Long-Term Outcomes in Patients with Macular Edema Secondary to Retinal Vein Occlusion Treated with Intravitreal Injections

A study assessed long-term functional and anatomical outcomes associated with intravitreal injections for patients with macular edema (ME) secondary to retinal vein occlusion (RVO) in a real-life clinical setting. The researchers concluded that intravitreal injections were appropriate to treat branch RVO (BRVO) and central RVO (CRVO).

Between August 2008 and September 2018, 223 consecutive eyes with ME secondary to RVO received the first three intravitreal ranibizumab or dexamethasone injections. Best-corrected visual acuity (BCVA) and central macular thickness (CMT) measurements were used to guide subsequent retreatment, with the goal of attaining macular fluid regression and BCVA stability. BCVA and CMT measurements were taken at baseline and annually. The mean number of annual injections and occurrence of adverse events were both documented. Patients were followed for a mean 47.8 months, with a minimum of 12 months for all patients.

At baseline, the mean BCVA was 0.79 logMar, and mean CMT was 615.7 μm. At 12-month follow-up, significant improvements were observed in mean BCVA (0.62 logMar) and CMT (401.04 μm); significant improvements persisted through final follow-up. More significant improvements in visual outcomes were observed in eyes with BRVO and non-ischemic RVO than eyes with CRVO and ischemic RVO. During the first 12 months of the study, an average of 4.08 ranibizumab injections and 1.5 dexamethasone injections were administered; injection rates progressively decreased. One eye in the CRVO group developed endophthalmitis, and one in the BRVO group developed an intraocular pressure increase that required trabeculectomy.

The authors concluded that intravitreal ranibizumab and/or dexamethasone injections provided effective long-term BCVA and CMT improvement with no new safety signals and a decline in the number of required intraocular injections. “The results support intravitreal treatments for BRVO and CRVO in patient populations with similar characteristics in similar settings,” they noted.