Combination Therapy for Macular Oedema in Retinal Vein Occlusions: 3-Year Results from a Real-World Clinical Practice

Faye Horner,* Peck Lin Lip,* Bushra Mushtaq, Randhir Chavan, Bashar Mohammed, Arijit Mitra Birmingham and Midland Eye Centre, Sandwell & West Birmingham NHS Trust, Birmingham B18 7QH, UK*These authors contributed equally to this workCorrespondence: Peck Lin LipBirmingham and Midland Eye Cent...

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Autores principales: Horner F, Lip PL, Mushtaq B, Chavan R, Mohammed B, Mitra A
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Publicado: Dove Medical Press 2020
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spelling oai:doaj.org-article:b42b245adad0412a9d4e291fbfa5469a2021-12-02T09:19:59ZCombination Therapy for Macular Oedema in Retinal Vein Occlusions: 3-Year Results from a Real-World Clinical Practice1177-5483https://doaj.org/article/b42b245adad0412a9d4e291fbfa5469a2020-03-01T00:00:00Zhttps://www.dovepress.com/combination-therapy-for-macular-oedema-in-retinal-vein-occlusions-3-ye-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Faye Horner,* Peck Lin Lip,* Bushra Mushtaq, Randhir Chavan, Bashar Mohammed, Arijit Mitra Birmingham and Midland Eye Centre, Sandwell & West Birmingham NHS Trust, Birmingham B18 7QH, UK*These authors contributed equally to this workCorrespondence: Peck Lin LipBirmingham and Midland Eye Centre, Sandwell & West Birmingham NHS Trust, City Hospital Dudley Road, Birmingham B18 7QH, UKTel +44 121 5543801Fax +44 121 5076791Email pllipwoo@gmail.comPurpose: To report long-term efficacy and treatment outcomes of the combination therapy for treating macular oedema (MO) in retinal vein occlusions (RVOs) from a real-world UK practice.Methods: The initial reported 66 RVO patients with MO treated with combination therapy (initial Ranibizumab, later optional addition of Ozurdex and laser) were followed up to Year  3: visual acuity (VA) and central retinal thickness (CRT) were analysed against baseline and previous Year  1 results. Safety and adverse events were also recorded.Results: Baseline LogMAR VA of 0.71 (Snellen 6/30) improved to 0.48 (Snellen 6/18) at Year  3 (p= 0.006); 63% experienced VA improvement (40% improved ≥ 3 lines), 27% had worse vision. Stability of mean VA (6/18) was already achieved at first post-loading phase review and was maintained in each subsequent year. Statistically significant CRT improvement was noted in each year (Year  3 median CRT=264μm) compared to baseline (median CRT=531μm). There was a reduction in the mean number of total injections to 2.5 in Year  3 (vs 5.5 in Year  1). Comparing Year  3 against Year  1, mean Ranibizumab injection frequency was 2.1 vs 4.3; mean Ozurdex injection frequency was 0.2 vs 1.1. In Year  3, 39.6% of patients did not require any form of injections, laser frequency was also reduced to 22.9% (vs 81.8% in Year  1). There was no endophthalmitis in the cohort, one progressed to neovascular glaucoma in Year  2 and mortality rate was recorded as 6%.Conclusion: Our real-world clinical practice for RVO patients using a combined therapy is associated with good long-term VA and anatomical outcomes with less intravitreal re-treatment rates.Keywords: RandOL protocol, Ozurdex, ischaemia, laser, mortality, aspirin  Horner FLip PLMushtaq BChavan RMohammed BMitra ADove Medical Pressarticlerandol protocolozurdexischaemialasermortalityaspirin.OphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 14, Pp 955-965 (2020)
institution DOAJ
collection DOAJ
language EN
topic randol protocol
ozurdex
ischaemia
laser
mortality
aspirin.
Ophthalmology
RE1-994
spellingShingle randol protocol
ozurdex
ischaemia
laser
mortality
aspirin.
Ophthalmology
RE1-994
Horner F
Lip PL
Mushtaq B
Chavan R
Mohammed B
Mitra A
Combination Therapy for Macular Oedema in Retinal Vein Occlusions: 3-Year Results from a Real-World Clinical Practice
description Faye Horner,* Peck Lin Lip,* Bushra Mushtaq, Randhir Chavan, Bashar Mohammed, Arijit Mitra Birmingham and Midland Eye Centre, Sandwell & West Birmingham NHS Trust, Birmingham B18 7QH, UK*These authors contributed equally to this workCorrespondence: Peck Lin LipBirmingham and Midland Eye Centre, Sandwell & West Birmingham NHS Trust, City Hospital Dudley Road, Birmingham B18 7QH, UKTel +44 121 5543801Fax +44 121 5076791Email pllipwoo@gmail.comPurpose: To report long-term efficacy and treatment outcomes of the combination therapy for treating macular oedema (MO) in retinal vein occlusions (RVOs) from a real-world UK practice.Methods: The initial reported 66 RVO patients with MO treated with combination therapy (initial Ranibizumab, later optional addition of Ozurdex and laser) were followed up to Year  3: visual acuity (VA) and central retinal thickness (CRT) were analysed against baseline and previous Year  1 results. Safety and adverse events were also recorded.Results: Baseline LogMAR VA of 0.71 (Snellen 6/30) improved to 0.48 (Snellen 6/18) at Year  3 (p= 0.006); 63% experienced VA improvement (40% improved ≥ 3 lines), 27% had worse vision. Stability of mean VA (6/18) was already achieved at first post-loading phase review and was maintained in each subsequent year. Statistically significant CRT improvement was noted in each year (Year  3 median CRT=264μm) compared to baseline (median CRT=531μm). There was a reduction in the mean number of total injections to 2.5 in Year  3 (vs 5.5 in Year  1). Comparing Year  3 against Year  1, mean Ranibizumab injection frequency was 2.1 vs 4.3; mean Ozurdex injection frequency was 0.2 vs 1.1. In Year  3, 39.6% of patients did not require any form of injections, laser frequency was also reduced to 22.9% (vs 81.8% in Year  1). There was no endophthalmitis in the cohort, one progressed to neovascular glaucoma in Year  2 and mortality rate was recorded as 6%.Conclusion: Our real-world clinical practice for RVO patients using a combined therapy is associated with good long-term VA and anatomical outcomes with less intravitreal re-treatment rates.Keywords: RandOL protocol, Ozurdex, ischaemia, laser, mortality, aspirin  
format article
author Horner F
Lip PL
Mushtaq B
Chavan R
Mohammed B
Mitra A
author_facet Horner F
Lip PL
Mushtaq B
Chavan R
Mohammed B
Mitra A
author_sort Horner F
title Combination Therapy for Macular Oedema in Retinal Vein Occlusions: 3-Year Results from a Real-World Clinical Practice
title_short Combination Therapy for Macular Oedema in Retinal Vein Occlusions: 3-Year Results from a Real-World Clinical Practice
title_full Combination Therapy for Macular Oedema in Retinal Vein Occlusions: 3-Year Results from a Real-World Clinical Practice
title_fullStr Combination Therapy for Macular Oedema in Retinal Vein Occlusions: 3-Year Results from a Real-World Clinical Practice
title_full_unstemmed Combination Therapy for Macular Oedema in Retinal Vein Occlusions: 3-Year Results from a Real-World Clinical Practice
title_sort combination therapy for macular oedema in retinal vein occlusions: 3-year results from a real-world clinical practice
publisher Dove Medical Press
publishDate 2020
url https://doaj.org/article/b42b245adad0412a9d4e291fbfa5469a
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