TY - JOUR
T1 - Benefits of a Laser Chorioretinal Anastomosis Plus Ranibizumab vs Ranibizumab Alone for Central Retinal Vein Occlusion
T2 - 4-Year Results
AU - Allister, I. L.M.
AU - Smithies, Lynne A.
AU - Chen, Fred K.
AU - Mackey, David A.
AU - Sanfilippo, Paul G.
N1 - Funding Information:
Financial Support: The ranibizumab used in this study was supplied by Novartis, Sydney, Australia. The sponsor of the drug had no role in the design or conduct of this research. The Centre for Eye Research Australia receives Operational Infrastructure Support from the Victorian Government. PGS and FKC are supported by Australian National Health and Medical Research Council Fellowships (MRF1142962:FKC). Financial Disclosures: I.L.A. is a board member of Novartis and Bayer (Switzerland). F.K.C. has received research funding from Novartis and has been a board member of Allergan, Alcon and Novartis. None of the other authors declare financial disclosures or conflicts of interest. All authors attest that they meet the current ICMJE criteria for authorship.
Funding Information:
Financial Support: The ranibizumab used in this study was supplied by Novartis, Sydney, Australia. The sponsor of the drug had no role in the design or conduct of this research. The Centre for Eye Research Australia receives Operational Infrastructure Support from the Victorian Government. PGS and FKC are supported by Australian National Health and Medical Research Council Fellowships (MRF1142962:FKC).
Funding Information:
Financial Disclosures: I.L.A. is a board member of Novartis and Bayer (Switzerland). F.K.C. has received research funding from Novartis and has been a board member of Allergan, Alcon and Novartis. None of the other authors declare financial disclosures or conflicts of interest. All authors attest that they meet the current ICMJE criteria for authorship.
Publisher Copyright:
© 2023 Elsevier Inc.
PY - 2023/8
Y1 - 2023/8
N2 - PURPOSE: To evaluate what clinical gains can be achieved over conventional treatment with ranibizumab alone for central retinal vein occlusion (CRVO) when causal pathology is additionally addressed successfully with a laser-induced chorio-retinal anastomosis (L-CRA). DESIGN: Two-year extension of prospective, randomized controlled clinical trial. METHODS: A total of 58 patients with macular edema secondary to CRVO were randomized 1:1 to receive either an L-CRA (n = 29) or sham procedure (n = 29) at baseline and then monthly intravitreal ranibizumab 0.5 mg. Outcomes (best corrected visual acuity [BCVA], central subfield thickness [CST], injection requirements) were monitored in the monthly pro re nata (PRN) ranibizumab phase from months 7 to 48. RESULTS: Injection requirements for patients with a functioning L-CRA (24 of 29) during the monthly PRN period from 7 to 24 months were a mean (95% CI) of 2.18 (1.57, 2.78) injections compared to 7.07 (6.08, 8.06) (P <.0001) for control (ranibizumab alone). These decreased further over the next 2 years to 0.29 (0.14, 0.61) compared to 2.20 (1.68, 2.88) (P <.001) for the third year and 0.25 (0.11, 0.56) and 1.84 (1.34, 2.54) for the fourth year (P <.001). Mean BCVA was statistically different at all follow-up time points from month 7 through month 48 for the group with the functioning L-CRA compared to the control monotherapy group. This improved to 14.06 letters at month 48 (P =.009). There was no difference in CST between any of the groups over the 48 months of follow-up. CONCLUSION: For CRVO patients, addressing causal pathology in addition to conventional therapy improves BCVA and reduces injection requirements.
AB - PURPOSE: To evaluate what clinical gains can be achieved over conventional treatment with ranibizumab alone for central retinal vein occlusion (CRVO) when causal pathology is additionally addressed successfully with a laser-induced chorio-retinal anastomosis (L-CRA). DESIGN: Two-year extension of prospective, randomized controlled clinical trial. METHODS: A total of 58 patients with macular edema secondary to CRVO were randomized 1:1 to receive either an L-CRA (n = 29) or sham procedure (n = 29) at baseline and then monthly intravitreal ranibizumab 0.5 mg. Outcomes (best corrected visual acuity [BCVA], central subfield thickness [CST], injection requirements) were monitored in the monthly pro re nata (PRN) ranibizumab phase from months 7 to 48. RESULTS: Injection requirements for patients with a functioning L-CRA (24 of 29) during the monthly PRN period from 7 to 24 months were a mean (95% CI) of 2.18 (1.57, 2.78) injections compared to 7.07 (6.08, 8.06) (P <.0001) for control (ranibizumab alone). These decreased further over the next 2 years to 0.29 (0.14, 0.61) compared to 2.20 (1.68, 2.88) (P <.001) for the third year and 0.25 (0.11, 0.56) and 1.84 (1.34, 2.54) for the fourth year (P <.001). Mean BCVA was statistically different at all follow-up time points from month 7 through month 48 for the group with the functioning L-CRA compared to the control monotherapy group. This improved to 14.06 letters at month 48 (P =.009). There was no difference in CST between any of the groups over the 48 months of follow-up. CONCLUSION: For CRVO patients, addressing causal pathology in addition to conventional therapy improves BCVA and reduces injection requirements.
UR - http://www.scopus.com/inward/record.url?scp=85154033262&partnerID=8YFLogxK
U2 - 10.1016/j.ajo.2023.03.034
DO - 10.1016/j.ajo.2023.03.034
M3 - Article
C2 - 37030494
AN - SCOPUS:85154033262
SN - 0002-9394
VL - 252
SP - 101
EP - 110
JO - American Journal of Ophthalmology
JF - American Journal of Ophthalmology
ER -