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Treatment outcomes of retinal vein occlusion in clinical practice in Nepal
BACKGROUND: This study evaluated the treatment outcomes of retinal vein occlusion (RVO) in a routine clinical practice in Nepal. METHODS: This was a retrospective analysis of observational data of patients with RVO who attended the retina clinic of the Tilganga Institute of Ophthalmology from 1 Nove...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7890616/ https://www.ncbi.nlm.nih.gov/pubmed/33602158 http://dx.doi.org/10.1186/s12886-021-01857-y |
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author | Bhandari, Sanjeeb Poudel, Manish Paudyal, Indira Joshi, Pratibha L. Shrestha, Chunu Paudyal, Govinda Pradhan, Eli |
author_facet | Bhandari, Sanjeeb Poudel, Manish Paudyal, Indira Joshi, Pratibha L. Shrestha, Chunu Paudyal, Govinda Pradhan, Eli |
author_sort | Bhandari, Sanjeeb |
collection | PubMed |
description | BACKGROUND: This study evaluated the treatment outcomes of retinal vein occlusion (RVO) in a routine clinical practice in Nepal. METHODS: This was a retrospective analysis of observational data of patients with RVO who attended the retina clinic of the Tilganga Institute of Ophthalmology from 1 November 2017 to 31 October 2018. The main outcome was the mean change in visual acuity (VA) at 12 months from the start of treatment. Other outcomes of interest were the mean change in central subfield thickness (CST) and the number of treatments over 12 months. RESULTS: A total of 99 eyes (of 99 patients) with RVO (60 - branch RVO [BRVO] and 39 - central RVO [CRVO] were available for the analysis. Eyes with CRVO had worse VA and CST at baseline. Eyes in both groups were similar for age, associated factors for RVO, duration of vision loss and the presence of ischemia at baseline. The mean (95% Confidence Interval [CI]) VA change at 12 months for BRVO was − 0.35 (− 0.46, − 0.23) logMAR (p < 0.001) from a mean (SD) of 0.75 (0.42) logMAR at baseline with 63% achieving VA < 0.3 logMAR while for CRVO it was − 0.35 (− 0.46, − 0.23) logMAR (p = 0.19) from 1.13 (0.61) logMAR at baseline and VA < 0.3 logMAR in 36%. The mean (95% CI) change in CST over 12 months was − 114 (− 189, − 40) μm (p = 0.003) from a mean (SD) of 423 (151) μm at baseline for BRVO and − 184(− 276, − 91) μm (p < 0.001) from 519 (213) μm for CRVO. Patients in both groups received a median of 2 bevacizumab injections over 12 months. Around 37% eyes were lost before 12 months’ observation. The mean VA and CST trajectory in these eyes at their last visit was similar to those that completed 12 months. CONCLUSION: The outcomes of RVO over the 12 months were inferior and the number of treatments fewer than those of the clinical trials and other reports from routine clinical practice. Future studies to identify the treatment barriers are warranted to improve the treatment outcomes in our patients. |
format | Online Article Text |
id | pubmed-7890616 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-78906162021-02-22 Treatment outcomes of retinal vein occlusion in clinical practice in Nepal Bhandari, Sanjeeb Poudel, Manish Paudyal, Indira Joshi, Pratibha L. Shrestha, Chunu Paudyal, Govinda Pradhan, Eli BMC Ophthalmol Research Article BACKGROUND: This study evaluated the treatment outcomes of retinal vein occlusion (RVO) in a routine clinical practice in Nepal. METHODS: This was a retrospective analysis of observational data of patients with RVO who attended the retina clinic of the Tilganga Institute of Ophthalmology from 1 November 2017 to 31 October 2018. The main outcome was the mean change in visual acuity (VA) at 12 months from the start of treatment. Other outcomes of interest were the mean change in central subfield thickness (CST) and the number of treatments over 12 months. RESULTS: A total of 99 eyes (of 99 patients) with RVO (60 - branch RVO [BRVO] and 39 - central RVO [CRVO] were available for the analysis. Eyes with CRVO had worse VA and CST at baseline. Eyes in both groups were similar for age, associated factors for RVO, duration of vision loss and the presence of ischemia at baseline. The mean (95% Confidence Interval [CI]) VA change at 12 months for BRVO was − 0.35 (− 0.46, − 0.23) logMAR (p < 0.001) from a mean (SD) of 0.75 (0.42) logMAR at baseline with 63% achieving VA < 0.3 logMAR while for CRVO it was − 0.35 (− 0.46, − 0.23) logMAR (p = 0.19) from 1.13 (0.61) logMAR at baseline and VA < 0.3 logMAR in 36%. The mean (95% CI) change in CST over 12 months was − 114 (− 189, − 40) μm (p = 0.003) from a mean (SD) of 423 (151) μm at baseline for BRVO and − 184(− 276, − 91) μm (p < 0.001) from 519 (213) μm for CRVO. Patients in both groups received a median of 2 bevacizumab injections over 12 months. Around 37% eyes were lost before 12 months’ observation. The mean VA and CST trajectory in these eyes at their last visit was similar to those that completed 12 months. CONCLUSION: The outcomes of RVO over the 12 months were inferior and the number of treatments fewer than those of the clinical trials and other reports from routine clinical practice. Future studies to identify the treatment barriers are warranted to improve the treatment outcomes in our patients. BioMed Central 2021-02-18 /pmc/articles/PMC7890616/ /pubmed/33602158 http://dx.doi.org/10.1186/s12886-021-01857-y Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article Bhandari, Sanjeeb Poudel, Manish Paudyal, Indira Joshi, Pratibha L. Shrestha, Chunu Paudyal, Govinda Pradhan, Eli Treatment outcomes of retinal vein occlusion in clinical practice in Nepal |
title | Treatment outcomes of retinal vein occlusion in clinical practice in Nepal |
title_full | Treatment outcomes of retinal vein occlusion in clinical practice in Nepal |
title_fullStr | Treatment outcomes of retinal vein occlusion in clinical practice in Nepal |
title_full_unstemmed | Treatment outcomes of retinal vein occlusion in clinical practice in Nepal |
title_short | Treatment outcomes of retinal vein occlusion in clinical practice in Nepal |
title_sort | treatment outcomes of retinal vein occlusion in clinical practice in nepal |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7890616/ https://www.ncbi.nlm.nih.gov/pubmed/33602158 http://dx.doi.org/10.1186/s12886-021-01857-y |
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