Changes in retinal nonperfusion associated with suppression of vascular endothelial growth factor in retinal vein occlusion

Tahreem A. Mir, Saleema Kherani, Gulnar Hafiz, Adrienne Scott, Ingrid E Zimmer Galler, Adam Wenick, Sharon Solomon, Ian Han, David Poon, Lingmin He, Syed Mahmood Shah, Christopher J. Brady, Catherine Meyerle, Akrit Sodhi, Marguerite O. Linz, Raafay Sophie, Peter A Campochiaro

Research output: Contribution to journalArticle

Abstract

Purpose To assess changes in retinal nonperfusion (RNP) in patients with retinal vein occlusion (RVO) treated with ranibizumab. Design Secondary outcome measure in randomized double-masked controlled clinical trial. Participants Thirty-nine patients with central RVO (CRVO) and 42 with branch RVO (BRVO). Methods Subjects were randomized to 0.5 or 2.0 mg ranibizumab every month for 6 months and then were re-randomized to pro re nata (PRN) groups receiving either ranibizumab plus scatter laser photocoagulation or ranibizumab alone for an additional 30 months. Main Outcome Measures Comparison of percentage of patients with increased or decreased area of RNP in patients with RVO treated with 0.5 versus 2.0 mg ranibizumab, during monthly injections versus ranibizumab PRN, and in patients treated with ranibizumab PRN versus ranibizumab PRN plus laser. Results In RVO patients given monthly injections of 0.5 or 2.0 mg ranibizumab for 6 months, there was no significant difference in the percentage who showed reduction or increase in the area of RNP. However, regardless of dose, during the 6-month period of monthly injections, a higher percentage of patients showed a reduction in area of RNP and a lower percentage showed an increase in area of RNP compared with subsequent periods of ranibizumab PRN treatment. After the 6-month period of monthly injections, BRVO patients, but not CRVO patients, randomized to ranibizumab PRN plus laser showed significantly less progression of RNP compared with patients treated with ranibizumab PRN. Conclusions Regardless of dose (0.5 or 2.0 mg), monthly ranibizumab injections promote improvement and reduce progression of RNP compared with PRN injections. The addition of scatter photocoagulation to ranibizumab PRN may reduce progression of RNP in patients with BRVO, but a statistically significant reduction was not seen in patients with CRVO.

Original languageEnglish (US)
Pages (from-to)625-634.e1
JournalOphthalmology
Volume123
Issue number3
DOIs
StatePublished - Mar 1 2016

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Retinal Vein Occlusion
Vascular Endothelial Growth Factor A
Injections
Lasers
Light Coagulation
Ranibizumab
Outcome Assessment (Health Care)
Retinal Vein
Controlled Clinical Trials

ASJC Scopus subject areas

  • Ophthalmology

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Changes in retinal nonperfusion associated with suppression of vascular endothelial growth factor in retinal vein occlusion. / Mir, Tahreem A.; Kherani, Saleema; Hafiz, Gulnar; Scott, Adrienne; Zimmer Galler, Ingrid E; Wenick, Adam; Solomon, Sharon; Han, Ian; Poon, David; He, Lingmin; Shah, Syed Mahmood; Brady, Christopher J.; Meyerle, Catherine; Sodhi, Akrit; Linz, Marguerite O.; Sophie, Raafay; Campochiaro, Peter A.

In: Ophthalmology, Vol. 123, No. 3, 01.03.2016, p. 625-634.e1.

Research output: Contribution to journalArticle

Mir, Tahreem A. ; Kherani, Saleema ; Hafiz, Gulnar ; Scott, Adrienne ; Zimmer Galler, Ingrid E ; Wenick, Adam ; Solomon, Sharon ; Han, Ian ; Poon, David ; He, Lingmin ; Shah, Syed Mahmood ; Brady, Christopher J. ; Meyerle, Catherine ; Sodhi, Akrit ; Linz, Marguerite O. ; Sophie, Raafay ; Campochiaro, Peter A. / Changes in retinal nonperfusion associated with suppression of vascular endothelial growth factor in retinal vein occlusion. In: Ophthalmology. 2016 ; Vol. 123, No. 3. pp. 625-634.e1.
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abstract = "Purpose To assess changes in retinal nonperfusion (RNP) in patients with retinal vein occlusion (RVO) treated with ranibizumab. Design Secondary outcome measure in randomized double-masked controlled clinical trial. Participants Thirty-nine patients with central RVO (CRVO) and 42 with branch RVO (BRVO). Methods Subjects were randomized to 0.5 or 2.0 mg ranibizumab every month for 6 months and then were re-randomized to pro re nata (PRN) groups receiving either ranibizumab plus scatter laser photocoagulation or ranibizumab alone for an additional 30 months. Main Outcome Measures Comparison of percentage of patients with increased or decreased area of RNP in patients with RVO treated with 0.5 versus 2.0 mg ranibizumab, during monthly injections versus ranibizumab PRN, and in patients treated with ranibizumab PRN versus ranibizumab PRN plus laser. Results In RVO patients given monthly injections of 0.5 or 2.0 mg ranibizumab for 6 months, there was no significant difference in the percentage who showed reduction or increase in the area of RNP. However, regardless of dose, during the 6-month period of monthly injections, a higher percentage of patients showed a reduction in area of RNP and a lower percentage showed an increase in area of RNP compared with subsequent periods of ranibizumab PRN treatment. After the 6-month period of monthly injections, BRVO patients, but not CRVO patients, randomized to ranibizumab PRN plus laser showed significantly less progression of RNP compared with patients treated with ranibizumab PRN. Conclusions Regardless of dose (0.5 or 2.0 mg), monthly ranibizumab injections promote improvement and reduce progression of RNP compared with PRN injections. The addition of scatter photocoagulation to ranibizumab PRN may reduce progression of RNP in patients with BRVO, but a statistically significant reduction was not seen in patients with CRVO.",
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T1 - Changes in retinal nonperfusion associated with suppression of vascular endothelial growth factor in retinal vein occlusion

AU - Mir, Tahreem A.

AU - Kherani, Saleema

AU - Hafiz, Gulnar

AU - Scott, Adrienne

AU - Zimmer Galler, Ingrid E

AU - Wenick, Adam

AU - Solomon, Sharon

AU - Han, Ian

AU - Poon, David

AU - He, Lingmin

AU - Shah, Syed Mahmood

AU - Brady, Christopher J.

AU - Meyerle, Catherine

AU - Sodhi, Akrit

AU - Linz, Marguerite O.

AU - Sophie, Raafay

AU - Campochiaro, Peter A

PY - 2016/3/1

Y1 - 2016/3/1

N2 - Purpose To assess changes in retinal nonperfusion (RNP) in patients with retinal vein occlusion (RVO) treated with ranibizumab. Design Secondary outcome measure in randomized double-masked controlled clinical trial. Participants Thirty-nine patients with central RVO (CRVO) and 42 with branch RVO (BRVO). Methods Subjects were randomized to 0.5 or 2.0 mg ranibizumab every month for 6 months and then were re-randomized to pro re nata (PRN) groups receiving either ranibizumab plus scatter laser photocoagulation or ranibizumab alone for an additional 30 months. Main Outcome Measures Comparison of percentage of patients with increased or decreased area of RNP in patients with RVO treated with 0.5 versus 2.0 mg ranibizumab, during monthly injections versus ranibizumab PRN, and in patients treated with ranibizumab PRN versus ranibizumab PRN plus laser. Results In RVO patients given monthly injections of 0.5 or 2.0 mg ranibizumab for 6 months, there was no significant difference in the percentage who showed reduction or increase in the area of RNP. However, regardless of dose, during the 6-month period of monthly injections, a higher percentage of patients showed a reduction in area of RNP and a lower percentage showed an increase in area of RNP compared with subsequent periods of ranibizumab PRN treatment. After the 6-month period of monthly injections, BRVO patients, but not CRVO patients, randomized to ranibizumab PRN plus laser showed significantly less progression of RNP compared with patients treated with ranibizumab PRN. Conclusions Regardless of dose (0.5 or 2.0 mg), monthly ranibizumab injections promote improvement and reduce progression of RNP compared with PRN injections. The addition of scatter photocoagulation to ranibizumab PRN may reduce progression of RNP in patients with BRVO, but a statistically significant reduction was not seen in patients with CRVO.

AB - Purpose To assess changes in retinal nonperfusion (RNP) in patients with retinal vein occlusion (RVO) treated with ranibizumab. Design Secondary outcome measure in randomized double-masked controlled clinical trial. Participants Thirty-nine patients with central RVO (CRVO) and 42 with branch RVO (BRVO). Methods Subjects were randomized to 0.5 or 2.0 mg ranibizumab every month for 6 months and then were re-randomized to pro re nata (PRN) groups receiving either ranibizumab plus scatter laser photocoagulation or ranibizumab alone for an additional 30 months. Main Outcome Measures Comparison of percentage of patients with increased or decreased area of RNP in patients with RVO treated with 0.5 versus 2.0 mg ranibizumab, during monthly injections versus ranibizumab PRN, and in patients treated with ranibizumab PRN versus ranibizumab PRN plus laser. Results In RVO patients given monthly injections of 0.5 or 2.0 mg ranibizumab for 6 months, there was no significant difference in the percentage who showed reduction or increase in the area of RNP. However, regardless of dose, during the 6-month period of monthly injections, a higher percentage of patients showed a reduction in area of RNP and a lower percentage showed an increase in area of RNP compared with subsequent periods of ranibizumab PRN treatment. After the 6-month period of monthly injections, BRVO patients, but not CRVO patients, randomized to ranibizumab PRN plus laser showed significantly less progression of RNP compared with patients treated with ranibizumab PRN. Conclusions Regardless of dose (0.5 or 2.0 mg), monthly ranibizumab injections promote improvement and reduce progression of RNP compared with PRN injections. The addition of scatter photocoagulation to ranibizumab PRN may reduce progression of RNP in patients with BRVO, but a statistically significant reduction was not seen in patients with CRVO.

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