CRVO and BRVO can cause macular edema with the decrease of visual acuity. Treatment with anti-VEGF for macular edema in patients with RVO is now the best choice to improve the visual acuity and the life quality of the patients. Considering the role of VEGF as one of the main factors in the development of macular edema, this study aims to examine the anatomical and functional long-term effects of the use of anti-VEGF intravitreal drugs in the treatment of secondary macular edema caused by RVO.
This is a retrospective study, where 25 patients diagnosed with macular edema following RVO were included. Patient Visual acuity with Snellen chart, intraocular pressure, fluorangiography, and OCT was done on all the patients in their first visit. The patients were treated with intravitreal Aflibercept and were followed up for 2 years.
The results of this study revealed that aflibercept was effective in patients that have macular edema following RVO, in maintaining or improving visual acuity in a long-term follow-up of 26.2 ± 7.6 months and in terms of reducing macular edema. Compared to one-third of CRVO patients, BRVO patients appear to have a better prognosis because 75% presented ≥6 / 12 visual acuity at the end of the follow-up period. Our results also suggest that intraretinal fluid and macular cystoid edema with increased TCF were associated with adverse visual outcomes. The integrity of outer retinal layers influences the improvement of BCVA, the damage in the photoreceptor can lead to poor visual acuity.
1. Chatziralli I, Theodossiadis G, Chatzirallis A, Parikakis E, Mitropoulos P, Theodossiadis P. Ranibizumab for retinal vein occlusion: predictive factors and long-term outcomes in real-life data. Retina. 2018;38(3):559-68.
2. Iosseliani DG, Bosha NS, Sandodze TS, Azarov AV, Semitko SP. The effect of revascularization of the internal Carotid artery on the Microcirculation of the eye. J Adv Pharm Educ Res. 2020;10(2):209-14
3. Dhyani A, Kumar G. A New Vision to Eye: Novel Ocular Drug Delivery System. Pharmacophore. 2019;10(1):13-20.
4. Spaide RF, Yannuzzi LA, Sisco LJ. Chronic cystoid macular edema and predictors of visual acuity. Ophthalmic Surg. 1993.
5. Varma R, Bressler NM, Suñer I, Lee P, Dolan CM, Ward J, et al. Improved vision-related function after ranibizumab for macular edema after retinal vein occlusion: results from the BRAVO and CRUISE trials. Ophthalmology. 2012;119(10):2108-18. doi: 10.1016/j.ophtha.2012.05.017
6. Rhoades W, Dickson D, Nguyen QD, Do DV. Management of macular edema due to central retinal vein occlusion–the role of aflibercept. Taiwan J Ophthalmol. 2017;7(2):70-6.
7. Ogura Y, Roider J, Korobelnik JF, Holz FG, Simader C, Schmidt-Erfurth U, et al. Intravitreal aflibercept for macular edema secondary to central retinal vein occlusion: 18-month results of the phase 3 GALILEO study. Am J Ophthalmol. 2014;158(5):1032-8. doi: 10.1016/j.ajo.2014.07.027
8. Coelho J, Pessoa B, Meireles A. Long-term management of non-ischemic central retinal vein occlusion with fluocinolone acetonide intravitreal implant 190 μg (ILUVIEN®). Ther Adv Ophthalmol. 2019;11:2515841418820755. doi: 10.1177/2515841418820755
9. Wolf-Schnurrbusch UE, Ghanem R, Rothenbuehler SP, Enzmann V, Framme C, Wolf S. Predictors of short-term visual outcome after anti-VEGF therapy of macular edema due to central retinal vein occlusion. Invest Ophthalmol Vis Sci. 2011;52(6):3334-7. doi: 10.1167/iovs.10-6097
10. Krasniqi M, Trebicka B. Visual impairment and quality of life, a cross-sectional study. Int J Psychosoc Rehabil. 2020;24(07):10234-40.