Improved visual outcome with early treatment in macular edema secondary to retinal vein occlusions: 6-month results of a Korean RVO study

Jpn J Ophthalmol. 2014 Mar;58(2):146-54. doi: 10.1007/s10384-014-0305-9. Epub 2014 Jan 31.

Abstract

Purpose: To determine the correlation between the duration of macular edema (ME) and visual outcomes among Korean patients with retinal vein occlusion (RVO).

Methods: Multicenter, interventional case series. Treatment-naive patients (n = 249) with branch or central RVO (BRVO/CRVO) and ME for <6 months were included. We assessed the correlation between the duration of ME and treatment outcomes including the mean logarithm of the minimum angle of resolution best-corrected visual acuity (logMAR BCVA) improvement, the proportion of patients achieving at least a 3-line gain in BCVA, and the mean reduction in central retinal thickness (CRT) at 6 months.

Results: One hundred and fifty-six patients with BRVO and 93 patients with CRVO were divided into five groups based on the duration of ME (<2, 2-4 weeks, 1-2, 2-3, 3-6 months); the mean baseline BCVA and CRT among the groups did not differ significantly. In BRVO, the mean logarithm of the minimum angle of resolution (logMAR) BCVA improvements in the groups were 0.51, 0.32, 0.17, 0.19, and 0.13, respectively (P = 0.002). The respective percentages of at least 3-line gains were 64, 53, 39, 38, and 21 % (P < 0.001). The BCVA didn't significantly improve in CRVO. The decrease in CRT was not correlated significantly with the duration of ME in either disease.

Conclusions: Treatment of BRVO as early as 2 weeks after onset of ME enhanced the visual outcome; there was no correlation in the patients with CRVO. This finding supports the current trend favoring early treatment to obtain better visual outcomes in patients with BRVO.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Angiogenesis Inhibitors / therapeutic use
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Bevacizumab
  • Female
  • Follow-Up Studies
  • Glucocorticoids / therapeutic use
  • Humans
  • Intravitreal Injections
  • Laser Coagulation
  • Macular Edema / drug therapy*
  • Macular Edema / etiology
  • Macular Edema / physiopathology
  • Male
  • Middle Aged
  • Retinal Vein Occlusion / complications
  • Retinal Vein Occlusion / drug therapy*
  • Retinal Vein Occlusion / physiopathology
  • Secondary Prevention
  • Time Factors
  • Triamcinolone Acetonide / therapeutic use
  • Visual Acuity / physiology*

Substances

  • Angiogenesis Inhibitors
  • Antibodies, Monoclonal, Humanized
  • Glucocorticoids
  • Bevacizumab
  • Triamcinolone Acetonide