Central vein occlusion study

Abbreviations CVOS, Central Vein Occlusion Study BVOS, Branch Vein Occlusion Study. 

Wolfe et al. (60) added treatment with pentoxifylline for six months following hemodilution. At one-year follow-up the mean visual acuity improved by 1.5 lines in the 19 treated patients versus a decline of 1.5 lines in the 21 control patients. The mean arteriole-venous transit time normalized more quickly in the treatment group but was equal at one year in both groups. Plasma viscosity decreased with treatment. It is difficult in this study to determine whether the treatment was more beneficial for nonischemic or ischemic CRVO. In this study, CRVOs were considered ischemic when they met two or more of the following conditions two disk areas of nonperfusion, visual acuity less than or equal to 20/200, greater than 10 cotton wool spots. The central vein occlusion study has demonstrated that a better benchmark for ischemic CRVO may be the presence of more than 10 disk areas of non-perfusion. 

Central Vein Occlusion Study Group. Baseline and early natural history report. The Central Vein Occlusion Study. Arch Ophthalmol 1993 111 1087-1095. 

The Central Vein Occlusion Study Group. Natural history and clinical management of central retinal vein occlusion. Arch Ophthalmol 1997 115 486-491. 

The beneficial outcomes of systemic bevacizumab therapy for CNV stimulated investigators to administer the drug intravitreally, using a dose that would be therapeutically equivalent to the systemic dose used in the SANA study but approximately 400-fold less overall (about 1.25 mg total dose vs. 5 mg/kg). Although initial studies had not suggested any benefit from bevacizumab, a 1.0-mg intravitreal injection of bevacizumab was administered to a patient with wet AMD poorly responsive to pegaptanib therapy and to another patient with macular edema after central retinal vein occlusion (CRVO). Both patients demonstrated complete resolution of edema by OCT at 1 week acuity improved from 20/200... 

Plasmapheresis has been added to hemodilution as a further method to decrease viscosity and improve blood flow. Plasmapheresis has been performed in a study of five eyes with central retinal vein occlusion where all patients improved visual acuity by at least one line at final follow-up. These authors recommended use of plasmapheresis when hemodilution has failed. 

Green WR, Chan CC, Hutchins GM, Terry JM. Central retinal vein occlusion a prospective histopathologic study of 29 eyes in 28 cases. Trans Am Ophthalmol Soc 1981 79 371-422. 

Elman MJ. Thrombolytic therapy for central retinal vein occlusion results of a pilot study. Trans Am Ophthalmol Soc 1996 94 471-504. 

Glacet-Bernard A, Kuhn D, Vine AK, Oubraham H, Coscas G, Soubrane G. Treatment of recent onset central retinal vein occlusion with intravitreal tissue plasminogen activator a pilot study. Br J Ophthalmol 2000 84 609-613. 

Hansen LL, Daniesevskis P, Amtz HR, Hovener G, Wiederholt M. A randomized prospective study on treatment of central retinal vein occlusion by isovolaemic haemodilution and photocoagulation. Br J Ophthalmol 1985 69 108-116. 

Wolfe S, Arend O, Bertram B, et al. Hemodilution therapy in central retinal vein occlusion. One-year results of a prospective randomized study. Graefes Arch Clin Exp Ophthalmol 1994 232 33-39. 

Opremcak EM, Bruce RA, Lomeo MD, Ridenour CD, Letson AD, Rehmar AJ. Radial optic neurotomy for central retinal vein occlusion a retrospective pilot study of 11 consecutive cases. Retina 2001 21 408-415. 

In an open, prospective, uncontrolled study, 10 patients with macular edema due to central retinal vein occlusion were randomly assigned to ranibizumab 0.3 or 0.5 mg and adverse reactions were studied [6. There were no severe adverse events. 

Brown DM, Heier JS, Clark WL, Boyer DS, Vitti R, Berliner AJ, et al. Intravitreal aflibercept injection for macular edema secondary to central retinal vein occlusion 1-year results from the phase 3 COPERNICUS study. Am J Ophthalmol March 2013 155(3). 429 7.e7. doi 10.1016/ j.ajo.2012.09.026. Epub 2012 December 4. PubMed PMID 23218699. 

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