occlusion (RVO). To investigate visual outcome and pattern of discontinuation in a variable anti-VEGF dosing regimen for central or branch vein occlusion (BRVO) up to 5 years.
Retrospective chart review with a total of 369 patients, 147 with central vein occlusion (CRVO) and 222 with BRVO initiated intravitreal treatment with anti-VEGF in 2012-13 in a community based hospital. Methods: Patient data from a database were retrieved from 2012 to 2017. Descriptive evaluation of main outcome measures for the cohort of patients. Main Outcome Measures: visual acuity in Snellen (conversion of Snellen to a logarithmic scale), number of intravitreal injections and length of treatment.
56 patients (25% ) with BRVO were in treatment more than 4 years. Up to 89 (40%) were in treatment more than 3 years, some after a period longer than 6 months without injections. Mean number of total injections was 21. Mean baseline visual acuity of 0.32 and significant increase (p<0.001) to the most recent visual acuity of 0.50 Snellen for patients in treatment for more than 3 years. Outcome is similar to mean baseline visual acuity 0.31-> most recent 0.49 Snellen for all 222 patients with BRVO.40 (27%) with CRVO were in treatment more than 3 years. Mean baseline visual acuity of 0.21 and significant increase (p<0.05) to the most recent visual acuity of 0.28 Snellen. Mean number of total injections was 23. 45% females and 55% males in both cohorts. 11 patients ( 5%) developed vein occlusions in both eyes, the far majority BRVO. All patients were treated with either ranibizumab, aflibercept or both.
30-40% of patients with BRVO may expect active anti-VEGF treatment beyond 3-4 years. Visual outcome is significant improved from baseline and comparable to short-term outcomes.patients with CRVO in long-term treatment do have higher baseline visual acuity compared to all included patients with CRVO.
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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