One year efficacy of intravitreal injection with ranibizumb for macular edema secondary to ischemic and non-ischemic central retinal vein occlusion_Chinese Journal of Ocular Fundus Diseases

Authors：

Jia Yuanyuan ,  Yu Xiaobing , Ye Hong , Dai Hong , Li Kejia

Department of Ophthalmology, Beijing Hospital, National Center of Gerontology, Beijing 100730, China (Jia Yuanyuan, Ye Hong, Li Kejia, now working at Department of Ophthalmology, Beijing Changping District Traditional Chinese and Western Medicine Hospital);

Corresponding author：

Yu Xiaobing, Email: yuxiaobing@sina.com

Keywords：

Retinal vein occlusion/complications; Macular edema/drug therapy; Angiogenesis inhibitors/therapeutic use; Antibodies, monoclonal/therapeutic use

DOI：

10.3760/cma.j.issn.1005-1015.2018.05.006

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ObjectiveTo compare the one year efficacy of intravitreal injection with ranibizumb for macular edema (ME) secondary to ischemic and non-ischemic central retinal vein occlusion (CRVO).MethodsA total of 88 patients (88 eyes) with ME secondary to CRVO were enrolled in this retrospective study. The best corrected visual acuity (BCVA) was detected by the Early Treatment Diabetic Retinopathy Study Chart. The optical coherence tomography was used to measure the foveal retinal thickness (CRT) and macular edema volume. The patients were divided into non-ischemic group and ischemic group, 44 eyes of 44 patients in each group. There was no significant differences in age (t=0.650, P=0.517) and gender (χ²=0.436, P=0.509) between the two groups. Compared with the ischemic group, the CRT was significantly decreased in the non-ischemic group (t=−2.291, P=0.024), and the edema volume in the macular area was significantly reduced (t=−2.342, P=0.022). All eyes were treated with continuous intravitreal injection of ranibizumab three times, and repeated injections were performed as needed. The patients without obvious ME regression after treatment were combined with triamcinolone acetonide injection. The patients with peripheral retinal non-perfusion area were combined with peripheral retinal laser photocoagulation. The follow-up was 1 year. The number of injections was counted. The changes of BCVA, CRT and edema volume in the macular area were compared between the two groups.ResultsDuring the 1-year follow-up period, 88 eyes were injected 1 to 10 times, with the mean of 4.51±2.33. The number of injections in the ischemic group and non-ischemic group were 4.55±1.59 and 4.48±2.91, respectively. There was no significant difference in the average number of injections between the two groups (t=0.136, P=0.892). The number of acetonide injections and laser treatment in the ischemic group was significantly higher than that in the non-ischemic group (t=3.729, 9.512; P＜0.001). At the last follow-up, compared with the ischemic group, the BCVA was increased (t=8.128), the CRT was decreased (t=−7.029) and the edema volume in the macular area was decreased (t=−7.213) in the non-ischemic group (P＜0.001).ConclusionCompared with ME secondary to ischemic CRVO, intravitreal injection of ranibizumab for ME secondary to non-ischemic CRVO has the better outcome of vision improvement and edema regression as well as less frequent of acetonide injections and laser treatment.

Citation： Jia Yuanyuan, Yu Xiaobing, Ye Hong, Dai Hong, Li Kejia. One year efficacy of intravitreal injection with ranibizumb for macular edema secondary to ischemic and non-ischemic central retinal vein occlusion. Chinese Journal of Ocular Fundus Diseases, 2018, 34(5): 443-447. doi: 10.3760/cma.j.issn.1005-1015.2018.05.006 Copy

1.	刘晓玲, 孙心铨. 重视糖尿病视网膜病变以及眼底病激光光凝的规范化治疗[J]. 中华眼底病杂志, 2010, 26(2): 101-104. DOI: 10.3760/cma.j.issn.1005-1015.2010.02.01.Liu XL, Sun XQ. Standardization of laser treatment for diabetic retinopathy and other ocular fundus diseases[J]. Chin J Ocul Fundus Dis, 2010, 26(2): 101-104. DOI: 10.3760/cma.j.issn.1005-1015.2010.02.01.
2.	Kim YJ, Jeong CB, Hwang JM, et al. New parametric imaging method with fluorescein angiograms for detecting areas of capillary nonperfusion[J]. Health Inform Res, 2014, 20(3): 191-198. DOI: 10.4258/hir.2014.20.3.191.
3.	Hayreh SS, Zimmerman MB. Ocular neovascularization associated with central and hemicentral retinal vein occlusion[J]. Retina, 2012, 32(8): 1553-1565. DOI: 10.1097/IAE.0b013e318246912c.
4.	Pieramici DJ, Avery RL. Ranibizumab: treatment in patients with neovascular age-related macular degeneration[J]. Expert Opin Biol Ther, 2006, 6(11): 1237-1245.
5.	毛剑波, 褚梦琪, 陈亦棋, 等. 玻璃体腔注射康柏西普治疗视网膜静脉阻塞黄斑水肿短期疗效观察[J]. 中华眼底病杂志, 2016, 32(4): 372-376. DOI: 10.3760/cma.j.issn.1005-1015.2016.04.007.Mao JB, Chu MQ, Chen YQ, et al. The efficacy of intravitreal conbercept for macular edema secondary to retinal vein occlusion[J]. Chin J Ocul Fundus Dis, 2016, 32(4): 372-376. DOI: 10.3760/cma.j.issn.1005-1015.2016.04.007.
6.	Rouvas A, Petrou P, Ntourski A, et al. Intravitreal ranibizumab (Lucentis) for branch retinal vein occlusion-induced macular edma: nine-month result of a prospective study[J]. Retina, 2010, 30(6): 893-902.
7.	Azad R, Vivek K, Sharma Y, et al. Ranibizumab as an adjunct to laser for macular edema secondary to branch retinal vein occlusion[J]. Indian J Ophthalmol, 2012, 60(4): 263-266. DOI: 4103/0301-4738.98701.
8.	郑红梅, 邢怡桥, 陈长征, 等. 玻璃体腔注射抗血管内皮生长因子单克隆抗体ranibizumab联合格栅样激光光凝治疗视网膜分支静脉阻塞合并黄斑水肿疗效观察[J]. 中华眼底病杂志, 2012, 28(5): 472-476. DOI: 10.3760/cma.j.issn.1005-1015.2012.05.010.Zheng HM, Xing YQ, Chen CZ, et al. Combined intravitreal ranibizumab and grid laser photocoagulation for branch retinal vein occlusion with macular edema[J]. Chin J Ocul Fundus Dis, 2012, 28(5): 472-476. DOI: 10.3760/cma.j.issn.1005-1015.2012.05.010.
9.	解正高, 陈放, 朱俊, 等. BRVO合并黄斑水肿治疗中ranibizumab与黄斑格栅样光凝的联合应用[J]. 中华实验眼科杂志, 2015, 33 (6): 511-512. DOI: 10.3760/cma.j.issn.2095-0160.2015.06.006.Xie ZG, Chen F, Zhu J, et al. Combined application of BRVO combined with macular edema in treatment of ranibizumab and macular grille[J]. Chin J Exp Ophthalmol, 2015, 33(6): 511-512. DOI: 10.3760/cma.j.issn.2095-0160.2015.06.006.
10.	宋爽, 喻晓兵, 戴虹. 玻璃体腔注射雷珠单抗联合曲安奈德或激光光凝治疗视网膜分支静脉阻塞继发黄斑水肿疗效观察[J]. 中华眼底病杂志, 2015, 31(1): 18-21. DOI: 10.3760/cma.j.issn.1005-1015.2015.01.006.Song S, Yu XB, Dai H. The efficacy of intravitreal ranibizumab and (or) triamcinolone combined with laser photocoagulation for macular edema secondary to branch retinal vein occlusion[J]. Chin J Ocul Fundus Dis, 2015, 31(1): 18-21. DOI: 10.3760/cma.j.issn.1005-1015.2015.01.006.
11.	McIntosh RL, Mohamed Q, Saw SM, et al. Interventions for branch retinal vein occlusion: an evidence- based systematic review [J]. Ophthalmology, 2007, 114(5): 835-854. DOI: 10.1016/j.ophtha.2001.01.010.
12.	Ohashi H, Oh H, Nishiwaki H, et al. Delayed absorption of macular edema accompanying serous retinal detachment after grid laser treatment in patients with branch retinal veinocclusion[J]. Ophthalmology, 2004, 111(11): 2050-2056. DOI: 10.1016/ophtha.2004.04.031.
13.	Fan C, Wang Y, Ji Q, et al. Comparison of clinical efficacy of intravitreal ranibizumab with and without triamcinolone acetonide in macular edema secondary to central retinal vein occlusion[J]. Curr Eye Res, 2014, 39(9): 938-943. DOI: 10.3109/02713683.2014.885533.
14.	Maturi RK, Chen V, Raghinaru D, et al. A 6-month, subjectmasked, randomized controlled study to assess efficacy of dexamethasone as an adjunct to bevacizumab compared with bevacizumab alone in the treatment of patients with macular edema due to central or branch retinal vein occlusion [J]. Clin Ophthalmol, 2014, 8: 1057-1064. DOI: 10.2147/OPTH.S60159.

1. 刘晓玲, 孙心铨. 重视糖尿病视网膜病变以及眼底病激光光凝的规范化治疗[J]. 中华眼底病杂志, 2010, 26(2): 101-104. DOI: 10.3760/cma.j.issn.1005-1015.2010.02.01.Liu XL, Sun XQ. Standardization of laser treatment for diabetic retinopathy and other ocular fundus diseases[J]. Chin J Ocul Fundus Dis, 2010, 26(2): 101-104. DOI: 10.3760/cma.j.issn.1005-1015.2010.02.01.
2. Kim YJ, Jeong CB, Hwang JM, et al. New parametric imaging method with fluorescein angiograms for detecting areas of capillary nonperfusion[J]. Health Inform Res, 2014, 20(3): 191-198. DOI: 10.4258/hir.2014.20.3.191.
3. Hayreh SS, Zimmerman MB. Ocular neovascularization associated with central and hemicentral retinal vein occlusion[J]. Retina, 2012, 32(8): 1553-1565. DOI: 10.1097/IAE.0b013e318246912c.
4. Pieramici DJ, Avery RL. Ranibizumab: treatment in patients with neovascular age-related macular degeneration[J]. Expert Opin Biol Ther, 2006, 6(11): 1237-1245.
5. 毛剑波, 褚梦琪, 陈亦棋, 等. 玻璃体腔注射康柏西普治疗视网膜静脉阻塞黄斑水肿短期疗效观察[J]. 中华眼底病杂志, 2016, 32(4): 372-376. DOI: 10.3760/cma.j.issn.1005-1015.2016.04.007.Mao JB, Chu MQ, Chen YQ, et al. The efficacy of intravitreal conbercept for macular edema secondary to retinal vein occlusion[J]. Chin J Ocul Fundus Dis, 2016, 32(4): 372-376. DOI: 10.3760/cma.j.issn.1005-1015.2016.04.007.
6. Rouvas A, Petrou P, Ntourski A, et al. Intravitreal ranibizumab (Lucentis) for branch retinal vein occlusion-induced macular edma: nine-month result of a prospective study[J]. Retina, 2010, 30(6): 893-902.
7. Azad R, Vivek K, Sharma Y, et al. Ranibizumab as an adjunct to laser for macular edema secondary to branch retinal vein occlusion[J]. Indian J Ophthalmol, 2012, 60(4): 263-266. DOI: 4103/0301-4738.98701.
8. 郑红梅, 邢怡桥, 陈长征, 等. 玻璃体腔注射抗血管内皮生长因子单克隆抗体ranibizumab联合格栅样激光光凝治疗视网膜分支静脉阻塞合并黄斑水肿疗效观察[J]. 中华眼底病杂志, 2012, 28(5): 472-476. DOI: 10.3760/cma.j.issn.1005-1015.2012.05.010.Zheng HM, Xing YQ, Chen CZ, et al. Combined intravitreal ranibizumab and grid laser photocoagulation for branch retinal vein occlusion with macular edema[J]. Chin J Ocul Fundus Dis, 2012, 28(5): 472-476. DOI: 10.3760/cma.j.issn.1005-1015.2012.05.010.
9. 解正高, 陈放, 朱俊, 等. BRVO合并黄斑水肿治疗中ranibizumab与黄斑格栅样光凝的联合应用[J]. 中华实验眼科杂志, 2015, 33 (6): 511-512. DOI: 10.3760/cma.j.issn.2095-0160.2015.06.006.Xie ZG, Chen F, Zhu J, et al. Combined application of BRVO combined with macular edema in treatment of ranibizumab and macular grille[J]. Chin J Exp Ophthalmol, 2015, 33(6): 511-512. DOI: 10.3760/cma.j.issn.2095-0160.2015.06.006.
10. 宋爽, 喻晓兵, 戴虹. 玻璃体腔注射雷珠单抗联合曲安奈德或激光光凝治疗视网膜分支静脉阻塞继发黄斑水肿疗效观察[J]. 中华眼底病杂志, 2015, 31(1): 18-21. DOI: 10.3760/cma.j.issn.1005-1015.2015.01.006.Song S, Yu XB, Dai H. The efficacy of intravitreal ranibizumab and (or) triamcinolone combined with laser photocoagulation for macular edema secondary to branch retinal vein occlusion[J]. Chin J Ocul Fundus Dis, 2015, 31(1): 18-21. DOI: 10.3760/cma.j.issn.1005-1015.2015.01.006.
11. McIntosh RL, Mohamed Q, Saw SM, et al. Interventions for branch retinal vein occlusion: an evidence- based systematic review [J]. Ophthalmology, 2007, 114(5): 835-854. DOI: 10.1016/j.ophtha.2001.01.010.
12. Ohashi H, Oh H, Nishiwaki H, et al. Delayed absorption of macular edema accompanying serous retinal detachment after grid laser treatment in patients with branch retinal veinocclusion[J]. Ophthalmology, 2004, 111(11): 2050-2056. DOI: 10.1016/ophtha.2004.04.031.
13. Fan C, Wang Y, Ji Q, et al. Comparison of clinical efficacy of intravitreal ranibizumab with and without triamcinolone acetonide in macular edema secondary to central retinal vein occlusion[J]. Curr Eye Res, 2014, 39(9): 938-943. DOI: 10.3109/02713683.2014.885533.
14. Maturi RK, Chen V, Raghinaru D, et al. A 6-month, subjectmasked, randomized controlled study to assess efficacy of dexamethasone as an adjunct to bevacizumab compared with bevacizumab alone in the treatment of patients with macular edema due to central or branch retinal vein occlusion [J]. Clin Ophthalmol, 2014, 8: 1057-1064. DOI: 10.2147/OPTH.S60159.

Chinese Journal of Ocular Fundus Diseases

One year efficacy of intravitreal injection with ranibizumb for macular edema secondary to ischemic and non-ischemic central retinal vein occlusion

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