4.2 Article

Five-year outcomes after intravitreal bevacizumab of treatment-naive eyes with macular edema secondary to CRVO in routine clinical practice: Results of the Pan-American Collaborative Retina Study (PACORES) group

Journal

INTERNATIONAL OPHTHALMOLOGY
Volume 42, Issue 3, Pages 951-958

Publisher

SPRINGER
DOI: 10.1007/s10792-021-02077-5

Keywords

Central retinal vein occlusion; Macular edema; VEGF; Bevacizumab; Ranibizumab; Aflibercept; Real world; Routine clinical practice

Categories

Funding

  1. Topcon Medical Systems Inc.

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The study concluded that after 5 years of treatment with an average of 10.6 injections, there was a mean gain in BCVA. Eyes with a better baseline BCVA and a shorter duration of symptoms were more likely to achieve better BCVA at 5 years, with more eyes achieving a BCVA of >= 20/40 and gaining >= 3 lines.
Purpose The purpose of this study was to report the 5-year outcomes of treatment-naive eyes with cystoid macular edema secondary to central retinal vein occlusion treated with intravitreal bevacizumab in routine clinical practice. Methods We conducted multicenter retrospective non-comparative case series of 102 eyes. The main outcome measured was the change in best-corrected visual acuity (BCVA) at 5 years. Secondary outcomes included the number of injections and the change in CMT at 5 years. Results At 5 years, the mean BCVA improved from 1.22 +/- 0.58 (Snellen 20/428) at baseline to 1.00 +/- 0.68 logMAR (Snellen 20/200; p < 0.0001). At 5 years, 48 (47%) eyes had a gain of >= 3 lines, 41 (40.2%) eyes remained within 3 lines and 13 (12.7%) eyes had a loss of >= 3 lines of BCVA. The CMT improved from 740 +/- 243 to 322 +/- 179 mu m (p < 0.0001). At 5 years, 59 (57.8%) eyes had a completely dry SD-OCT. Patients received a total of 10.6 +/- 6.1 (range 6-27) injections. Baseline BCVA (p < 0.0001) and the duration of symptoms prior to initial anti-VEGF injection (p = 0.0274) were the only predictive factors for BCVA at 5 years. Conclusions After 5 years with an average of 10.6 injections, there was a mean gain of 0.22 logMAR. In addition, more eyes achieved a BCVA of >= 20/40, gained >= 3 lines and less patients had a BCVA <= 20/200. Eyes with a better baseline BCVA and a shorter duration of symptoms were more likely to achieve better BCVA at 5 years.

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