Comparison of ranibizumab and triamcinolone for treatment of macular edema secondary to central retinal vein occlusion
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Objective: To compare the efficacy of intravitreal injections of triamcinolone acetonide (TA) and that of ranibizumab for macular edema secondary to central retinal vein occlusion (CRVO). Methods: In a retrospective assessment 12 TA-treated patients and 12 ranibizumab-treated ones with macular edema after CRVO were pair-matched according to initial best-corrected visual acuity (BCVA) and central macular thickness (CMT). BCVA and CMT were the main endpoints. Results: The initial BCVA of 0.78±0.12 increased significantly to 0.55±0.24 in the TA-treated patients ( P =0.005). And the initial CMT of (598.92±192.67) μm decreased significantly to (258.28±75.38) μm ( P =0.002). In the ranibizumab-treated patients, the initial BCVA of 0.78±0.11 increased significantly to 0.48±0.21 ( P =0.002) and the initial CMT of (591.75±181.68) μm decreased significantly to (281.17±63.08) μm ( P =0.002). There was no significance between the initial and final BCVA and CMT of TA-treated patients and ranibizumab-treated patients. Conclusion: Both treatments decreased the CMT and induced an improvement in BCVA from baseline.Cite
To report the long-term visual and anatomic outcomes of intravitreal injections for macular edema (ME) secondary to retinal vein occlusion (RVO) in a real-life clinical setting.Retrospective interventional case series.A total of 223 consecutive eyes with ME secondary to RVO, treated with the first three intravitreal Ranibizumab or dexamethasone injections between August 2008 and September 2018, were enrolled in the study. Subsequent retreatment was guided by best-corrected visual acuity (BCVA) and central macular thickness (CMT) measurements, aimed at achieving macular fluid regression and BCVA stability. BCVA and CMT were recorded at baseline and at subsequent annual time points. The mean number of injections administered each year and the incidence of adverse events were recorded.The mean BCVA and CMT at baseline were 0.79 logMar (SD 0.71) and 615.7 μm (SD 257.5), respectively. The mean follow-up (FU) period was 47.8 months (min 12-max 120). At 12 months, the mean BCVA and CMT had significantly improved to 0.62 logMar (SD 0.68; p < 0.0001) and 401.04 μm (SD 257.5), respectively. The mean follow-up (FU) period was 47.8 months (min 12-max 120). At 12 months, the mean BCVA and CMT had significantly improved to 0.62 logMar (SD 0.68; p < 0.0001) and 401.04 .Intravitreal Ranibizumab and/or dexamethasone injections were found to be effective at inducing a long-lasting improvement of BCVA and CMT in a real-life clinical setting. A safety profile similar to that already well-established in Ranibizumab and dexamethasone treatment was observed, as well as a steady decrease in the number of intraocular injections required. The results support intravitreal treatments for BRVO and CRVO in patient populations with similar characteristics in similar settings.
Retinal Vein
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Objective To compare the effect of intravitreal triamcinolone vs intravitreal bevacizumab for the treatment of macular edema in non-ischaemic central retinal vein occlusion.Methods The comparative single-center nonrandomized retrospective clinical interventionalstudy included 47 eyes of 47 patients with non-ischaemic CRVO, macular edema was diagnosed by examination of regular inspection, fundus fluorescein angiography(FFA) and optic coherence tomography(OCT ).This cases were divided into a a triamcinolone group of 28 patients (4.0 mg triamcinolone) and bevacizumab group of 19 patients (1.25 mg bevacizumab). During follow-up, 1.1±0.8 re-injections of the triamcinolone group (range: 1-2 injections) and 1.5± 1 re-injections ofbevacizumab (range: 1-3 injections) were administered.The mean follow-up were 5.98±4.35 months in TA group and 3.20±2.92 in bevacizumab group.At baseline, both study groups did not vary significantly in age, duration of symptoms ,visual acuity (BCVA),center macular thickness (CMT).Comprehensive ophthalmic evaluation was performed at baseline and at weeks 4,8,12 after treatment.Main outcome measures included CMT measured with OCT and BCVA. Results No significant differences between groups were observed for BCVA at week4(t=-0.141, P=0.889), 8(t=-1.637, P=0.127), 12(t=-0.479, P=0.650 )and for CMT at weeks4 (f=-0.479, P=0.650), 8 ((=0.743, P=0.478), 12 (t=1.979, P=0.083).There was a significant increase in 10P in the TA group. Conclusion The result in our observation showed that intravitreal injection of either triamcinolone acetonide or bevacizumab was well tolerated with a significant improvement in BCVA and decrease in macular edema for patients with non-ischaemic retinal vein occlusion .A randomly controlled multicenter clinical trial is necessary.
Key words:
triamcinolone acetonide; bevacizumab; retinal vein occlusion; macular Edema
Fundus (uterus)
Retinal Vein
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Objective
To compare the short-term efficacy of conbercept and ranibizumab for macular edema in central retinal vein occlusion (CRVO)and explore the relationship between the integrity of ellipsoidal zone and visual acuity.
Methods
Forty-four eyes of 44 patients with macular edema in CRVO were enrolled into this retrospective and comparative study. There were 15 eyes of 15 males, 29 eyes of 29 females; age ranged from 49 - 61 years old, with an average age of (54.65±3.10) years. All patients were examined with best-corrected visual acuity (BCVA), intraocular pressure (IOP), slit lamp, fundus photograph, fundus fluorescein angiography (FFA), optical coherence tomography(OCT). BCVA were examined with interactional visual chart and recorded with logarithm of the minimum angle of resolution acuity. Twenty-three eyes were intravitreal injected with conbercept 0.5 mg (group A) and 21 eyes were intravitreal injected with ranibizumab 0.5 mg (group B). There was no statistical difference of age (t=-1.41), gender (χ2= 0.55), the percentage of hypertension patients (χ2=0.27), average BCVA (t=-2.06), IOP (t=-2.52), central macular thickness (CMT) (t=-1.96), number of different integrity of ellipsoidal zone patients (χ2=1.00) and number of different types of macular edema patients (χ2=1.03) among the two groups (P>0.05). The change in BCVA and CMT at 3, 6 months between the two groups were compared. The relationship between BCVA at 6 months and BCVA, CMT at baseline were explored. The relationship between three groups of ellipsoidal zone and BCVA at baseline were evaluated. The change of BCVA after treatment between the three groups of ellipsoidal zone were Compared. The number of intravitreal injections between two groups was compared.
Results
During the 3, 6 months after treatment, the mean BCVA were all improved with statistically difference in group A (t=5.13, 7.39; P 0.05). During the 3, 6 months after treatment, the mean CMT were all decreased with statistically difference in group A (t=11.58, 15.96; P 0.05). In both groups, BCVA at 6 months was related to BCVA at baseline (r= 0.44, 0.62; P 0.05). In the two groups, BCVA at baseline was related to the integrity of ellipsoidal zone (r=0.97, 0.70; P<0.05). There was statistical difference of the number of intravitreal injections in the two groups (t=-6.88, P<0.05). There was no systemic or ocular serious side effects during the follow up.
Conclusions
Comparing to ranibizumab, conbercept has the same effective to the treatment of macular edema in CRVO, but the number of intravitreal injections is less. The integrity of ellipsoidal zone is related to BCVA.
Key words:
Retinal vein occlusion/drug therapy; Macular edema /drug therapy; Angiogenesis inhibitors/therapeutic use; Antibodies, monoclonal/therapeutic use; Tomography, optical coherence
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Objective To compare the efficiency ofintravitreal injection oftriamcinolone acetonide or bevacizumab for the treatment ofmaeular edema in retinal vein occlusion. Methods One hundred and sixteen eyes of 116 patients with macular edema of retinal vein occlusion were diagnosed by examination of regular inspection, fundus fluorescein angiography (FFA) and optic coherence tomography (OCT). There were 75 patients in TA group and 41 patients in bevacizumab group. One hundred and sixteen patients received intravitreal injection of either 4mg/0. 1ml of triamcinolone acetonide or 1.25mg/0.05ml of bevacizumab. There were no significant differences between the two groups with regards to patients' age, duration of disease, best-corrected visual acuity (BCVA), central macular thickness (CMT) at baseline. Comprehensive ophthalmic evaluation was performed at baseline and at weeks 4, 8 and 12 after treatment. Main outcome measures included CMT measured with OCT and BCVA. Results Separate within-group analysis of showed significant improvement in BCVA from baseline in TA group at weeks 4 (P=0.000)、8 (P=0.000)、12 (P=0.000), and at weeks 4 (P=0.000), 8 (P=0.000) in bevacizumab group. The results showed significant reduction in CMT in TA group at weeks 4(P=0.000), 8(P=0.000), 12(P=0.004), and at weeks 4(P=0.003), 8(P=0.000) in bevacizumab group. But no significant interaction between groups were observed for BCVA at weeks 4(P=0.985), 8(P=0.989), 12(P=0.306) and for CMT at weeks 4(P=0.075), 8(P=0.453), 12(P=0.583). There was a significant increase in IOP in the TA group when compared with the bevacizumab group. Conclusion The result in our observation showed that intravitreai injection of either triamcinolone acetonide or bevacizumab was well tolerated with a significant improvement in BCVA and decrease in macular edema for patients with retinal vein occlusion. A randomly controlled multi-center clinical triai is necessary.
Key words:
Bevacizumab; Triamcinolone acetonide; Macular edema; Retinal vein occlusion
Retinal Vein
Fundus (uterus)
Acetonide
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To determine the time of anatomical and visual responses of intravitreal aflibercept (IVA) injections in patients with naive macular edema (ME) due to branch retinal vein occlusion (BRVO). 54 eyes of 54 patients who had three IVA injections after BRVO were retrospectively studied. All of the patients had three monthly IVA injections. SD-OCT was performed at the initial visit and one month after every injection. Changes in central macular thickness (CMT), best corrected visual acuity (BCVA) were determined. Results: 28 of 54 patients were women and 26 of 54 patients were man. Mean age was 62.56±2.35 years. Mean BCVA of the patients was logMAR 1.00±0.13 and the mean CMT was 476±35 µm. After first injections; mean BCVA and CMT were improved to logMAR 0.73±0.19, 279±15 µm respectively. These improvements were statically significant (p=0.047 and p=0.000 respectively). After second injections there was not any improvement in BCVA or CMT. The mean BCVA logMAR 0.75±0.18 and mean CMT 279±10 µm (p=0.725 and p=0.991). After third injections mean CMT was 267±6 µm and mean BCVA was logMAR 0.58±0.15. Although after third injections, CMT did not change but BCVA was statically significant improved (p=0.77 and p=0.036 respectively). Visual recovery comes after anatomical recovery after intravitreal aflibercept injections in patients with naive ME due to BRVO.
Aflibercept
Retinal Vein
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Observation on the clinical efficacy of combined therapy for the treatment of diabetic macular edema
Objective
To observe the clinical efficacy of intravitreal Ranibizumab combined with macular grid photocoagulation for treatment of diabetic macular edema (DME).
Methods
Sixty eyes of 60 patients with DME in the First Affiliated Hospital of Zhengzhou University from November 2013 to October 2014.They were randomly divided into 2 groups: the combined therapy group of 30 eyes and the control group of 30 eyes.The patients in combined therapy group received intravitreal Ranibizumab injection, and then combined with standard macular grid photocoagulation one week later. The patients in the control group received intravitreal Ranibizumab only.The visual acuity was examined with standard chart.The vision results converted into logarithmic of the minimum angle resolution (logMAR) to record. The changes of the logMAR of best corrected visual acuity (BCVA) and central macular thickness (CMT) before and 1, 3, 6 months after the treatment were compared. The average BCVA of the combined therapy group before treatment was 0.75±0.32 and the average BCVA of control group was 0.74±0.29.There was no statistically significant difference (t=0.20, P=0.83) in BCVA between the two groups. The average CMT is (486.87±92.44)μm in the combined therapy group and(487.13±86.519)μm in the control group before treatment.There was no statistically significant difference (t=1.247, P=0.089) in the CMT of two groups.
Results
At 1, 3, 6 months after the treatment, the BCVA of patients in control group were(0.41±4.10), (0.40±0.85)and(0.36±9.85)and the CMT were (273.53±103.36)μm, (275.21±92.14)μm and (274.65±93.21)μm, respectively. Howerer, in combined therapy group, the BCVA were (0.44±1.60), (0.43±1.73)and(0.44±2.36)and the CMT were (273.53±103.36)μm, (275.21±92.14)μm and (274.65±93.21)μm respectively. There were statistically significant differences (t=2.16, P=0.04; t=2.34, P=0.02; t=4.25, P=0.00)in the BCVA and in the CMT (t=2.114, P=0.021; t=2.352, P=0.015; t=2.534, P=0.008)at 1, 3, 6 months after the treatment between the two groups.The BCVA in both two groups were significantly improved compared with that of preoperative (P<0.05). The CMT decreased rapidly after the treatment(P<0.05). During the follow-up, the BCVA presented declining trend and the CMT was on the rise slowly in the control group. The BCVA and CMT in combined therapy group remained stable.
Conclusion
Intravitreal Ranibizumab injection combined with macular grid photocoagulation and simple Ranibizumab intravitreal injection can improve the vision and reduce macular edema in DME patients and the therapeutic efficacy of the combined group is more stable than the control group.
Key words:
Macular edema, diabetic; Ranibizumab, intravitreal injection; Grid photocoagulation, macular
Diabetic macular edema
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Objective
To investigate the effects of intravitreous injection of conbercept for macular edema secondary to retina1vein occlusion(RVO) during 6 months period.
Methods
A retrospective clinical study. 34 patients (34 eyes) were included in this study, who were diagnosed with macular edema due to retinal vein occlusion by ophthalmologic examination, fundus photography, optical coherence tomography (OCT), fundus fluorescein angiography and other methods. The best corrected visual acuity (BCVA) was examined using the international standard visual acuity chart, and the results were converted to the logMAR visual acuity. The average logMAR BCVA was 0.90±0.68, and the mean macular central retinal thickness (CMT) was (672.27±227.51) μm before treatment. All subjects received intravitreal injection of 0.5 mg conbercept (0.05 ml) at the first visit. Injections were repeated based on the visual acuity changes and the OCT findings. 34 eyes received 69 times of injection, the average number of injections was 2.03±1.03. BCVA, OCT were examined before and after treatment using the same method. BCVA and CMT changes, drugs and treatments associated cardiac and cerebral vascular accident, intraocular pressure elevation, retinal tears, retinal detachment, endophthalmitis and other complications after treatment were observed. Linear correlation analysis was used to analyze the correlation between prognosis BCVA and baseline BCVA, correlation between prognosis BCVA and baseline CMT, and also correlation between BCVA and CMT at different time points before and after treatment.
Results
At 1 week and 1, 2, 3, 6 months after treatment, the average logMAR BCVA was 0.65±0.61, 0.56±0.61, 0.46±0.55, 0.56±0.71, 0.44±0.48 respectively. During 1, 2, 3, 6 months after treatment, the mean logMAR BCVA were improved with statistically significant difference (Z=34.029, 47.294, 41.338, 43.603; P 0.05). At 1 week and 1, 2, 3, 6 months after treatment, the average CMT was (285.89±96.69), (256.65±143.39), (278.68±156.92), (290.11±188.17), (217.15±48.04) μm respectively. At 1 week and 1, 2, 3, 6 months after treatment, the mean CMT were all decreased with statistically significant difference (Z=68.500, 98.735, 93.235, 91.132, 109.162; P 0.05). Before and 3, 6 months after treatment, BCVA was negatively correlated with CMT (r=0.491, 0.416, 0.386; P 0.05). Systemic adverse reactions and persistent intraocular pressure elevation, iatrogenic cataract, retinal detachment, retinal tear, endophthalmitis and ocular complications were never found in the follow-up period.
Conclusion
Intravitreal conbercept is a safe and effective approach for RVO, which can significantly improve visual acuity and reduce CMT.
Key words:
Retinal vein occlusion/drug therapy; Macular edema /drug therapy; Angiogenesis inhibitors/therapeutic use; Antibodies, monoclonal/therapeutic use; Tomography, optical coherence
Retinal Vein
Fundus Photography
Fundus (uterus)
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Objective
To evaluate the efficiency and safety of intravitreous Ranibizumab injection for macular edema (ME) secondary to central retinal vein occlusion (CRVO).
Methods
Forty patients (40 eyes) of CRVO were observed after Ranibizumab 0.5mg intravitreous injection. Before and after injection, best corrected visual acuity (BCVA), intraocular pressure, slit lamp, ophthalmoscope, fundus photography and optical coherence tomography (OCT) were examined. Comparative analysis was proceeded about BCVA and central macular thickness (CMT) before and after treatments.
Results
All of BCVA after injection were evident improved. The differences had statistically significance. In 2, 3, 5 months after injection, CMTs were evident decreased, had statistically significance compared to before injection. In 1 week, 1 month, 4 and 6 months after injection, though CMT decreased, had no statistically significance compared to before injection. Correlation analysis displayed significant negative correlation between BCVA and CMT. All the patients showed no serious adverse reactions.
Conclusions
Intravitreal injection of Ranibizumab is effective and safe for therapy of ME secondary CRVO in short term, has no serious adverse reactions.
Key words:
Anti-vascular endothelial growth factor; Retinal vein occlusion; Macular edema
Retinal Vein
Fundus (uterus)
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Purpose:To assess the natural course of the mild diabetic macular edema(DME) and to compare the visual outcomes with the patients with receiving either macular laser photocoagulation or intravitreal injection of triamcinolone acetonide(IVTA).Methods: 28 eyes with central macular thickness (CMT) of between 250 to 300µm were followed without treatment and 48 eyes with CMT between 300 to 500µm had been divided into 3 subgroups according to treatment.We evaluated the best corrected visual acuity (BCVA) and CMT of natural course group and compared the BCVA and CMT of the patients who had been treated with IVTA or macular laser treatment. Results:The eyes with DME between 250 to 300µm showed no significant change in BCVA and CMT at 6 month.Among the eyes with DME between 300 to 500µm, all 3 subgroups showed no statistically significant change of BCVA at any follow up period and no significant difference was revealed among the subgroups.All subgroups showed significant reduction of CMT after 1 month and maintained until final follow-up and there was no significant difference among subgroups.Conclusions: Mild DME between 250 to 500µm did not show significant worsening of BCVA or macular edema without any specific treatment.
Diabetic macular edema
Acetonide
Panretinal photocoagulation
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To evaluate the safety and efficacy of a dexamethasone (DEX) intravitreal implant for diabetic macular edema (DME).
Diabetic macular edema
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