Latin American Consensus on Retinal Vein Occlusion

Abstract

The introduction of anti-VEGF agents has allowed unprecedented progress in the management and treatment of ophthalmologic conditions characterized by an increased vascular permeability and intraocular neovascularization. One of these conditions is retinal vein occlusion (RVO). RVO is one of the most common causes of reduced vision due to retinal vascular disease. Without timely treatment, macular edema, macular ischemia, neovascularization and other potential sequelae of RVO can lead to photoreceptor cell death and consequently to irreversible vision loss. Treatments for this indication that have been recently approved by several regulatory agencies throughout the world include: the VEGF inhibitor ranibizumab (Lucentis, Genentech), the VEGF and placental growth factor inhibitor aflibercept (Eylea, Regeneron Pharmaceuticals and Bayer HealthCare), and a slow release intravitreal implant of dexamethasone (Ozurdex, Allergan). In addition bevacizumab (Avastin, Genentech) has been used extensively in an off-label manner. These new treatments allow us to preserve vision for many RVO patients who could not have expected such favorable results just 5 or 6 years ago. However, not every treatment is effective for every patient, and whether one option is superior to another or a combination of options is superior to monotherapy, have yet to be definitively determined. A growing body of literature with strong evidence supports the use of these new treatments. However, in several instances the literature is not conclusive to support unified management of RVO. This document is a summary analysis on RVO assembled by a group of specialists summoned by the Pan-American Vitreo-Retinal Society (SPRV) to participate in this Latin American consensus.

Keywords

• Retinal vein occlusion, Anti-VEGF therapy, surgical treatment, neovascular glaucoma.