Top

Graefe's Archive for Clinical and Experimental Ophthalmology

Published in:

01-03-2017 | Retinal Disorders

Predictive factors for functional improvement following intravitreal bevacizumab injections after central retinal vein occlusion

Authors: Kai Januschowski, Nicolas Feltgen, Amelie Pielen, Bernhard Spitzer, Matus Rehak, Georg Spital, Spyridon Dimopoulos, Carsten H. Meyer, Gesine B. Szurman, Bevacizumab Study Group Venous Occlusion

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 3/2017

Abstract

Purpose

Vision loss in central retinal vein occlusion (CRVO) is mostly caused by macular edema (ME) and can be treated with intravitreal bevacizumab injections. The goal of this study was to identify predictive factors for improvement in visual acuity.

Methods

Three hundred and sixteen eyes of six centres having received intravitreal bevacizumab for ME due to CRVO were enrolled in this multicentre, retrospective, interventional case series. The follow-up time was 24 to 48 weeks. Investigated patient characteristics were pretreatment, duration of CRVO prior to the first injection, initial best-corrected visual acuity (BCVA), baseline central retinal thickness as measured by optical coherence tomography, gender, eye, age, comorbidity with glaucoma, systemic hypertension, or diabetes mellitus.

Results

Multiple regression analysis confirmed the following baseline predictive factors for an increase in visual acuity: low BCVA (p < 0.001), high CRT (p < 0.02), and treatment naïve patients (p = 0.03). None of the other investigated patient characteristics could be identified as prognostic factors for increase in visual acuity (p > 0.1).

Conclusions

Intravitreal injections of bevacizumab in a routine clinical setting effectively improved and stabilized BCVA in CRVO. Our large multicenter study identified initial BCVA, baseline CRT, and pre-treatment as prognostic factors for visual improvement.

Hayreh SS (2007) Neovascular glaucoma. Prog Retin Eye Res 26(5):470–485. doi:10.1016/j.preteyeres.2007.06.001 CrossRefPubMedPubMedCentral

Hayreh SS, Zimmerman MB, Podhajsky P (1994) Incidence of various types of retinal vein occlusion and their recurrence and demographic characteristics. Am J Ophthalmol 117(4):429–441CrossRefPubMed

Aiello LP, Avery RL, Arrigg PG, Keyt BA, Jampel HD, Shah ST, Pasquale LR, Thieme H, Iwamoto MA, Park JE et al (1994) Vascular endothelial growth factor in ocular fluid of patients with diabetic retinopathy and other retinal disorders. N Engl J Med 331(22):1480–1487. doi:10.1056/NEJM199412013312203 CrossRefPubMed

Noma H, Funatsu H, Mimura T, Harino S, Hori S (2009) Vitreous levels of interleukin-6 and vascular endothelial growth factor in macular edema with central retinal vein occlusion. Ophthalmology 116(1):87–93. doi:10.1016/j.ophtha.2008.09.034 CrossRefPubMed

Epstein DL, Algvere PV, von Wendt G, Seregard S, Kvanta A (2012) Benefit from Bevacizumab for macular edema in central retinal vein occlusion: twelve-month results of a prospective, randomized study. Ophthalmology. doi:10.1016/j.ophtha.2012.06.037

Brown DM, Campochiaro PA, Singh RP, Li Z, Gray S, Saroj N, Rundle AC, Rubio RG, Murahashi WY (2010) Ranibizumab for macular edema following central retinal vein occlusion: six-month primary end point results of a phase III study. Ophthalmology 117(6):1124–1133. doi:10.1016/j.ophtha.2010.02.022, e1121CrossRefPubMed

Boyer D, Heier J, Brown DM, Clark WL, Vitti R, Berliner AJ, Groetzbach G, Zeitz O, Sandbrink R, Zhu X, Beckmann K, Haller JA (2012) Vascular endothelial growth factor Trap-Eye for macular edema secondary to central retinal vein occlusion: six-month results of the phase 3 COPERNICUS study. Ophthalmology 119(5):1024–1032. doi:10.1016/j.ophtha.2012.01.042 CrossRefPubMed

Brown DM, Heier JS, Clark WL, Boyer DS, Vitti R, Berliner AJ, Zeitz O, Sandbrink R, Zhu X, Haller JA (2013) Intravitreal aflibercept injection for macular edema secondary to central retinal vein occlusion: 1-year results from the phase 3 COPERNICUS study. Am J Ophthalmol 155(3):429–437. doi:10.1016/j.ajo.2012.09.026, e427CrossRefPubMed

Jaissle GB, Szurman P, Feltgen N, Spitzer B, Pielen A, Rehak M, Spital G, Heimann H, Meyer CH (2011) Predictive factors for functional improvement after intravitreal bevacizumab therapy for macular edema due to branch retinal vein occlusion. Graefe’s Arch Clin Exp Ophthalmol = Albrecht von Graefes Arch Klin Exp Ophthalmol 249(2):183–192. doi:10.1007/s00417-010-1470-2 CrossRef

10.

Daien V, Navarre S, Fesler P, Vergely L, Villain M, Schneider C (2012) Visual acuity outcome and predictive factors after bevacizumab for central retinal vein occlusion. Eur J Ophthalmol 22(6):1013–1018. doi:10.5301/ejo.5000162 CrossRefPubMed

11.

Hirose M, Matsumiya W, Honda S, Nakamura M (2014) Efficacy and visual prognostic factors of intravitreal bevacizumab as needed for macular edema secondary to central retinal vein occlusion. Clin Ophthalmol 8:2301–2305. doi:10.2147/OPTH.S74888 PubMedPubMedCentral

12.

Januschowski K, Dimopoulos S, Szurman P, Feltgen N, Spitzer B, Pielen A, Rehak M, Spital G; Bevacizumab Study Group Venous Occlusion, Meyer CH, Szurman GB (2015) Injection scheme for intravitreal bevacizumab therapy for macular oedema due to central retinal vein occlusion: results of a multicenter study. Acta Ophthalmol. 2015 Aug;93(5):e400-2. doi:10.1111/aos.12600.

13.

Krohne TU, Liu Z, Holz FG, Meyer CH (2012) Intraocular pharmacokinetics of ranibizumab following a single intravitreal injection in humans. Am J Ophthalmol 154(4):682–686. doi:10.1016/j.ajo.2012.03.047, e682CrossRefPubMed

14.

Kakinoki M, Sawada O, Sawada T, Saishin Y, Kawamura H, Ohji M (2012) Effect of vitrectomy on aqueous VEGF concentration and pharmacokinetics of bevacizumab in macaque monkeys. Invest Ophthalmol Vis Sci 53(9):5877–5880. doi:10.1167/iovs.12-10164 CrossRefPubMed

15.

Jaissle GB, Szurman P, Bartz-Schmidt KU (2005) Recommendation for the implementation of intravitreal injections--statement of the German Retina Society, the German Society of Ophthalmology (DOG) and the German Professional Association of Ophthalmologists (BVA). Klin Monbl Augenheilkd 222(5):390–395. doi:10.1055/s-2005-858231 CrossRefPubMed

16.

Ach T, Hoeh AE, Schaal KB, Scheuerle AF, Dithmar S (2010) Predictive factors for changes in macular edema in intravitreal bevacizumab therapy of retinal vein occlusion. Graefe’s Arch Clin Exp Ophthalmol = Albrecht von Graefes Arch Klin Exp Ophthalmol 248(2):155–159. doi:10.1007/s00417-009-1167-6 CrossRef

17.

Schmidt B, Krummenauer F, Losche CC (2012) Evaluation of possible prognostic factors for the course of visual acuity after intravitreal ttriamconolone acetonide. Klin Monatsbl Augenheilkd 229(1):56–61. doi:10.1055/s-0031-1281586 CrossRefPubMed

18.

McIntosh RL, Rogers SL, Lim L, Cheung N, Wang JJ, Mitchell P, Kowalski JW, Nguyen HP, Wong TY (2010) Natural history of central retinal vein occlusion: an evidence-based systematic review. Ophthalmology 117(6):1113–1123. doi:10.1016/j.ophtha.2010.01.060, e1115CrossRefPubMed

19.

Wolf-Schnurrbusch UE, Ghanem R, Rothenbuehler SP, Enzmann V, Framme C, Wolf S (2011) Predictors of short-term visual outcome after anti-VEGF therapy of macular edema due to central retinal vein occlusion. Invest Ophthalmol Vis Sci 52(6):3334–3337. doi:10.1167/iovs.10-6097 CrossRefPubMed

20.

Pikkel J, Chassid O, Busool Y, Srour W, Sharabi-Nov A, Beiran I (2013) Bevacizumab for CRVO associated CME: effect of timing and frequency of injections on final visual outcome. J Ophthalmol 2013:974670. doi:10.1155/2013/974670 CrossRefPubMedPubMedCentral

21.

Pielen A, Feltgen N, Isserstedt C, Callizo J, Junker B, Schmucker C (2013) Efficacy and safety of intravitreal therapy in macular edema due to branch and central retinal vein occlusion: a systematic review. PLoS One 8(10), e78538. doi:10.1371/journal.pone.0078538 CrossRefPubMedPubMedCentral

22.

Ogura Y, Roider J, Korobelnik JF, Holz FG, Simader C, Schmidt-Erfurth U, Vitti R, Berliner AJ, Hiemeyer F, Stemper B, Zeitz O, Sandbrink R (2014) Intravitreal aflibercept for macular edema secondary to central retinal vein occlusion: 18-month results of the phase 3 GALILEO study. Am J Ophthalmol 158(5):1032–1038. doi:10.1016/j.ajo.2014.07.027 CrossRefPubMed

23.

Heier JS, Clark WL, Boyer DS, Brown DM, Vitti R, Berliner AJ, Kazmi H, Ma Y, Stemper B, Zeitz O, Sandbrink R, Haller JA (2014) Intravitreal aflibercept injection for macular edema due to central retinal vein occlusion: two-year results from the COPERNICUS study. Ophthalmology 121(7):1414–1420. doi:10.1016/j.ophtha.2014.01.027, e1411CrossRefPubMed

Title: Predictive factors for functional improvement following intravitreal bevacizumab injections after central retinal vein occlusion
Authors: Kai Januschowski
Nicolas Feltgen
Amelie Pielen
Bernhard Spitzer
Matus Rehak
Georg Spital
Spyridon Dimopoulos
Carsten H. Meyer
Gesine B. Szurman
Bevacizumab Study Group Venous Occlusion
Publication date: 01-03-2017
Publisher: Springer Berlin Heidelberg
Published in: Graefe's Archive for Clinical and Experimental Ophthalmology / Issue 3/2017
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI: https://doi.org/10.1007/s00417-016-3471-2

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Predictive factors for functional improvement following intravitreal bevacizumab injections after central retinal vein occlusion

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 3/2017

NGF/anti-VEGF combined exposure protects RCS retinal cells and photoreceptors that underwent a local worsening of inflammation

Upregulation of NLRP3 inflammasome components in Mooren’s ulcer

Letter in response to letter: intraocular use of acid violet 17 at a concentration of 1.5 mg/ml is not safe

Optic disc and peripapillary retinal nerve fiber layer characteristics associated with glaucomatous optic disc in young myopia

RETRACTED ARTICLE: Casticin inhibits epithelial-mesenchymal transition of EBV-infected human retina pigmental epithelial cells through the modulation of intracellular lipogenesis

A multicenter, 12-month randomized study comparing dexamethasone intravitreal implant with ranibizumab in patients with diabetic macular edema