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Related Experiment Videos

[Retinal Vein Occlusion - Which Treatment When?]

A Bajor1, A Pielen1, L Danzmann1

  • 1Universitätsklinik für Augenheilkunde, Medizinische Hochschule Hannover.

Klinische Monatsblatter Fur Augenheilkunde
|April 5, 2017
PubMed
Summary

Intravitreal anti-VEGF therapy is effective for treating macular edema from retinal vein occlusion. Treatment decisions should prioritize optical coherence tomography (OCT) over visual acuity, with dexamethasone implants as an alternative.

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[Strategies of Intravitreal Injections with Anti-VEGF: "Pro re Nata versus Treat and Extend"].

Klinische Monatsblatter fur Augenheilkunde·2017

Area of Science:

  • Ophthalmology
  • Retinal Diseases
  • Vascular Disorders

Background:

  • Macular edema secondary to retinal vein occlusion (RVO) is a leading cause of vision loss.
  • Intravitreal therapies have revolutionized RVO management.
  • Early and consistent treatment is crucial for visual prognosis.

Purpose of the Study:

  • To review current evidence-based treatment strategies for macular edema in RVO.
  • To compare the efficacy and safety of different therapeutic modalities.
  • To highlight the importance of monitoring and adjunctive treatments.

Main Methods:

  • Review of current literature on intravitreal anti-VEGF agents (aflibercept, ranibizumab, off-label bevacizumab).
  • Discussion of treatment regimens including initial loading doses, pro-re-nata (PRN), and treat-and-extend.
  • Consideration of intravitreal dexamethasone implants as an alternative therapy.
  • Emphasis on optical coherence tomography (OCT) for treatment decisions.
  • Role of fluorescein angiography in identifying ischemic areas.
  • Evaluation of laser photocoagulation for ischemic retina.

Main Results:

  • Intravitreal anti-VEGF therapy demonstrates safety and efficacy for RVO-induced macular edema.
  • Post-initial loading doses, OCT is superior to visual acuity for guiding re-injection frequency.
  • Dexamethasone implants offer a viable alternative, considering side effect profiles like cataract progression and elevated intraocular pressure.
  • Early detection and treatment of retinal ischemia via fluorescein angiography and laser photocoagulation can reduce injection frequency and improve edema response.
  • Prompt intervention for significant retinal ischemia prevents complications such as neovascularization and secondary glaucoma.

Conclusions:

  • Intravitreal anti-VEGF therapy, guided by OCT, is the primary treatment for RVO-related macular edema.
  • Dexamethasone implants provide an alternative therapeutic option.
  • Fluorescein angiography and timely laser treatment are essential for managing ischemic complications and optimizing outcomes.

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