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Published in: Ophthalmology and Therapy 2/2019

Open Access 01-06-2019 | Diabetic Retinopathy | Original Research

Real-Life Evidence for Using a Treat-and-Extend Injection Regime for Patients with Central Retinal Vein Occlusion

Authors: Maria Eleftheriadou, Luke Nicholson, Giulia D’Alonzo, Peter K. F. Addison

Published in: Ophthalmology and Therapy | Issue 2/2019

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Abstract

Introduction

To report the 52-week treatment outcomes with intravitreal injections of aflibercept using a treat-and-extend regimen for treating macular edema secondary to central retinal vein occlusion (CRVO).

Methods

A retrospective analysis of patients newly diagnosed with CRVO was performed. Patients receiving aflibercept between 1 December 2016 and 31 March 2017 were included in the analysis. Data on age, gender, visual acuity measured on Early Treatment of Diabetic Retinopathy Study charts, presence of macular and peripheral ischemia, anatomical changes observed on spectral domain–optical coherence tomography examination and the number of injections needed were recorded.

Results

The mean gain in vision was 17.8 ± 19.1 (± standard deviation) letters and 15.1 ± 20.2 letters at weeks 24 and 52 of follow-up, respectively. The proportion of patients who gained ≥ 15 letters in best-corrected visual acuity was 52.9% at week 24 and 50% at week 52. The mean reduction in central subfield macular thickness was 331.5 and 311.6 at weeks 24 and week 52, respectively. For the patients completing 52 weeks of follow-up, the mean number of treatments was 4.9 ± 1.3 injections in the first 26 weeks and 3.2 ± 2.0 injections in the second 26 weeks.

Conclusions

The Moorfields protocol for treating macula edema in CRVO achieves a quick response to treatment without over- or under-treating patients with a fixed protocol. Overall, our individualized treat-and-extend protocol achieved real-life outcomes approaching those of clinical trials. As there are currently no such trials using this practically useful regimen, our study provides real-world evidence for using a treat-and-extend protocol for aflibercept in CRVO.
Literature
1.
go back to reference Ho M, Liu DT, Lam DS, et al. Retinal vein occlusions, from basics to the latest treatment. Retina (Philadelphia). 2016;36:432–48.CrossRef Ho M, Liu DT, Lam DS, et al. Retinal vein occlusions, from basics to the latest treatment. Retina (Philadelphia). 2016;36:432–48.CrossRef
2.
go back to reference Klein R, Klein BE, Moss SE, et al. The epidemiology of retinal vein occlusion: the Beaver Dam Eye Study. Trans Am Ophthalmol Soc. 2000;98:133–41.PubMedPubMedCentral Klein R, Klein BE, Moss SE, et al. The epidemiology of retinal vein occlusion: the Beaver Dam Eye Study. Trans Am Ophthalmol Soc. 2000;98:133–41.PubMedPubMedCentral
3.
go back to reference Rogers S, McIntosh RL, Cheung N, et al. International Eye Disease Consortium: the prevalence of retinal vein occlusion: pooled data from population studies from the United States, Europe, Asia, and Australia. Ophthalmology. 2010;117:313–9.CrossRef Rogers S, McIntosh RL, Cheung N, et al. International Eye Disease Consortium: the prevalence of retinal vein occlusion: pooled data from population studies from the United States, Europe, Asia, and Australia. Ophthalmology. 2010;117:313–9.CrossRef
4.
go back to reference McIntosh RL, Rogers SL, Lim L, et al. Natural history of central retinal vein occlusion: an evidence-based systematic review. Ophthalmology. 2010;117:1113–23.CrossRef McIntosh RL, Rogers SL, Lim L, et al. Natural history of central retinal vein occlusion: an evidence-based systematic review. Ophthalmology. 2010;117:1113–23.CrossRef
5.
go back to reference Wong TY, Scott IU. Clinical practice. Retinal-vein occlusion. N Engl J Med. 2010;363:2135–44.CrossRef Wong TY, Scott IU. Clinical practice. Retinal-vein occlusion. N Engl J Med. 2010;363:2135–44.CrossRef
6.
go back to reference Central Vein Occlusion Study Group. Evaluation of grid pattern photocoagulation for macular oedema in central vein occlusion: the Central Vein Occlusion Study Group M report. Ophthalmology. 1995;102:1425–33.CrossRef Central Vein Occlusion Study Group. Evaluation of grid pattern photocoagulation for macular oedema in central vein occlusion: the Central Vein Occlusion Study Group M report. Ophthalmology. 1995;102:1425–33.CrossRef
7.
go back to reference Jonas JB, Kreissig I, Degenring RF. Intravitreal triamcinolone acetonide as treatment of macular oedema in central retinal vein occlusion. Graefes Arch Clin Exp Ophthalmol. 2002;240:782–3.CrossRef Jonas JB, Kreissig I, Degenring RF. Intravitreal triamcinolone acetonide as treatment of macular oedema in central retinal vein occlusion. Graefes Arch Clin Exp Ophthalmol. 2002;240:782–3.CrossRef
8.
go back to reference Ding X, Li J, Hu X, et al. Prospective study of intravitreal triamcinolone acetonide versus bevacizumab for macular oedema secondary to central retinal vein occlusion. Retina. 2011;31:838–45.CrossRef Ding X, Li J, Hu X, et al. Prospective study of intravitreal triamcinolone acetonide versus bevacizumab for macular oedema secondary to central retinal vein occlusion. Retina. 2011;31:838–45.CrossRef
9.
go back to reference Scott IU, VanVeldhuisen PC, Oden NL, et al. Baseline predictors of visual acuity and retinal thickness outcomes in patients with retinal vein occlusion: standard Care Versus COrticosteroid for REtinal Vein Occlusion Study report 10. Ophthalmology. 2011;118:345–52.CrossRef Scott IU, VanVeldhuisen PC, Oden NL, et al. Baseline predictors of visual acuity and retinal thickness outcomes in patients with retinal vein occlusion: standard Care Versus COrticosteroid for REtinal Vein Occlusion Study report 10. Ophthalmology. 2011;118:345–52.CrossRef
10.
go back to reference Heier JS, Campochiaro PA, Yau L, et al. Ranibizumab for macular oedema due to retinal vein occlusions: long-term follow-up in the HORIZON trial. Ophthalmology. 2012;119(4):802–9.CrossRef Heier JS, Campochiaro PA, Yau L, et al. Ranibizumab for macular oedema due to retinal vein occlusions: long-term follow-up in the HORIZON trial. Ophthalmology. 2012;119(4):802–9.CrossRef
11.
go back to reference Boyer D, Heier J, Brown DM, et al. Vascular endothelial growth factor trap-eye for macular oedema secondary to central retinal vein occlusion: six-month results of the Phase 3 COPERNICUS Study. Ophthalmology. 2012;119(5):1024–32.CrossRef Boyer D, Heier J, Brown DM, et al. Vascular endothelial growth factor trap-eye for macular oedema secondary to central retinal vein occlusion: six-month results of the Phase 3 COPERNICUS Study. Ophthalmology. 2012;119(5):1024–32.CrossRef
12.
go back to reference Brown DM, Campochiaro PA, Singh RP, et al. Ranibizumab for macular oedema following central retinal vein occlusion: six-month primary end point results of a phase III study. Ophthalmology. 2010;117(6):1124–1133.e1121.CrossRef Brown DM, Campochiaro PA, Singh RP, et al. Ranibizumab for macular oedema following central retinal vein occlusion: six-month primary end point results of a phase III study. Ophthalmology. 2010;117(6):1124–1133.e1121.CrossRef
13.
go back to reference Korobelnik JF, Holz FG, Roider J, et al. Intravitreal aflibercept injection for macular oedema resulting from central retinal vein occlusion: one-year results of the phase 3 GALILEO study. Ophthalmology. 2014;121(1):202–8.CrossRef Korobelnik JF, Holz FG, Roider J, et al. Intravitreal aflibercept injection for macular oedema resulting from central retinal vein occlusion: one-year results of the phase 3 GALILEO study. Ophthalmology. 2014;121(1):202–8.CrossRef
14.
go back to reference Holz FG, Roider J, Ogura Y, et al. VEGF Trap-Eye for macular ooedema secondary to central retinal vein occlusion: 6-month results of the phase III GALILEO study. Br J Ophthalmol. 2013;97(3):278–84.CrossRef Holz FG, Roider J, Ogura Y, et al. VEGF Trap-Eye for macular ooedema secondary to central retinal vein occlusion: 6-month results of the phase III GALILEO study. Br J Ophthalmol. 2013;97(3):278–84.CrossRef
15.
go back to reference Campochiaro PA, Brown DM, Awh CC, et al. Sustained benefits from ranibizumab for macular oedema following central retinal vein occlusion: twelve-month outcomes of a phase III study. Ophthalmology. 2011;118(10):2041–9.CrossRef Campochiaro PA, Brown DM, Awh CC, et al. Sustained benefits from ranibizumab for macular oedema following central retinal vein occlusion: twelve-month outcomes of a phase III study. Ophthalmology. 2011;118(10):2041–9.CrossRef
16.
go back to reference Campochiaro PA, Sophie R, Pearlman J, et al. RETAIN Study Group: long-term outcomes in patients with retinal vein occlusion treated with ranibizumab: the RETAIN study. Ophthalmology. 2014;121:209–19.CrossRef Campochiaro PA, Sophie R, Pearlman J, et al. RETAIN Study Group: long-term outcomes in patients with retinal vein occlusion treated with ranibizumab: the RETAIN study. Ophthalmology. 2014;121:209–19.CrossRef
17.
go back to reference Brown DM, Heier JS, Clark WL, et al. Intravitreal aflibercept injection for macular oedema secondary to central retinal vein occlusion: 1-year results from the phase 3 COPERNICUS Study. Am J Ophthalmol. 2013;155:429–37.CrossRef Brown DM, Heier JS, Clark WL, et al. Intravitreal aflibercept injection for macular oedema secondary to central retinal vein occlusion: 1-year results from the phase 3 COPERNICUS Study. Am J Ophthalmol. 2013;155:429–37.CrossRef
Metadata
Title
Real-Life Evidence for Using a Treat-and-Extend Injection Regime for Patients with Central Retinal Vein Occlusion
Authors
Maria Eleftheriadou
Luke Nicholson
Giulia D’Alonzo
Peter K. F. Addison
Publication date
01-06-2019
Publisher
Springer Healthcare
Published in
Ophthalmology and Therapy / Issue 2/2019
Print ISSN: 2193-8245
Electronic ISSN: 2193-6528
DOI
https://doi.org/10.1007/s40123-019-0184-8

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