Long-term Treatment Effect of Intravitreal Ant-VEGF in Branch Retinal Vein Occlusion
Status:
Completed
Trial end date:
2013-02-01
Target enrollment:
Participant gender:
Summary
Retinal vein occlusion (RVO) is the second leading cause of retinal vascular disease in
patients older than 50 years.The prevalence varies from 0.7% to 1.6% in the literature.
Visual recovery depends on ischemic damage of the retina, the occurence of macular edema (ME)
and the development of neovascular glaucoma. The occurence of ME is the main reason for
visual loss and frustrates visual recovery among patients with both central or branch RVO.
Therapeutic options that have been used and discussed over the years are the treatment with
anticoagulants, fibrinolytics, corticosteroids, acetazolamide and isovolemic haemodilution.
Furthermore, surgical options like vitrectomy and radial optic neurotomy were used.
Panretinal photocoagulation and grid pattern photocoagulation had established as additional
tool to induce chorioretinal anastomosis. Nevertheless, the effectiveness and the evidence of
these different treatment options could not be verified and remains mostly unknown.
Nowadays, intravitreal anti-VEGF application had become the treatment of choice for ME
secondary to RVO. Multi-center studies have already shown the effectiveness of anti-VEGF
treatment to reduce intraretinal fluid and retinal hemorrhages (BRAVO, CRUISE).
Unfortunately, often high numbers of re-treatments become necessary over the years. In our
knowledge, there are no reports showing more than 3 years treatment effects of antiangiogenic
drugs in patients with BRVO. However, the results of treatment effect longer than 3 years are
important, as the mean age < 70 years with an onset of BRVO has been estimated in about 60%
of all cases. In addition, most patients with regard to the application of anti-VEGF
treatment in real clinical setting, there is only rare experience concerning need of optimum
time duration for follow-up at the departments. Hence, the present study aimed to evaluate
the long-term clinical outcomes, safety and therapeutic benefit of a flexible dosing regimen
of intravitreal anti-VEGF therapy in patients with ME secondary to BRVO.