Long-term outcomes in ranibizumab-treated patients with retinal vein occlusion; The role of progression of retinal nonperfusion

Raafay Sophie, Gulnar Hafiz, Adrienne W. Scott, Ingrid Zimmer-Galler, Quan Dong Nguyen, Howard Ying, Diana V. Do, Sharon Solomon, Akrit Sodhi, Peter Gehlbach, Elia Duh, David Baranano, Peter A. Campochiaro

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Abstract

Purpose To determine the percentage of ranibizumab-treated patients with retinal vein occlusion (RVO) who had resolution of edema for at least 6 months after the last injection, along with factors and outcomes that correlate with resolution. Design Post hoc analysis of open-label clinical trial. Methods Twenty patients with branch RVO (BRVO) and 20 with central RVO (CRVO) received ranibizumab monthly for 3 months and as needed for recurrent/persistent macular edema, no more frequently than every 2 months. Patients still requiring injections after month 40 received scatter and grid laser photocoagulation to try to reduce the need for injections. Main outcome measures included the percentage of patients who had resolution of edema, change in best-corrected visual acuity (BCVA) from baseline, and change in area of retinal nonperfusion in central subfields. Results Nine patients with BRVO (45%) had edema resolution from injections alone after a mean of 20.2 months, 4 resolved after addition of laser, 4 were unresolved through 72 months, and 3 exited prior to resolution. Five patients with CRVO (25%) resolved from injections alone after a mean of 14.0 months, 8 remained unresolved through 72 months despite addition of laser, and 7 exited prior to resolution. For BRVO or CRVO, there was a negative correlation between posterior retinal nonperfusion area and BCVA at months 18, 24, and 36 (P <.05). Conclusions In patients with RVO, infrequent ranibizumab injections to control edema may not be sufficient to prevent progression of retinal nonperfusion, which may contribute to loss of visual gains.

Original languageEnglish (US)
JournalAmerican journal of ophthalmology
Volume156
Issue number4
DOIs
StatePublished - Jan 1 2013

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Retinal Vein Occlusion
Injections
Edema
Lasers
Visual Acuity
Retinal Vein
Macular Edema
Light Coagulation
Ranibizumab
Outcome Assessment (Health Care)
Clinical Trials

ASJC Scopus subject areas

  • Ophthalmology

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Long-term outcomes in ranibizumab-treated patients with retinal vein occlusion; The role of progression of retinal nonperfusion. / Sophie, Raafay; Hafiz, Gulnar; Scott, Adrienne W.; Zimmer-Galler, Ingrid; Nguyen, Quan Dong; Ying, Howard; Do, Diana V.; Solomon, Sharon; Sodhi, Akrit; Gehlbach, Peter; Duh, Elia; Baranano, David; Campochiaro, Peter A.

In: American journal of ophthalmology, Vol. 156, No. 4, 01.01.2013.

Research output: Contribution to journalArticle

Sophie, R, Hafiz, G, Scott, AW, Zimmer-Galler, I, Nguyen, QD, Ying, H, Do, DV, Solomon, S, Sodhi, A, Gehlbach, P, Duh, E, Baranano, D & Campochiaro, PA 2013, 'Long-term outcomes in ranibizumab-treated patients with retinal vein occlusion; The role of progression of retinal nonperfusion', American journal of ophthalmology, vol. 156, no. 4. https://doi.org/10.1016/j.ajo.2013.05.039
Sophie, Raafay ; Hafiz, Gulnar ; Scott, Adrienne W. ; Zimmer-Galler, Ingrid ; Nguyen, Quan Dong ; Ying, Howard ; Do, Diana V. ; Solomon, Sharon ; Sodhi, Akrit ; Gehlbach, Peter ; Duh, Elia ; Baranano, David ; Campochiaro, Peter A. / Long-term outcomes in ranibizumab-treated patients with retinal vein occlusion; The role of progression of retinal nonperfusion. In: American journal of ophthalmology. 2013 ; Vol. 156, No. 4.
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AU - Hafiz, Gulnar

AU - Scott, Adrienne W.

AU - Zimmer-Galler, Ingrid

AU - Nguyen, Quan Dong

AU - Ying, Howard

AU - Do, Diana V.

AU - Solomon, Sharon

AU - Sodhi, Akrit

AU - Gehlbach, Peter

AU - Duh, Elia

AU - Baranano, David

AU - Campochiaro, Peter A.

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N2 - Purpose To determine the percentage of ranibizumab-treated patients with retinal vein occlusion (RVO) who had resolution of edema for at least 6 months after the last injection, along with factors and outcomes that correlate with resolution. Design Post hoc analysis of open-label clinical trial. Methods Twenty patients with branch RVO (BRVO) and 20 with central RVO (CRVO) received ranibizumab monthly for 3 months and as needed for recurrent/persistent macular edema, no more frequently than every 2 months. Patients still requiring injections after month 40 received scatter and grid laser photocoagulation to try to reduce the need for injections. Main outcome measures included the percentage of patients who had resolution of edema, change in best-corrected visual acuity (BCVA) from baseline, and change in area of retinal nonperfusion in central subfields. Results Nine patients with BRVO (45%) had edema resolution from injections alone after a mean of 20.2 months, 4 resolved after addition of laser, 4 were unresolved through 72 months, and 3 exited prior to resolution. Five patients with CRVO (25%) resolved from injections alone after a mean of 14.0 months, 8 remained unresolved through 72 months despite addition of laser, and 7 exited prior to resolution. For BRVO or CRVO, there was a negative correlation between posterior retinal nonperfusion area and BCVA at months 18, 24, and 36 (P <.05). Conclusions In patients with RVO, infrequent ranibizumab injections to control edema may not be sufficient to prevent progression of retinal nonperfusion, which may contribute to loss of visual gains.

AB - Purpose To determine the percentage of ranibizumab-treated patients with retinal vein occlusion (RVO) who had resolution of edema for at least 6 months after the last injection, along with factors and outcomes that correlate with resolution. Design Post hoc analysis of open-label clinical trial. Methods Twenty patients with branch RVO (BRVO) and 20 with central RVO (CRVO) received ranibizumab monthly for 3 months and as needed for recurrent/persistent macular edema, no more frequently than every 2 months. Patients still requiring injections after month 40 received scatter and grid laser photocoagulation to try to reduce the need for injections. Main outcome measures included the percentage of patients who had resolution of edema, change in best-corrected visual acuity (BCVA) from baseline, and change in area of retinal nonperfusion in central subfields. Results Nine patients with BRVO (45%) had edema resolution from injections alone after a mean of 20.2 months, 4 resolved after addition of laser, 4 were unresolved through 72 months, and 3 exited prior to resolution. Five patients with CRVO (25%) resolved from injections alone after a mean of 14.0 months, 8 remained unresolved through 72 months despite addition of laser, and 7 exited prior to resolution. For BRVO or CRVO, there was a negative correlation between posterior retinal nonperfusion area and BCVA at months 18, 24, and 36 (P <.05). Conclusions In patients with RVO, infrequent ranibizumab injections to control edema may not be sufficient to prevent progression of retinal nonperfusion, which may contribute to loss of visual gains.

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