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Current practice in the management of branch retinal vein occlusion in Japan: Survey results of retina specialists in Japan

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A Correction to this article was published on 22 April 2020

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Abstract

Purpose

To elucidate the current clinical practice patterns of branch retinal vein occlusion (BRVO) management by retina specialists in Japan in the era of anti-vascular endothelial growth factor (VEGF) therapy.

Study design

A voting survey using an answer pad system.

Methods

On May 28, 2017, forty-one retina specialists were surveyed on the pathology and clinical practice of BRVO management.

Results

Most specialists (77.5%) use fundus examination and optical coherence tomography (OCT) for diagnosis of macular edema (ME) secondary to BRVO. All assess the condition of the ellipsoid zone (EZ) and external limiting membrane (ELM) and consider this a visual prognostic factor. For ME secondary to BRVO, anti-VEGF therapy is the first choice, and most specialists (82.4%) select initial injection followed by a pro re nata (PRN) regimen. For switching to other treatment options for persistent cases, combination therapy of anti-VEGF injections and laser therapy is the most common choice (35.9%), whereas 25.6% select vitreous surgery and 15.4% select adding steroid injections.

Conclusions

Our survey presents the current opinions on the diagnosis and treatment of BRVO by retina specialists in Japan, and reveals the common views about damage to the EZ/ELM as a factor of poor prognosis and anti-VEGF therapy as the first line treatment, highlighting various opinions on initiation and switching of therapy.

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Change history

  • 22 April 2020

    In the original publication, under section, BRVO treatment practice pattern, the sentence in p. 369 was published as.

References

  1. Rehak M, Wiedemann P. Retinal vein thrombosis: pathogenesis and management. J Thromb Haemost. 2010;8:1886–94.

    CAS  PubMed  Google Scholar 

  2. Rogers S, McIntosh RL, Cheung N, Lim L, Wang JJ, Mitchell P, et al. The prevalence of retinal vein occlusion: pooled data from population studies from the United States, Europe, Asia, and Australia. Ophthalmology. 2010;117:313–9.

    PubMed  PubMed Central  Google Scholar 

  3. Yasuda M, Kiyohara Y, Arakawa S, Hata Y, Yonemoto K, Doi Y, et al. Prevalence and systemic risk factors for retinal vein occlusion in a general Japanese population: the Hisayama study. Investig Ophthalmol Vis Sci. 2010;51:3205–9.

    Google Scholar 

  4. Zhao J, Sastry SM, Sperduto RD, Chew EY, Remaley NA. Arteriovenous crossing patterns in branch retinal vein occlusion. The Eye Disease Case-Control Study Group. Ophthalmology. 1993;100:423–8.

    CAS  PubMed  Google Scholar 

  5. Lam FC, Chia SN, Lee RM. Macular grid laser photocoagulation for branch retinal vein occlusion. Cochrane Database Syst Rev. 2015;2015:CD008732. https://doi.org/10.1002/14651858.cd008732.pub2.

    Article  Google Scholar 

  6. Aref AA, Scott IU. Management of macular edema secondary to branch retinal vein occlusion: an evidence-based update. Adv Ther. 2011;28:28–39.

    PubMed  Google Scholar 

  7. Rogers SL, McIntosh RL, Lim L, Mitchell P, Cheung N, Kowalski JW, et al. Natural history of branch retinal vein occlusion: an evidence-based systematic review. Ophthalmology. 2010;117(1094–101):e5.

    Google Scholar 

  8. Wetzig PC. The treatment of acute branch vein occlusion by photocoagulation. Am J Ophthalmol. 1979;87:65–73.

    CAS  PubMed  Google Scholar 

  9. Luttrull JK, Dorin G. Subthreshold diode micropulse laser photocoagulation (SDM) as invisible retinal phototherapy for diabetic macular edema: a review. Curr Diabetes Rev. 2012;8:274–84.

    PubMed  PubMed Central  Google Scholar 

  10. Aiello LP, Avery RL, Arrigg PG, Keyt BA, Jampel HD, Shah ST, et al. Vascular endothelial growth factor in ocular fluid of patients with diabetic retinopathy and other retinal disorders. N Engl J Med. 1994;331:1480–7. https://doi.org/10.1056/NEJM199412013312203.

    Article  CAS  PubMed  Google Scholar 

  11. Stéfansson E. Physiology of vitreous surgery. Graefes Arch Clin Exp Ophthalmol. 2009;247:147–63.

    PubMed  Google Scholar 

  12. Haller JA, Bandello F, Belfort R Jr, Blumenkranz MS, Gillies M, Heier J, et al. Randomized, sham-controlled trial of dexamethasone intravitreal implant in patients with macular edema due to retinal vein occlusion. Ophthalmology. 2010;117(1134–46):e3.

    Google Scholar 

  13. Campochiaro PA, Clark WL, Boyer DS, Heier JS, Brown DM, Vitti R, et al. Intravitreal aflibercept for macular edema following branch retinal vein occlusion: the 24-week results of the VIBRANT study. Ophthalmology. 2015;122:538–44.

    PubMed  Google Scholar 

  14. Campochiaro PA, Heier JS, Feiner L, Gray S, Saroj N, Rundle AC, et al. Ranibizumab for macular edema following branch retinal vein occlusion: six-month primary end point results of a phase III study. Ophthalmology. 2010;117(1102–12):e1.

    Google Scholar 

  15. Tadayoni R, Waldstein SM, Boscia F, Gerding H, Pearce I, Priglinger S, et al. Individualized stabilization criteria-driven ranibizumab versus laser in branch retinal vein occlusion: six-month results of BRIGHTER. Ophthalmology. 2016;123:1332–44.

    PubMed  Google Scholar 

  16. Mitry D, Bunce C, Charteris D. Anti-vascular endothelial growth factor for macular oedema secondary to branch retinal vein occlusion. Cochrane Database Syst Rev. 2013;2013:009510. https://doi.org/10.1002/14651858.cd009510.pub2.

    Article  Google Scholar 

  17. Demir M, Oba E, Guven D, Acar Z, Cinar S. Results of intravitreal triamcinolone acetonide in patients with macular edema secondary to branch retinal vein occlusion. Int J Clin Pharm. 2014;36:438–42.

    CAS  PubMed  Google Scholar 

  18. Inagaki K, Ohkoshi K, Ohde S, Deshpande GA, Ebihara N, Murakami A. Subthreshold micropulse photocoagulation for persistent macular edema secondary to branch retinal vein occlusion including best-corrected visual acuity greater than 20/40. J Ophthalmol. 2014;2014:251257.

    PubMed  PubMed Central  Google Scholar 

  19. Kola M, Hacioglu D, Turk A, Erdol H. The effectiveness and reliability of posterior sub-Tenon triamcinolone acetonide injection in branch retinal vein occlusion-related macular edema. Cutan Ocul Toxicol. 2016;35:185–9.

    CAS  PubMed  Google Scholar 

  20. Nishida A, Kojima H, Kameda T, Mandai M, Kurimoto Y. Five-year outcomes of pars plana vitrectomy for macular edema associated with branch retinal vein occlusion. Clin Ophthalmol. 2017;11:369–75.

    CAS  PubMed  PubMed Central  Google Scholar 

  21. Iijima H. Mechanisms of vision loss in eyes with macular edema associated with retinal vein occlusion. Jpn J Ophthalmol. 2018;62:265–73.

    PubMed  Google Scholar 

  22. Ota M, Tsujikawa A, Murakami T, Yamaike N, Sakamoto A, Kotera Y, et al. Foveal photoreceptor layer in eyes with persistent cystoid macular edema associated with branch retinal vein occlusion. Am J Ophthalmol. 2008;145:273–80.

    PubMed  Google Scholar 

  23. Muraoka Y, Tsujikawa A, Takahashi A, Iida Y, Murakami T, Ooto S, et al. Foveal damage due to subfoveal hemorrhage associated with branch retinal vein occlusion. PLoS One. 2015;10:e0144894.

    PubMed  PubMed Central  Google Scholar 

  24. Manabe K, Tsujikawa A, Osaka R, Nakano Y, Fujita T, Shiragami C, et al. Metamorphopsia associated with branch retinal vein occlusion. PLoS One. 2016;11:e0153817.

    PubMed  PubMed Central  Google Scholar 

  25. Sugiura Y, Okamoto F, Morikawa S, Okamoto Y, Hiraoka T, Oshika T. Time course of changes in metamorphopsia following intravitreal ranibizumab injection for branch retinal vein occlusion. Retina. 2018;38(8):1581–7.

    CAS  PubMed  Google Scholar 

  26. Finkelstein D. Ischemic macular edema. Recognition and favorable natural history in branch vein occlusion. Arch Ophthalmol. 1992;110:1427–34.

    CAS  PubMed  Google Scholar 

  27. Sakimoto S, Kamei M, Suzuki M, Yano S, Matsumura N, Sakaguchi H, et al. Relationship between grades of macular perfusion and foveal thickness in branch retinal vein occlusion. Clin Ophthalmol. 2013;7:39–45.

    PubMed  Google Scholar 

  28. Iijima H. Reduced light sensitivity due to impaired retinal perfusion in branch retinal vein occlusion. Jpn J Ophthalmol. 2018;62:151–7.

    PubMed  Google Scholar 

  29. Tomiyasu T, Hirano Y, Yoshida M, Suzuki N, Nishiyama T, Uemura A, et al. Microaneurysms cause refractory macular edema in branch retinal vein occlusion. Sci Rep. 2016;6:29445.

    CAS  PubMed  PubMed Central  Google Scholar 

  30. Brown DM, Campochiaro PA, Bhisitkul RB, Ho AC, Gray S, Saroj N, et al. Sustained benefits from ranibizumab for macular edema following branch retinal vein occlusion: 12-month outcomes of a phase III study. Ophthalmology. 2011;118:1594–602.

    PubMed  Google Scholar 

  31. Singer MA, Awh CC, Sadda S, Freeman WR, Antoszyk AN, Wong P, et al. HORIZON: an open-label extension trial of ranibizumab for choroidal neovascularization secondary to age-related macular degeneration. Ophthalmology. 2012;119:1175–83.

    PubMed  Google Scholar 

  32. Clark WL, Boyer DS, Heier JS, Brown DM, Haller JA, Vitti R, et al. Intravitreal aflibercept for macular edema following branch retinal vein occlusion: 52-week results of the VIBRANT Study. Ophthalmology. 2016;123:330–6.

    PubMed  Google Scholar 

  33. Group BVOS. Argon laser photocoagulation for macular edema in branch vein occlusion. The Branch Vein Occlusion Study Group. Am J Ophthalmol. 1984;98:271–82.

    Google Scholar 

  34. Group BVOS. Argon laser scatter photocoagulation for prevention of neovascularization and vitreous hemorrhage in branch vein occlusion. A randomized clinical trial. Branch Vein Occlusion Study Group. Arch Ophthalmol. 1986;104:34–41.

    Google Scholar 

  35. Tadayoni R, Waldstein SM, Boscia F, Gerding H, Gekkieva M, Barnes E, et al. Sustained benefits of ranibizumab with or without laser in branch retinal vein occlusion: 24-month results of the BRIGHTER Study. Ophthalmology. 2017;124:1778–87.

    PubMed  Google Scholar 

  36. Chatziralli IP, Jaulim A, Peponis VG, Mitropoulos PG, Moschos MM. Branch retinal vein occlusion: treatment modalities: an update of the literature. Semin Ophthalmol. 2014;29:85–107.

    PubMed  Google Scholar 

  37. Scott IU, Ip MS, VanVeldhuisen PC, Oden NL, Blodi BA, Fisher M, et al. A randomized trial comparing the efficacy and safety of intravitreal triamcinolone with standard care to treat vision loss associated with macular Edema secondary to branch retinal vein occlusion: the standard care vs corticosteroid for retinal vein occlusion (SCORE) study report 6. Arch Ophthalmol. 2009;127:1115–28.

    PubMed  PubMed Central  Google Scholar 

  38. Noma H, Mimura T, Eguchi S. Association of inflammatory factors with macular edema in branch retinal vein occlusion. JAMA Ophthalmol. 2013;131:160–5.

    CAS  PubMed  Google Scholar 

  39. Yanagi Y. Update on treatment of retinal vein occlusion. J Eye. 2013;30:155–63 [in Japanese].

    CAS  Google Scholar 

  40. Moon J, Kim M, Sagong M. Combination therapy of intravitreal bevacizumab with single simultaneous posterior subtenon triamcinolone acetonide for macular edema due to branch retinal vein occlusion. Eye (Lond). 2016;30:1084–90.

    CAS  Google Scholar 

  41. Yamada Y, Takamura Y, Matsumura T, Morioka M, Gozawa M, Inatani M. Posterior subtenon infusion of triamcinolone acetonide as adjunctive treatment to panretinal photocoagulation using pattern scan laser for diabetic retinopathy. Jpn J Ophthalmol. 2018;62:686–92.

    CAS  PubMed  Google Scholar 

  42. Harino S, Bessho K, Kida T. Prospective multicenter study of visual outcomes following three different treatments for macular edema associated with branch retinal vein occlusion: a study by the Japanese BRVO study group. Jpn J Ophthalmol. 2012;56:250–61.

    PubMed  Google Scholar 

  43. Sato T, Sawada K, Iwahashi-Shima C, Bando H, Ikeda T, Emi K. 25-gauge vitrectomy versus intravitreal bevacizumab for macular edema secondary to branch retinal vein occlusion: 1 year follow-up. Ann Acad Med Singap. 2012;41:294–9.

    PubMed  Google Scholar 

  44. Kakinoki M, Sawada O, Sawada T, Saishin Y, Kawamura H, Ohji M. Effect of vitrectomy on aqueous VEGF concentration and pharmacokinetics of bevacizumab in macaque monkeys. Investig Ophthalmol Vis Sci. 2012;53:5877–80.

    CAS  Google Scholar 

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Acknowledgements

The specialist meeting on BRVO management was funded and coordinated by Bayer Yakuhin, Ltd., Japan. Medical writing and editing support was provided by Havas Worldwide Japan K.K. and the costs were borne by Bayer Yakuhin, Ltd. Bayer Yakuhin, Ltd. did not influence the contents of this paper in any way.

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Authors and Affiliations

  1. Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan

    Yuichiro Ogura

  2. Department of Ophthalmology, Mie University Graduate School of Medicine, Tsu, Japan

    Mineo Kondo

  3. Department of Ophthalmology and Micro-technology, Yokohama City University Graduate School of Medicine, Yokohama, Japan

    Kazuaki Kadonosono

  4. Tokyo Medical University Hachioji Medical Center, Hachioji, Japan

    Masahiko Shimura

  5. Aichi Medical University Hospital, Nagakute, Japan

    Motohiro Kamei

  6. Kyoto University Graduate School of Medicine, Kyoto, Japan

    Akitaka Tsujikawa

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  1. Yuichiro Ogura
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Correspondence to Yuichiro Ogura.

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Conflicts of interest

Y. Ogura, Consultant fee (Bayer, Alcon, Janssen Pharma, Kowa, Novartis, Sanwa Kagaku, Senju, Wakamoto), Speaker Fee (Santen, Topcon, Wakamoto), Grant (Novartis, Santen); M. Kondo, Grant (Novartis); K. Kadonosono, None; M. Shimura, None; M. Kamei, Speaker fee (Alcon, AMO, Bayer, Bausch & Lomb, Ellex, HOYA, Johnson & Johnson, Kowa, Nidek, Novartis, Otsuka, Pfizer, Santen, Senju), Consultant fee (Astellas, HOYA, Nidek, Senju), Grant (Alcon, AMO, Bayer, HOYA, Kowa, Nidek, Novartis, Otsuka, Pfizer, Santen, Senju); A. Tsujikawa, Lecture fee (Pfizer, Bayer, Santen, Novartis, Senju, Alcon, Nidek, AMO, Kowa, Chugai, Sanwa Kagaku, Astellas Pharma, Johnson & Johnson, Alcon Pfarma, Otsuka, Ezai), Grant (Pfizer, Bayer, Japan Society for the Promotion of Science, Santen, Novartis, Senju, Alcon, AMO, Hoya, Kowa, Alcon Pharma, Otsuka).

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Corresponding author: Yuichiro Ogura

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Ogura, Y., Kondo, M., Kadonosono, K. et al. Current practice in the management of branch retinal vein occlusion in Japan: Survey results of retina specialists in Japan. Jpn J Ophthalmol 63, 365–373 (2019). https://doi.org/10.1007/s10384-019-00685-4

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  • DOI: https://doi.org/10.1007/s10384-019-00685-4

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