TY - JOUR
T1 - Long-term outcomes in ranibizumab-treated patients with retinal vein occlusion; The role of progression of retinal nonperfusion
AU - Sophie, Raafay
AU - Hafiz, Gulnar
AU - Scott, Adrienne W.
AU - Zimmer-Galler, Ingrid
AU - Nguyen, Quan Dong
AU - Ying, Howard
AU - Do, Diana V.
AU - Solomon, Sharon
AU - Sodhi, Akrit
AU - Gehlbach, Peter
AU - Duh, Elia
AU - Baranano, David
AU - Campochiaro, Peter A.
N1 - Funding Information:
All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. The authors indicate the following disclosures: Quan Dong Nguyen is a consultant for Bausch and Lomb and for Santen. The Johns Hopkins University receives payment for his consulting with Genentech, Acucela, Pfizer, Regeneron, GlaxoSmithKline, and Heidelberg. Johns Hopkins University, the previous employer of Dr Nguyen, has received research support from Genentech, MacuSight, and Regeneron. Dr Nguyen chairs the Steering Committee for the RISE and RIDE studies. Diana V. Do is a consultant for ISTA and Johns Hopkins University has received payment for her consulting with Regeneron and Genentech. She has received an honorarium from Heidelberg. Johns Hopkins University, the previous employer of Dr Do, receives research support from Genentech, Regeneron, Heidelberg, and Pfizer. Peter A. Campochiaro is a consultant for Kala Pharmaceuticals and Applied Genetic Technologies Coorporation and served as a consultant for Allergan within the past 2 years. He has equity in GrayBug, Inc, Johns Hopkins University receives payment for his consultation with Genentech, Regeneron, and Aerpio. He receives research support from Genentech, Regeneron, Allergan, Aerpio, Genzyme, and Oxford BioMedica. These activities are being managed by the Conflict of Interest Committee of the Johns Hopkins University School of Medicine. Research was supported by an Investigator Initiated Study grant from Genentech, Inc and was registered on December 1, 2006 at www.clinicaltrials.gov ( NCT00407355 ). The authors had complete control of all aspects of the study free from any influence or input from Genentech. Contributions of authors: design of the study (P.A.C.); conduct of the study (P.A.C., G.H., A.W.S., IZG, QDN, HY, DVD, SS, AS, PG, ED, DB, RS); collection, management, analysis, and interpretation of the data (RS, PAC); preparation of manuscript (PAC, RS); and review of the manuscript (RS, GH, A.W.S., IZG, QDN, HY, DVD, SS, AS, PG, ED, DB, PAC).
Funding Information:
Other Acknowledgments: Jiangxia Wang has provided statistical support for the manuscript; Biostatistics Center, Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health; Supported by Wilmer Biostatistics Core Grant EY01765 .
PY - 2013/10
Y1 - 2013/10
N2 - Purpose To determine the percentage of ranibizumab-treated patients with retinal vein occlusion (RVO) who had resolution of edema for at least 6 months after the last injection, along with factors and outcomes that correlate with resolution. Design Post hoc analysis of open-label clinical trial. Methods Twenty patients with branch RVO (BRVO) and 20 with central RVO (CRVO) received ranibizumab monthly for 3 months and as needed for recurrent/persistent macular edema, no more frequently than every 2 months. Patients still requiring injections after month 40 received scatter and grid laser photocoagulation to try to reduce the need for injections. Main outcome measures included the percentage of patients who had resolution of edema, change in best-corrected visual acuity (BCVA) from baseline, and change in area of retinal nonperfusion in central subfields. Results Nine patients with BRVO (45%) had edema resolution from injections alone after a mean of 20.2 months, 4 resolved after addition of laser, 4 were unresolved through 72 months, and 3 exited prior to resolution. Five patients with CRVO (25%) resolved from injections alone after a mean of 14.0 months, 8 remained unresolved through 72 months despite addition of laser, and 7 exited prior to resolution. For BRVO or CRVO, there was a negative correlation between posterior retinal nonperfusion area and BCVA at months 18, 24, and 36 (P <.05). Conclusions In patients with RVO, infrequent ranibizumab injections to control edema may not be sufficient to prevent progression of retinal nonperfusion, which may contribute to loss of visual gains.
AB - Purpose To determine the percentage of ranibizumab-treated patients with retinal vein occlusion (RVO) who had resolution of edema for at least 6 months after the last injection, along with factors and outcomes that correlate with resolution. Design Post hoc analysis of open-label clinical trial. Methods Twenty patients with branch RVO (BRVO) and 20 with central RVO (CRVO) received ranibizumab monthly for 3 months and as needed for recurrent/persistent macular edema, no more frequently than every 2 months. Patients still requiring injections after month 40 received scatter and grid laser photocoagulation to try to reduce the need for injections. Main outcome measures included the percentage of patients who had resolution of edema, change in best-corrected visual acuity (BCVA) from baseline, and change in area of retinal nonperfusion in central subfields. Results Nine patients with BRVO (45%) had edema resolution from injections alone after a mean of 20.2 months, 4 resolved after addition of laser, 4 were unresolved through 72 months, and 3 exited prior to resolution. Five patients with CRVO (25%) resolved from injections alone after a mean of 14.0 months, 8 remained unresolved through 72 months despite addition of laser, and 7 exited prior to resolution. For BRVO or CRVO, there was a negative correlation between posterior retinal nonperfusion area and BCVA at months 18, 24, and 36 (P <.05). Conclusions In patients with RVO, infrequent ranibizumab injections to control edema may not be sufficient to prevent progression of retinal nonperfusion, which may contribute to loss of visual gains.
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U2 - 10.1016/j.ajo.2013.05.039
DO - 10.1016/j.ajo.2013.05.039
M3 - Article
C2 - 24053892
AN - SCOPUS:84884553088
SN - 0002-9394
VL - 156
SP - 693-705.e11
JO - American journal of ophthalmology
JF - American journal of ophthalmology
IS - 4
ER -