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Macular edema secondary to retinal vein occlusion in a real-life setting: a multicenter, nationwide, 3-year follow-up study

  • Retinal Disorders
  • Published:
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Abstract

Purpose

To evaluate the presence of macular edema secondary to retinal vein occlusion (RVO)—both central retinal vein occlusion (CRVO) and branch retinal vein occlusion (BRVO)—3 years after diagnosis in patients who underwent intravitreal therapy and to identify potential prognostic factors and biomarkers of persistent macular edema.

Methods

National multicenter, observational, exploratory, retrospective cohort study of 104 consecutive patients with macular edema secondary to RVO diagnosed from January 2014 to December 2015 with minimum 3-year follow-up time. Data analyzed included best-corrected visual acuity (BCVA), clinical and demographic data, and spectral domain optical coherence tomography parameters.

Results

At final observation, median baseline central retinal thickness significantly improved from baseline 538 to 290 μm (p < 0.001) and complete macular edema resolution was achieved in 51.0% of patients (56.3% and 42.5% in BRVO and CRVO patients, respectively). BCVA also improved (p < 0.01). Logistic regression analysis revealed a relationship between recurrence of macular edema and disorganization of retinal inner layers (DRIL) at baseline (odds ratio = 2.88; p = 0.013).

Conclusion

Good long-term anatomical and functional outcomes are achieved with intravitreal treatments in RVO patients. Anatomical success and visual gains seen in the first year were maintained throughout the entire follow-up, though DRIL is a major risk factor for recurrence.

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Data availability

The datasets analyzed during the current study are available from the corresponding author Jorge V. Costa upon reasonable request.

References

  1. Sawada O, Mev O (2016) Retinal vein occlusion. Dev Ophthalmol 55:147–153

    Article  PubMed  Google Scholar 

  2. McIntosh RL, Rogers SL, Lim L et al (2010) Natural history of central retinal vein occlusion: an evidence-based systematic review. Ophthalmol 117:1113–1123

    Article  Google Scholar 

  3. Rogers S, McIntosh RL, Cheung N et al (2010) The prevalence of retinal vein occlusion: pooled data from population studies from the United States, Europe, Asia, and Australia. Ophthalmology 117:313–319

    Article  PubMed  Google Scholar 

  4. Rehak J, Rehak M (2008) Branch retinal vein occlusion: pathogenesis, visual prognosis, and treatment modalities. Curr Eye Res 33:111–131

    Article  PubMed  Google Scholar 

  5. Schmidt-Erfurth U, Garcia-Arumi J, Gerendas BS et al (2019) Guidelines for the management of retinal vein occlusion by the European Society of Retina Specialists (EURETINA). Ophthalmologica 242(3):123–162

    Article  CAS  Google Scholar 

  6. Campochiaro PA, Brown DM, Awh CC et al (2011) Sustained benefits from ranibizumab for macular edema following central retinal vein occlusion: twelve-month outcomes of a phase III study. Ophthalmology 118(10):2041–2049

    Article  Google Scholar 

  7. Campochiaro PA, Heier JS, Feiner L et al (2010) Ranibizumab for macular edema following branch retinal vein occlusion: six-month primary end point results of a phase III study. Ophthalmology 117(6):1102–1112

    Article  Google Scholar 

  8. Heier JS, Clark WL, Boyer DS et al (2014) Intravitreal aflibercept injection for macular edema due to central retinal vein occlusion: two-year results from the COPERNICUS study. Ophthalmology 121(7):1414–1420

    Article  Google Scholar 

  9. Korobelnik JF, Holz FG, Roider J et al (2014) Intravitreal aflibercept injection for macular edema resulting from central retinal vein occlusion: one-year results of the Phase 3 GALILEO Study. Ophthalmology 121(1):202–208

    Article  Google Scholar 

  10. Clark WL, Boyer DS, Heier JS et al (2016) Intravitreal aflibercept for macular edema following branch retinal vein occlusion: 52-week results of the VIBRANT study. Ophthalmology 23(2):330–336

    Article  Google Scholar 

  11. Kornhauser T, Schwartz R, Goldstein M et al (2016) Bevacizumab treatment of macular edema in CRVO and BRVO: long-term follow-up. (BERVOLT study: Bevacizumab for RVO long-term follow-up). Graefes Arch Clin Exp Ophthalmol 254(5):835–844

    Article  CAS  PubMed  Google Scholar 

  12. Scott IU, Ip MS, VanVeldhuisen PC et al (2009) A randomized trial comparing the efficacy and safety of intravitreal triamcinolone with standard care to treat vision loss associated with macular edema secondary to branch retinal vein occlusion: the Standard Care vs Corticosteroid for Retinal Vein Occlusion (SCORE) Study report 6. Arch Ophthalmol 127:1115–1128

    Article  PubMed  Google Scholar 

  13. Haller JA, Bandello F, Belfort R Jr et al (2010) Randomized, sham-controlled trial of dexamethasone intravitreal implant in patients with macular edema due to retinal vein occlusion. Ophthalmology 117:1134–1146

    Article  Google Scholar 

  14. Campochiaro PA, Sophie R, Pearlman J et al (2014) Long-term outcomes in patients with retinal vein occlusion treated with ranibizumab: the RETAIN study. Ophthalmology 121(1):209–219

    Article  Google Scholar 

  15. Chatziralli I, Theodossiadis G, Chatzirallis A et al (2018) Ranibizumab for retinal vein occlusion: predictive factors and long-term outcomes in real-life data. Retina 38(3):559–568

    Article  CAS  Google Scholar 

  16. Moon BG, Cho AR, Kim YN, Kim JG (2018) Predictors of refractory macular edema after branch retinal vein occlusion following intravitreal bevacizumab. Retina 38(6):1166–1174

    Article  CAS  Google Scholar 

  17. Farinha C, Marques JP, Almeida E et al (2016) Treatment of retinal vein occlusion with ranibizumab in clinical practice: longer-term results and predictive factors of functional outcome. Ophthalmic Res 55:10–18

    Article  CAS  Google Scholar 

  18. Radwan SH, Soliman AZ, Tokarev J et al (2015) Association of disorganization of retinal inner layers with vision after resolution of center-involved diabetic macular edema. JAMA Ophthalmol 133:820–825

    Article  Google Scholar 

  19. Sun JK, Lin MM, Lammer J et al (2014) Disorganization of the retinal inner layers as a predictor of visual acuity in eyes with center-involved diabetic macular edema. JAMA Ophthalmol 132:1309–1316

    Article  PubMed  Google Scholar 

  20. Wirth MA, Becker MD, Graf N et al (2016) Aflibercept in branch retinal vein occlusion as second line therapy: clinical outcome 12 months after changing treatment from bevacizumab/ranibizumab—a pilot study. Int J Retina Vitreous 2:20

    Article  PubMed  Google Scholar 

  21. Suzuki M, Nagai N, Minami S et al (2020) Predicting recurrences of macular edema due to branch retinal vein occlusion during anti-vascular endothelial growth factor therapy. Graefes Arch Clin Exp Ophthalmol 258(1):49–56

    Article  Google Scholar 

  22. Giuffrè C, Cicinelli MV, Marchese A et al (2020) Simultaneous intravitreal dexamethasone and aflibercept for refractory macular edema secondary to retinal vein occlusion. Graefes Arch Clin Exp Ophthalmol 258(4):787–793

    Article  Google Scholar 

  23. Spooner K, Fraser-Bell S, Hong T, Chang AA (2019) Five-year outcomes of retinal vein occlusion treated with vascular endothelial growth factor inhibitors. BMJ Open Ophthalmol 4(1):e000249

    Article  PubMed  Google Scholar 

  24. Mimouni M, Segev O, Dori D et al (2017) Disorganization of the retinal inner layers as a predictor of visual acuity in eyes with macular edema secondary to vein occlusion. Am J Ophthalmol 182:160–167

    Article  Google Scholar 

  25. Rasendran C, Conti TF, Hom GL et al (2019) Current understanding of the pathophysiology of disorganization of the retinal inner layers and relationship to visual acuity. Am J Ophthalmic Clin Trials 2(5):1–10

    Google Scholar 

  26. Kang JW, Yoo R, Jo YH, Kim HC (2017) Correlation of microvascular structures on optical coherence tomography angiography with visual acuity in retinal vein occlusion. Retina 37(9):1700–1709

    Article  Google Scholar 

  27. Coscas F, Glacet-Bernard A, Miere A et al (2016) Optical coherence tomography angiography in retinal vein occlusion: evaluation of superficial and deep capillary plexa. Am J Ophthalmol 161:160–171

    Article  Google Scholar 

  28. Spaide RF (2016) Volume-rendered optical coherence tomography of retinal vein occlusion pilot study. Am J Ophthalmol 165:133–144

    Article  Google Scholar 

  29. Tsuboi K, Ishida Y, Kamei M (2017) Gap in capillary perfusion on optical coherence tomography angiography associated with persistent macular edema in branch retinal vein occlusion. Invest Ophthalmol Vis Sci 58(4):2038–2043

    Article  Google Scholar 

  30. Gu X, Yu X, Song S, Dai H (2017) Intravitreal dexamethasone implant versus intravitreal ranibizumab for the treatment of macular edema secondary to retinal vein occlusion in a chinese population. Ophthalmic Res 58(1):8–14

    Article  CAS  PubMed  Google Scholar 

  31. Ozkok A, Saleh OA, Sigford DK et al (2015) The omar study: comparison of ozurdex and triamcinolone acetonide for refractory cystoid macular edema in retinal vein occlusion. Retina 35(7):1393–1400

    Article  CAS  PubMed  Google Scholar 

  32. Gado AS, Macky TA (2014) Dexamethasone intravitreous implant versus bevacizumab for central retinal vein occlusion-related macular oedema: a prospective randomized comparison. Clin Exp Ophthalmol 42(7):650–655

    Article  PubMed  Google Scholar 

  33. Rezar S, Eibenberger K, Bühl W et al (2015) Anti-VEGF treatment in branch retinal vein occlusion: a real-world experience over 4 years. Acta Ophthalmol 93:719–725

    Article  CAS  PubMed  Google Scholar 

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Authors

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Correspondence to Jorge Vasco Costa.

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The authors declare that they have no conflict of interest.

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The study was conducted under the tenets of the Declarations of Helsinki and the study protocol was approved by the local Ethics Committee of all participating centers before study initiation.

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Informed consent was waived by the local Ethics Committee of all participating centers before study initiation.

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Informed consent was waived by the local Ethics Committee of all participating centers before study initiation.

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Costa, J.V., Moura-Coelho, N., Abreu, A.C. et al. Macular edema secondary to retinal vein occlusion in a real-life setting: a multicenter, nationwide, 3-year follow-up study. Graefes Arch Clin Exp Ophthalmol 259, 343–350 (2021). https://doi.org/10.1007/s00417-020-04932-0

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  • DOI: https://doi.org/10.1007/s00417-020-04932-0

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