scholarly journals Intravitreal Medications for Retinal Vein Occlusion: Systematic Review and Meta-analysis

2019 ◽  
Author(s):  
Alireza Lashay ◽  
Hamid Riazi-Esfahani ◽  
Masoud Mirghorbani ◽  
Mehdi Yaseri
Keyword(s):  
Systematic Review ◽  
Retinal Vein Occlusion ◽  
Meta Analysis ◽  
Mean Difference ◽  
Vascular Endothelial ◽  
Randomized Controlled ◽  
Vein Occlusion ◽  
Visual Improvement ◽  
Significant Difference ◽  
Endothelial Growth Factor

Purpose: To evaluate the outcomes of different intravitreal injections for the treatment of retinal vein occlusion including central retinal vein occlusion (CRVO) and branch retinal vein occlusion (BRVO). Methods: PubMed, Cochrane, the metaRegister of ControlledTrials, and ClinicalTrials were searched for intravitreal anti-Vascular Endothelial Growth Factor (VEGF) and steroids with relevant keywords and date limitation of 2009-2018. Meta-analysis was performed on studies that met the defined inclusion criteria. Main outcomes were visual acuity (VA) and central macular thickness (CMT). Results: Out of 681 studies, 36 articles (including 21 reporting CRVO and 15 dealing with BRVO) were selected for systematic review. All five intravitreal drugs including triamcinolone, dexamethasone, ranibizumab, bevacizumab, and aflibercept showed improvement of CMT and VA as compared to placebo or laser treatment. Six randomized controlled trials were selected for meta-analysis in RVO patients. The pooled mean difference of visual improvement between sham and ranibizumab was 12.7 Early Treatment for Diabetic Retinopathy Study (ETDRS) letters (95%CI: 11.00 to 13.2), and the pooled mean difference in CMT reduction was 221 μm (95%CI: 153 to 284); both changes were significantly in favor of ranibizumab. The pooled mean difference of visual improvement between bevacizumab and triamcinolone was 5.3 ETDRS letters in favor of bevacizumab (95%CI: 16 μm to 17.5 μm). Triamcinolone led to 68.1 μm greater CMT reduction than bevacizumab (95%CI: 58 μm to 76 μm). However, none of these differences were statistically significant. Conclusion: Treatment with anti-VEGF agents in RVO is superior to observation. No significant difference was seen between the eyes treated with bevacizumab or triamcinolone based on these results.

Vitamin B12 and Folate as Risk Factors for Retinal Vein Occlusion: A Meta-Analysis

2021 ◽  
Author(s):  
Dimitrios Kazantzis ◽  
Panagiotis Theodossiadis ◽  
Christos Kroupis ◽  
George Theodossiadis ◽  
Irini Chatziralli
Keyword(s):  
Vitamin B12 ◽  
Retinal Vein Occlusion ◽  
Meta Analysis ◽  
Serum Vitamin ◽  
Mean Difference ◽  
Serum Folate ◽  
Case Control Studies ◽  
Vein Occlusion ◽  
Pubmed Database ◽  
Significant Difference

Abstract Purpose To evaluate the association between serum vitamin B12/folate and retinal vein occlusion (RVO). Methods A comprehensive search of the PubMed database was performed, which identified 271 abstracts to be screened. Ten studies met our inclusion criteria and a meta-analysis of these comparative case-control studies was performed on the mean ± standard deviation serum vitamin B12 and folate levels, without language restrictions. Nine studies with 720 patients with RVO and 613 controls were included in the meta-analysis for vitamin B12, and 10 studies with 784 patients with RVO and 677 controls in the meta-analysis for folate. Results There was no statistically significant difference between patients with RVO and controls in serum vitamin B12 levels (mean difference: − 40.25 pg/mL, p = 0.28), either central RVO (mean difference: − 18.24 pg/mL, p = 0.71) or branch RVO (mean difference: − 23.56 pg/mL, p = 0.48). On the contrary, the plasma folate level was significantly lower in RVO patients than in controls (mean difference: − 1.34 ng/mL, p = 0.001), as well as in patients with CRVO compared to controls (mean difference: − 1.48 ng/mL, p = 0.006), but not in BRVO patients (mean difference: − 0.72 ng/mL, p = 0.11). Conclusions RVO is associated with low serum folate levels, but not with serum vitamin B12 levels.

scholarly journals Retinal venous pressure is decreased after anti-VEGF therapy in patients with retinal vein occlusion–related macular edema

2021 ◽  
Author(s):  
Teruyo Kida ◽  
Josef Flammer ◽  
Katarzyna Konieczka ◽  
Tsunehiko Ikeda
Keyword(s):  
Macular Edema ◽  
Intravitreal Injection ◽  
Retinal Vein Occlusion ◽  
Venous Pressure ◽  
Decisive Role ◽  
Retinal Venous Pressure ◽  
Vein Occlusion ◽  
Anti Vegf ◽  
Significant Difference ◽  
Endothelial Growth Factor

Abstract Purpose The pathomechanism leading to retinal vein occlusion (RVO) is unclear. Mechanical compression, thrombosis, and functional contractions of veins are discussed as the reasons for the increased resistance of venous outflow. We evaluated changes in the retinal venous pressure (RVP) following intravitreal injection of anti-vascular endothelial growth factor (VEGF) agent to determine the effect on RVO-related macular edema. Methods Twenty-six patients with RVO-related macular edema (16 branch RVOs [BRVOs] and 10 central RVOs [CRVOs], age 72.5 ± 8.8 years) who visited our hospital were included in this prospective study. Visual acuity (VA), intraocular pressure (IOP), central retinal thickness (CRT) determined by macular optical coherence tomography, and RVP measured using an ophthalmodynamometer were obtained before intravitreal injection of ranibizumab (IVR) and 1 month later. Results Comparison of the BRVOs and CRVOs showed that VA was significantly improved by a single injection in BRVOs (P < 0.0001; P = 0.1087 for CRVOs), but CRT and RVP were significantly decreased without significant difference in IOP after the treatment in both groups (P < 0.0001). Conclusion The anti-VEGF treatment resulted in a significant decrease in the RVP, but the RVP remained significantly higher than the IOP. An increased RVP plays a decisive role in the formation of macula edema, and reducing it is desirable.

Sign in / Sign up

Export Citation Format

Share Document