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Real-World Visual and Neovascularisation Outcomes from anti-VEGF in Central Retinal Vein Occlusion

Lookup NU author(s): Dr Jeffry Hogg, James Talks, Professor Mark PearceORCiD


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© 2020, © 2020 Taylor & Francis Group, LLC. Purpose: Central retinal vein occlusion (CRVO) can be complicated by macular oedema, requiring intravitreal injection (IVI) of anti-vascular endothelial growth factor (VEGF). CRVO can cause neovascularisation, potentially causing persistent pain if not identified early. Whilst clinical trial data describe visual and anti-neovascular benefit from anti-VEGF there are limited real-world data. Methods: A retrospective cohort study of a consecutive series of patients found from a review of the electronic medical record at a single UK centre. Visual acuity, macula status, number of IVIs and neovascular status were extracted at standardised timepoints. Results: In total, 231 eyes from 231 patients were identified with 6–48 months of follow up. Twenty-four months after treatment initiation, 81 eyes (53.3%) had no remaining macula oedema and mean visual acuity gained was 8.9 (SD 19.0) Early Treatment of Diabetic Retinopathy Study (ETDRS) letters following a mean of 10.1 (3.9) IVIs. Of 222 eyes that had no initial neovascularisation, 11 went on to develop it, with iris involvement in 10 eyes. Median time from treatment initiation to neovascularisation was 17.2 (range 5.0–44.1) months, and the median time from latest IVI to neovascularisation was 9.6 (2.9–27.6) months after a median of 4 (3–10) IVIs. Conclusions: Visual acuity in CRVO complicated by macular oedema improves following anti-VEGF treatment but real-world gains are more modest than those from clinical trials. Neovascularisation following CRVO can be substantially delayed by anti-VEGF treatment and so if individuals who have received IVIs are to be effectively screened for neovascularisation long-term surveillance is necessary.

Publication metadata

Author(s): Hogg HDJ, Talks SJ, Pearce M, Di Simplicio S

Publication type: Article

Publication status: Published

Journal: Ophthalmic Epidemiology

Year: 2021

Volume: 28

Issue: 1

Pages: 70-76

Online publication date: 12/07/2020

Acceptance date: 30/06/2020

ISSN (print): 0928-6586

ISSN (electronic): 1744-5086

Publisher: Taylor and Francis Ltd


DOI: 10.1080/09286586.2020.1792937

PubMed id: 32657647


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