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

Mustafa Iftikhar, Tahreem A. Mir, Gulnar Hafiz, Ingrid E Zimmer Galler, Adrienne Scott, Sharon D. Solomon, Akrit Sodhi, Adam Wenick, Catherine Meyerle, Kim Jiramongkolchai, Tin Yan Liu, J Fernando Arevalo, Mandeep Singh, Saleema Kherani, James Handa, Peter A Campochiaro

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

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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

Loss of Peak Vision in Retinal Vein Occlusion Patients Treated for Macular Edema. / Iftikhar, Mustafa; Mir, Tahreem A.; Hafiz, Gulnar; Zimmer Galler, Ingrid E; Scott, Adrienne; Solomon, Sharon D.; Sodhi, Akrit; Wenick, Adam; Meyerle, Catherine; Jiramongkolchai, Kim; Liu, Tin Yan; Arevalo, J Fernando; Singh, Mandeep; Kherani, Saleema; Handa, James; Campochiaro, Peter A.

In: American journal of ophthalmology, Vol. 205, 01.09.2019, p. 17-26.

Research output: Contribution to journalArticle

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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.",
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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 E

AU - Scott, Adrienne

AU - Solomon, Sharon D.

AU - Sodhi, Akrit

AU - Wenick, Adam

AU - Meyerle, Catherine

AU - Jiramongkolchai, Kim

AU - Liu, Tin Yan

AU - Arevalo, J Fernando

AU - Singh, Mandeep

AU - Kherani, Saleema

AU - Handa, James

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.

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