Department of Ophthalmology, Inselspital University Hospital Bern, Bern, Switzerland.
Bern Photographic Reading Center, Inselspital, University Hospital Bern, Bern, Switzerland.
BMJ Open Ophthalmol. 2024 Aug 24;9(1):e001659. doi: 10.1136/bmjophth-2024-001659.
BACKGROUND/AIMS: This study reports on the long-term functional and anatomical outcomes of patients with central retinal vein occlusion (CRVO) treated under the Bern treat-and-extend (T&E) protocol.
Observational study. Treatment-naive patients with CRVO and consecutive macular oedema treated with aflibercept were included. The T&E protocol involved 2 monthly injections followed by an extension based on individual assessments. At each visit, best-corrected visual acuity (BCVA), optical coherence tomography imaging and a 2 mg aflibercept injection were administered. Changes in BCVA, proportion of patients gaining ≥15 letters, central subfield thickness (CST) and treatment intervals were analysed.
Out of 173 patients, 64 had a follow-up of at least 2 years. BCVA improved from 46.7±25.3 at baseline to 78.3±0.5 at year 9. The proportion of patients with ≥15 letters gained was 56%, 53%, 56%, 62%, 52%, 52%, 43%, 50% and 33% at years 1-9, respectively. CST decreased significantly from 660±242 µm at baseline to 359±63 µm at year 9. Treatment intervals extended from 4 weeks initially to an average of 13.0±4.1 weeks by year 8.
The T&E regimen for CRVO shows sustained visual improvements and reduced CST over time. Patients maintained stable visual gains for many years, demonstrating the effectiveness of this treatment approach. However, no control group was available to compare our T&E regimen with other strategies.
背景/目的：本研究报告了接受 Bern 治疗和扩展（T&E）方案治疗的中心性视网膜静脉阻塞（CRVO）患者的长期功能和解剖学结果。
观察性研究。纳入了未经治疗的 CRVO 患者和连续发生黄斑水肿并接受阿柏西普治疗的患者。T&E 方案包括每月注射 2 次，然后根据个体评估进行扩展。每次就诊时，均进行最佳矫正视力（BCVA）、光学相干断层扫描成像和 2mg 阿柏西普注射。分析了 BCVA 的变化、获得≥15 个字母的患者比例、中央视网膜厚度（CST）和治疗间隔。
在 173 例患者中，有 64 例的随访时间至少为 2 年。BCVA 从基线时的 46.7±25.3 提高到第 9 年的 78.3±0.5。获得≥15 个字母的患者比例分别为第 1-9 年的 56%、53%、56%、62%、52%、52%、43%、50%和 33%。CST 从基线时的 660±242µm 显著下降至第 9 年的 359±63µm。治疗间隔从最初的 4 周逐渐延长，到第 8 年平均为 13.0±4.1 周。
CRVO 的 T&E 方案显示出随着时间的推移持续的视觉改善和 CST 降低。患者在多年内保持稳定的视力增益，证明了这种治疗方法的有效性。然而，由于没有对照组，我们无法将 T&E 方案与其他策略进行比较。
