Loss of Peak Vision in Retinal Vein Occlusion Patients Treated for Macular Edema

Research output: Contribution to journalArticle

Abstract

Purpose: To evaluate long-term visual and anatomic outcomes in patients with retinal vein occlusion (RVO) treated with anti–vascular endothelial growth factor (VEGF) agents. Design: Prospective, interventional case series. Participants: Patients with central RVO (CRVO) or branch RVO (BRVO). Methods: Number of anti-VEGF injections and improvement from baseline best-corrected visual acuity (BCVA) and central subfield thickness (CST) were prospectively recorded in 40 eyes of 39 CRVO patients and 50 eyes of 47 BRVO patients. Results: Mean follow-up was 58 months for BRVO and 78 months for CRVO. Within 6 months of last follow-up, 58% of BRVO patients and 75% of CRVO patients required anti-VEGF injections to control edema. Analysis of the course of each patient over time showed that for BRVO patients, BCVA letter score increased by a mean of 24, from baseline of 52 (20/100) to peak of 76 (20/32), and subsequently decreased by 13, to 63 (20/50), at final visit; and for CRVO patients, BCVA letter score increased by a mean of 26, from baseline of 48 (20/100) to peak of 74 (20/32), and subsequently decreased by 18, to 56 (20/80), at last follow-up. Loss from peak BCVA occurred primarily owing to persistent/recurrent edema and related foveal damage. Conclusions: Patients with RVO showed large improvements in BCVA after initiation of anti-VEGF injections, but in many patients some visual gains were lost over time owing to bouts of recurrent edema. Sustained suppression of VEGF may help to provide optimal outcomes in RVO and reduce treatment burden.

Original languageEnglish (US)
Pages (from-to)17-26
Number of pages10
JournalAmerican journal of ophthalmology
Volume205
DOIs
StatePublished - Sep 1 2019

Fingerprint

Retinal Vein Occlusion
Macular Edema
Vascular Endothelial Growth Factor A
Visual Acuity
Edema
Injections
Endothelial Growth Factors
Retinal Vein

ASJC Scopus subject areas

  • Ophthalmology

Cite this

@article{d5def54c318048caaf67798ec76954b0,
title = "Loss of Peak Vision in Retinal Vein Occlusion Patients Treated for Macular Edema",
abstract = "Purpose: To evaluate long-term visual and anatomic outcomes in patients with retinal vein occlusion (RVO) treated with anti–vascular endothelial growth factor (VEGF) agents. Design: Prospective, interventional case series. Participants: Patients with central RVO (CRVO) or branch RVO (BRVO). Methods: Number of anti-VEGF injections and improvement from baseline best-corrected visual acuity (BCVA) and central subfield thickness (CST) were prospectively recorded in 40 eyes of 39 CRVO patients and 50 eyes of 47 BRVO patients. Results: Mean follow-up was 58 months for BRVO and 78 months for CRVO. Within 6 months of last follow-up, 58{\%} of BRVO patients and 75{\%} of CRVO patients required anti-VEGF injections to control edema. Analysis of the course of each patient over time showed that for BRVO patients, BCVA letter score increased by a mean of 24, from baseline of 52 (20/100) to peak of 76 (20/32), and subsequently decreased by 13, to 63 (20/50), at final visit; and for CRVO patients, BCVA letter score increased by a mean of 26, from baseline of 48 (20/100) to peak of 74 (20/32), and subsequently decreased by 18, to 56 (20/80), at last follow-up. Loss from peak BCVA occurred primarily owing to persistent/recurrent edema and related foveal damage. Conclusions: Patients with RVO showed large improvements in BCVA after initiation of anti-VEGF injections, but in many patients some visual gains were lost over time owing to bouts of recurrent edema. Sustained suppression of VEGF may help to provide optimal outcomes in RVO and reduce treatment burden.",
author = "Mustafa Iftikhar and Mir, {Tahreem A.} and Gulnar Hafiz and Ingrid Zimmer-Galler and Scott, {Adrienne W.} and Solomon, {Sharon D.} and A. Sodhi and Wenick, {Adam S.} and Catherine Meyerle and Kim Jiramongkolchai and Liu, {T. Y.Alvin} and Arevalo, {J. Fernando} and Mandeep Singh and Saleema Kherani and Handa, {James T.} and Campochiaro, {Peter A.}",
year = "2019",
month = "9",
day = "1",
doi = "10.1016/j.ajo.2019.03.029",
language = "English (US)",
volume = "205",
pages = "17--26",
journal = "American Journal of Ophthalmology",
issn = "0002-9394",
publisher = "Elsevier USA",

}

TY - JOUR

T1 - Loss of Peak Vision in Retinal Vein Occlusion Patients Treated for Macular Edema

AU - Iftikhar, Mustafa

AU - Mir, Tahreem A.

AU - Hafiz, Gulnar

AU - Zimmer-Galler, Ingrid

AU - Scott, Adrienne W.

AU - Solomon, Sharon D.

AU - Sodhi, A.

AU - Wenick, Adam S.

AU - Meyerle, Catherine

AU - Jiramongkolchai, Kim

AU - Liu, T. Y.Alvin

AU - Arevalo, J. Fernando

AU - Singh, Mandeep

AU - Kherani, Saleema

AU - Handa, James T.

AU - Campochiaro, Peter A.

PY - 2019/9/1

Y1 - 2019/9/1

N2 - Purpose: To evaluate long-term visual and anatomic outcomes in patients with retinal vein occlusion (RVO) treated with anti–vascular endothelial growth factor (VEGF) agents. Design: Prospective, interventional case series. Participants: Patients with central RVO (CRVO) or branch RVO (BRVO). Methods: Number of anti-VEGF injections and improvement from baseline best-corrected visual acuity (BCVA) and central subfield thickness (CST) were prospectively recorded in 40 eyes of 39 CRVO patients and 50 eyes of 47 BRVO patients. Results: Mean follow-up was 58 months for BRVO and 78 months for CRVO. Within 6 months of last follow-up, 58% of BRVO patients and 75% of CRVO patients required anti-VEGF injections to control edema. Analysis of the course of each patient over time showed that for BRVO patients, BCVA letter score increased by a mean of 24, from baseline of 52 (20/100) to peak of 76 (20/32), and subsequently decreased by 13, to 63 (20/50), at final visit; and for CRVO patients, BCVA letter score increased by a mean of 26, from baseline of 48 (20/100) to peak of 74 (20/32), and subsequently decreased by 18, to 56 (20/80), at last follow-up. Loss from peak BCVA occurred primarily owing to persistent/recurrent edema and related foveal damage. Conclusions: Patients with RVO showed large improvements in BCVA after initiation of anti-VEGF injections, but in many patients some visual gains were lost over time owing to bouts of recurrent edema. Sustained suppression of VEGF may help to provide optimal outcomes in RVO and reduce treatment burden.

AB - Purpose: To evaluate long-term visual and anatomic outcomes in patients with retinal vein occlusion (RVO) treated with anti–vascular endothelial growth factor (VEGF) agents. Design: Prospective, interventional case series. Participants: Patients with central RVO (CRVO) or branch RVO (BRVO). Methods: Number of anti-VEGF injections and improvement from baseline best-corrected visual acuity (BCVA) and central subfield thickness (CST) were prospectively recorded in 40 eyes of 39 CRVO patients and 50 eyes of 47 BRVO patients. Results: Mean follow-up was 58 months for BRVO and 78 months for CRVO. Within 6 months of last follow-up, 58% of BRVO patients and 75% of CRVO patients required anti-VEGF injections to control edema. Analysis of the course of each patient over time showed that for BRVO patients, BCVA letter score increased by a mean of 24, from baseline of 52 (20/100) to peak of 76 (20/32), and subsequently decreased by 13, to 63 (20/50), at final visit; and for CRVO patients, BCVA letter score increased by a mean of 26, from baseline of 48 (20/100) to peak of 74 (20/32), and subsequently decreased by 18, to 56 (20/80), at last follow-up. Loss from peak BCVA occurred primarily owing to persistent/recurrent edema and related foveal damage. Conclusions: Patients with RVO showed large improvements in BCVA after initiation of anti-VEGF injections, but in many patients some visual gains were lost over time owing to bouts of recurrent edema. Sustained suppression of VEGF may help to provide optimal outcomes in RVO and reduce treatment burden.

UR - http://www.scopus.com/inward/record.url?scp=85068222057&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85068222057&partnerID=8YFLogxK

U2 - 10.1016/j.ajo.2019.03.029

DO - 10.1016/j.ajo.2019.03.029

M3 - Article

C2 - 30954469

AN - SCOPUS:85068222057

VL - 205

SP - 17

EP - 26

JO - American Journal of Ophthalmology

JF - American Journal of Ophthalmology

SN - 0002-9394

ER -