Lihteh Wu1,2, Dhariana Acon3, Maria H Berrocal4, Roberto Gallego-Pinazo5, Rosa Dolz-Marco5, Jose A Roca6, Mauricio Maia7, Sergio Rojas8, Marcelo Zas9, J F Arevalo10, Jay Chhablani11,12. 1. Asociados de Macula Vitreo y Retina de Costa Rica, Primer Piso, Torre Mercedes, Paseo Colón, San José, Costa Rica. LW65@cornell.edu. 2. Department of Ophthalmology, Illinois Eye and Ear Infirmary, University of Illinois Chicago School of Medicine, Chicago, IL, USA. LW65@cornell.edu. 3. Asociados de Macula Vitreo y Retina de Costa Rica, Primer Piso, Torre Mercedes, Paseo Colón, San José, Costa Rica. 4. Department of Ophthalmology, University of Puerto Rico, San Juan, Puerto Rico. 5. Oftalvist Clinic, Valencia, Spain. 6. Oftalmologos Contreras, Lima, Peru. 7. Department of Ophthalmology, Vision Institute, Federal University of Sao Paulo, Sao Paulo, Brazil. 8. Fundación Hospital Nuestra Señora de la Luz, Mexico City, Mexico. 9. Department of Ophthalmology, University of Buenos Aires, Buenos Aires, Argentina. 10. Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, USA. 11. L.V.Prasad Eye Institute, Hyderabad, India. 12. Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, USA.
Abstract
PURPOSE: The purpose of this study was to report the 5-year outcomes of treatment-naive eyes with cystoid macular edema secondary to central retinal vein occlusion treated with intravitreal bevacizumab in routine clinical practice. METHODS: We conducted multicenter retrospective non-comparative case series of 102 eyes. The main outcome measured was the change in best-corrected visual acuity (BCVA) at 5 years. Secondary outcomes included the number of injections and the change in CMT at 5 years. RESULTS: At 5 years, the mean BCVA improved from 1.22 ± 0.58 (Snellen 20/428) at baseline to 1.00 ± 0.68 logMAR (Snellen 20/200; p < 0.0001). At 5 years, 48 (47%) eyes had a gain of ≥ 3 lines, 41 (40.2%) eyes remained within 3 lines and 13 (12.7%) eyes had a loss of ≥ 3 lines of BCVA. The CMT improved from 740 ± 243 to 322 ± 179 µm (p < 0.0001). At 5 years, 59 (57.8%) eyes had a completely dry SD-OCT. Patients received a total of 10.6 ± 6.1 (range 6-27) injections. Baseline BCVA (p < 0.0001) and the duration of symptoms prior to initial anti-VEGF injection (p = 0.0274) were the only predictive factors for BCVA at 5 years. CONCLUSIONS: After 5 years with an average of 10.6 injections, there was a mean gain of 0.22 logMAR. In addition, more eyes achieved a BCVA of ≥ 20/40, gained ≥ 3 lines and less patients had a BCVA ≤ 20/200. Eyes with a better baseline BCVA and a shorter duration of symptoms were more likely to achieve better BCVA at 5 years.
PURPOSE: The purpose of this study was to report the 5-year outcomes of treatment-naive eyes with cystoid macular edema secondary to central retinal vein occlusion treated with intravitreal bevacizumab in routine clinical practice. METHODS: We conducted multicenter retrospective non-comparative case series of 102 eyes. The main outcome measured was the change in best-corrected visual acuity (BCVA) at 5 years. Secondary outcomes included the number of injections and the change in CMT at 5 years. RESULTS: At 5 years, the mean BCVA improved from 1.22 ± 0.58 (Snellen 20/428) at baseline to 1.00 ± 0.68 logMAR (Snellen 20/200; p < 0.0001). At 5 years, 48 (47%) eyes had a gain of ≥ 3 lines, 41 (40.2%) eyes remained within 3 lines and 13 (12.7%) eyes had a loss of ≥ 3 lines of BCVA. The CMT improved from 740 ± 243 to 322 ± 179 µm (p < 0.0001). At 5 years, 59 (57.8%) eyes had a completely dry SD-OCT. Patients received a total of 10.6 ± 6.1 (range 6-27) injections. Baseline BCVA (p < 0.0001) and the duration of symptoms prior to initial anti-VEGF injection (p = 0.0274) were the only predictive factors for BCVA at 5 years. CONCLUSIONS: After 5 years with an average of 10.6 injections, there was a mean gain of 0.22 logMAR. In addition, more eyes achieved a BCVA of ≥ 20/40, gained ≥ 3 lines and less patients had a BCVA ≤ 20/200. Eyes with a better baseline BCVA and a shorter duration of symptoms were more likely to achieve better BCVA at 5 years.
Authors: Richard Gale; Claire Gill; Maria Pikoula; Aaron Y Lee; Rachel L W Hanson; Spiros Denaxas; Catherine Egan; Adnan Tufail; Paul Taylor Journal: Br J Ophthalmol Date: 2020-09-22 Impact factor: 4.638