Clinical Characteristics of Patients with Retinal Vein Occlusion and Macular Edema at Cipto Mangunkusumo Hospital Kirana in Indonesia
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Published
Feb 27, 2024
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Abstract
Introduction: Retinal vein occlusion (RVO) is a significant retinal vascular disease, often resulting in macular edema and vision impairment. This study aims to investigate the clinical characteristics, management, and outcomes of RVO patients with macular edema at Cipto Mangunkusumo Hospital Kirana from January 2020 to December 2021.
Methods: This retrospective descriptive study analyzed medical records of 85 RVO patients with macular edema. Demographic data, clinical characteristics, management approaches, and treatment outcomes were examined. Data were analyzed using SPSS.
Results: Most patients were over 50 years old, predominantly male, and affected in one eye. Hypertension and diabetes mellitus were common comorbidities. Central RVO cases had worse initial visual acuity and macular thickness than branch RVO cases. Anti-VEGF injections were the primary therapy, and patients received an average of two injections in the first year. Macular thickness reduced after anti-VEGF injections, but visual acuity improvement was minimal.
Conclusion: Patients with RVO and macular edema are often older males with systemic risk factors. Anti-VEGF injections are the primary treatment, with improvements in macular thickness but limited visual acuity gain. Patient education, comprehensive management, and public awareness are recommended to enhance RVO care. Further research to analyze parameter relationships is needed.
Keywords
Retinal vein occlusion, macular edema, anti-VEGF injections, visual acuity, demographic characteristics
Article Details
How to Cite
ISFYANTO, Isfyanto et al.
Clinical Characteristics of Patients with Retinal Vein Occlusion and Macular Edema at Cipto Mangunkusumo Hospital Kirana in Indonesia.
International Journal of Retina, [S.l.], v. 7, n. 1, p. 26, feb. 2024.
ISSN 2614-8536.
Available at: <https://ijretina.com/index.php/ijretina/article/view/271>. Date accessed: 22 dec. 2024.
doi: https://doi.org/10.35479/ijretina.2024.vol007.iss001.271.
Section
Research Articles
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
References
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12. Costa JV, Moura-Coelho N, Abreu AC, Neves P, Ornelas M, Furtado MJ. Macular edema secondary to retinal vein occlusion in a real-life setting: a multicenter, nationwide, 3-year follow-up study.
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14. Campochiaro PA, Sophie R, Pearlman J, Brown DM, Boyer DS, Heier JS, et al. Long-term outcomes in patients with retinal vein occlusion treated with ranibizumab: the RETAIN study. Ophthalmology. 2014;121:209–19.
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20. Li Y, Hall NE, Pershing S, Hyman L, Haller JA, Lee AY, et al. Age, gender, and laterality of retinal vascular occlusion: A retrospective study from the IRIS® registry. Ophthalmology Retina. 2022;6(2):161–71. doi:10.1016/j.oret.2021.05.004
21. Hayreh SS. Retinal vein occlusion. Indian J Ophthalmol 1994;42:109-32
22. Ponto KA, Scharrer I, Binder H et al. Hypertension and multiple cardiovascular risk factors increase the risk for retinal vein occlusions. J Hypertens. 2019;37(7):1372–1383
23. Oh TR, Han KD, Choi HS, Kim CS, Bae EH, Ma SK, Kim SW. Hypertension as a risk factor for retinal vein occlusion in menopausal women: A nationwide Korean population-based study. Medicine (Baltimore). 2021 Oct 29;100(43):e27628. doi: 10.1097/MD.0000000000027628. PMID: 34713852; PMCID: PMC8556045.
24. Silitonga A, Sembiring S, Bangun C, H P. Bevacizumab for Retinal Vein Occlusion: Outcomes in Smec Eye Hospital Medan. IJRETINA. 2020;3:18–26.
25. Unsal E, Eltutar K, Sultan P, Gungel H. Efficacy and safety of Pro Re Nata regimen without loading dose ranibizumab injections in retinal vein occlusion. Pakistan J Med Sci. 2015;31:510–5.
26. Lee T, Nam K, JY K. Comparison of Pro Re Nata and Three Loading Injections of Intravitreal Bevacizumab for Macular Edema in Branch Retinal Vein Occlusion. J Retin. 2019;4:17–22.
27. Keane PA, Sadda SR. Retinal vein occlusion and macular edema - critical evaluation of the clinical value of ranibizumab. Clin Ophthalmol. 2011;5:771-81. doi: 10.2147/OPTH.S13774. Epub 2011 Jun 9. PMID: 21750610; PMCID: PMC3130914.56. Rogers SL, McIntosh RL, Lim L, et al. Natural history of branch retinal vein occlusion: an evidence-based systematic review. Ophthalmology. 2010;117:1094–1101.e1095.
28. Hykin P, Prevost AT, Vasconcelos JC, et al. Clinical Effectiveness of Intravitreal Therapy With Ranibizumab vs Aflibercept vs Bevacizumab for Macular Edema Secondary to Central Retinal Vein Occlusion: A Randomized Clinical Trial. JAMA Ophthalmol. 2019;137(11):1256–1264. doi:10.1001/jamaophthalmol.2019.3305
29. Hsu J, editor. Branch retinal vein occlusion [Internet]. American Academy of Ophthalmology; 2023 [cited 2023 Jun 22]. Available from: https://eyewiki.aao.org/Branch_Retinal_Vein_Occlusion
30. Costa, J.V., Moura-Coelho, N., Abreu, A.C. et al. Macular edema secondary to retinal vein occlusion in a real-life setting: a multicenter, nationwide, 3-year follow-up study. Graefes Arch Clin Exp Ophthalmol 259, 343–350 (2021). https://doi.org/10.1007/s00417-020-04932-0
31. Vaz-Pereira S, Marques IP, Matias J, Mira F, Ribeiro L, Flores R. Real-World Outcomes of Anti-VEGF Treatment for Retinal Vein Occlusion in Portugal. Eur J Ophthalmol. 2017;27:756– 61.
32. Victor, A. A. (2019). Anti-Vascular Endothelial Growth Factor (Anti-VEGF) in Central Retinal Vein Occlusion: Are Loading Dose Necessary?. Ophthalmologica Indonesiana,45(1),6. https://doi.org/10.35749/journal.v45i1.171.
2. Hayreh SS. Photocoagulation for retinal vein occlusion. Prog Retin Eye Res. 2021 Nov;85:100964.
3. Marcinkowska A, Wolska N, Luzak B, Cisiecki S, Marcinkowski K, Rozalski M. Platelet-Derived Procoagulant Microvesicles Are Elevated in Patients with Retinal Vein Occlusion (RVO). J Clin Med. 2022 Aug 30;11(17):5099.
4. Song P, Xu Y, Zha M, Zhang Y, Rudan I. Global epidemiology of retinal vein occlusion: a systematic review and meta-analysis of prevalence, incidence, and risk factors. J Glob Health. 2019;9:10427.
5. Putera I, karakteristik klinis, factor risiko sistemik dan hasil tatalaksana oklusi vena retina di Rumah Sakit Cipto Mangunkusumo Kirana, Jakarta; 2020.
6. Diana N. Karakteristik Klinis, Jenis dan Hasil Penatalaksanaan Oklusi Vena Retina Sentral di Poliklinik Mata Rumah Sakit Cipto Mangunkusumo Kirana. Jakarta; 2014
7. Arepalli S, Bessette A, Kaiser PK. Branch retinal veion Occlusion. In: Schachat AP, Sadda SR, Hilton DR, Wilkinson C, Wiedemann P,editors. Ryan’s Retina. 6th ed. Elsevier; 2022. p. 1177– 1188.
8. Oellers P, Hahn P, Ip MS, Fekrat S. Central retinal veion Occlusion. In: Schachat AP, Sadda SR, Hilton DR, Wilkinson C, Wiedemann P,editors. Ryan’s Retina. 6th ed. Elsevier; 2022. p. 1189– 1204.
9. Schmidt-Erfurth U, Garcia-Arumi J, Gerendas BS, Midena E, Sivaprasad S, Tadayoni R, et al. Guidelines for the Management of Retinal Vein Occlusion by the European Society of Retina Specialists (EURETINA). Ophthalmologica. 2019;242:123–62.
10. Noma H, Yasuda K, Shimura M. Cytokines and the Pathogenesis of Macular Edema in Branch Retinal Vein Occlusion. J Ophthalmol. 2019 May 2;2019:5185128.
11. Patil NS, Hatamnejad A, Mihalache A, Popovic MM, Kertes PJ, Muni RH. Anti-Vascular Endothelial Growth Factor Treatment Compared with Steroid Treatment for Retinal Vein Occlusion: A Meta-Analysis. Ophthalmologica. 2022;245(6):500-515.
12. Costa JV, Moura-Coelho N, Abreu AC, Neves P, Ornelas M, Furtado MJ. Macular edema secondary to retinal vein occlusion in a real-life setting: a multicenter, nationwide, 3-year follow-up study.
13. Graefes Arch Clin Exp Ophthalmol. 2021 Feb;259(2):343-350.
14. Campochiaro PA, Sophie R, Pearlman J, Brown DM, Boyer DS, Heier JS, et al. Long-term outcomes in patients with retinal vein occlusion treated with ranibizumab: the RETAIN study. Ophthalmology. 2014;121:209–19.
15. Hsu J, editor. Retinal vein occlusion [Internet]. American Academy of Ophthalmology; 2023 [cited 2023 Jun 22]. Available from: https://eyewiki.aao.org/Retinal_Vein_Occlusion
16. Thapa R, Bajimaya S, Paudyal G, Khanal S, Tan S, Thapa SS, et al. Prevalence, pattern and risk factors of retinal vein occlusion in an elderly population in Nepal: The Bhaktapur Retina Study. BMC Ophthalmology. 2017;17(1). doi:10.1186/s12886-017-0552-x
17. Ponto KA, Elbaz H, Peto T et al. Prevalence and risk factors of retinal vein occlusion: the Gutenberg Health Study. J Thromb Haemost. 2015;13(7):1254–1263
18. Fong AC, Schatz H, McDonald HR, Burton TC, Maberley AL, Joffe L, et al. Central retinal vein occlusion in young adults (papillophlebitis) Retina. 1992;12(1):3–11.
19. Nalcaci S, Degirmenci C, Akkin C, Mentes J. Etiological factors in young patients with retinal vein occlusion. Pakistan Journal of Medical Sciences. 2019;35(5). doi:10.12669/pjms.35.5.546
20. Li Y, Hall NE, Pershing S, Hyman L, Haller JA, Lee AY, et al. Age, gender, and laterality of retinal vascular occlusion: A retrospective study from the IRIS® registry. Ophthalmology Retina. 2022;6(2):161–71. doi:10.1016/j.oret.2021.05.004
21. Hayreh SS. Retinal vein occlusion. Indian J Ophthalmol 1994;42:109-32
22. Ponto KA, Scharrer I, Binder H et al. Hypertension and multiple cardiovascular risk factors increase the risk for retinal vein occlusions. J Hypertens. 2019;37(7):1372–1383
23. Oh TR, Han KD, Choi HS, Kim CS, Bae EH, Ma SK, Kim SW. Hypertension as a risk factor for retinal vein occlusion in menopausal women: A nationwide Korean population-based study. Medicine (Baltimore). 2021 Oct 29;100(43):e27628. doi: 10.1097/MD.0000000000027628. PMID: 34713852; PMCID: PMC8556045.
24. Silitonga A, Sembiring S, Bangun C, H P. Bevacizumab for Retinal Vein Occlusion: Outcomes in Smec Eye Hospital Medan. IJRETINA. 2020;3:18–26.
25. Unsal E, Eltutar K, Sultan P, Gungel H. Efficacy and safety of Pro Re Nata regimen without loading dose ranibizumab injections in retinal vein occlusion. Pakistan J Med Sci. 2015;31:510–5.
26. Lee T, Nam K, JY K. Comparison of Pro Re Nata and Three Loading Injections of Intravitreal Bevacizumab for Macular Edema in Branch Retinal Vein Occlusion. J Retin. 2019;4:17–22.
27. Keane PA, Sadda SR. Retinal vein occlusion and macular edema - critical evaluation of the clinical value of ranibizumab. Clin Ophthalmol. 2011;5:771-81. doi: 10.2147/OPTH.S13774. Epub 2011 Jun 9. PMID: 21750610; PMCID: PMC3130914.56. Rogers SL, McIntosh RL, Lim L, et al. Natural history of branch retinal vein occlusion: an evidence-based systematic review. Ophthalmology. 2010;117:1094–1101.e1095.
28. Hykin P, Prevost AT, Vasconcelos JC, et al. Clinical Effectiveness of Intravitreal Therapy With Ranibizumab vs Aflibercept vs Bevacizumab for Macular Edema Secondary to Central Retinal Vein Occlusion: A Randomized Clinical Trial. JAMA Ophthalmol. 2019;137(11):1256–1264. doi:10.1001/jamaophthalmol.2019.3305
29. Hsu J, editor. Branch retinal vein occlusion [Internet]. American Academy of Ophthalmology; 2023 [cited 2023 Jun 22]. Available from: https://eyewiki.aao.org/Branch_Retinal_Vein_Occlusion
30. Costa, J.V., Moura-Coelho, N., Abreu, A.C. et al. Macular edema secondary to retinal vein occlusion in a real-life setting: a multicenter, nationwide, 3-year follow-up study. Graefes Arch Clin Exp Ophthalmol 259, 343–350 (2021). https://doi.org/10.1007/s00417-020-04932-0
31. Vaz-Pereira S, Marques IP, Matias J, Mira F, Ribeiro L, Flores R. Real-World Outcomes of Anti-VEGF Treatment for Retinal Vein Occlusion in Portugal. Eur J Ophthalmol. 2017;27:756– 61.
32. Victor, A. A. (2019). Anti-Vascular Endothelial Growth Factor (Anti-VEGF) in Central Retinal Vein Occlusion: Are Loading Dose Necessary?. Ophthalmologica Indonesiana,45(1),6. https://doi.org/10.35749/journal.v45i1.171.