Kai Januschowski1,2, Nicolas Feltgen3, Amelie Pielen4,5, Bernhard Spitzer6, Matus Rehak7, Georg Spital8, Spyridon Dimopoulos9, Carsten H Meyer10, Gesine B Szurman11,9. 1. Eye Clinic Sulzbach, Knappschaftsklinikum Sulzbach Saar, An der Klinik 10, 66111, Sulzbach/Saar, Germany. Kai.januschowski@med.uni-tuebingen.de. 2. Centre for Ophthalmology, University Eye Clinic Tuebingen, Tuebingen, Germany. Kai.januschowski@med.uni-tuebingen.de. 3. University Eye Hospital, University of Goettingen, Goettingen, Germany. 4. University Eye Hospital, Hannover Medical School, Hannover, Germany. 5. Eye Center, University Medical Center Freiburg, Freiburg, Germany. 6. Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany. 7. Augenklinik Universitätsmedizin Berlin Charité, Campus Benjamin Franklin, Berlin, Germany. 8. Department of Ophthalmology, St. Franziskus Hospital, Muenster, Germany. 9. Centre for Ophthalmology, University Eye Clinic Tuebingen, Tuebingen, Germany. 10. Department of Ophthalmology, University of Bonn, Bonn, Germany. 11. Eye Clinic Sulzbach, Knappschaftsklinikum Sulzbach Saar, An der Klinik 10, 66111, Sulzbach/Saar, Germany.
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.
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.
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