The burden of disease of retinal vein occlusion: review of the literature

Abstract

Retinal vein occlusion (RVO) is the second most common cause of vision loss due to retinal vascular disease. A literature review was undertaken to understand the epidemiology, clinical consequence, current practice patterns, and cost of RVO. Pertinent articles were identified by computerized searches of the English language literature in MEDLINE supplemented with electronic and manual searches of society/association proceedings and bibliographies of electronically identified sources. Population-based studies report a prevalence rate of 0.5-2.0% for branch RVO and 0.1-0.2% for central RVO. The 15-year incidence rate is estimated to be 1.8% for branch RVO and 0.2% for central RVO. Patients with RVO report lower vision-related quality of life than those without ocular disease. Available treatment options are limited. Until recently there was no treatment for central RVO. Laser photocoagulation is only recommended for branch RVO in patients who have not experienced severe vision loss. Emerging evidence on the effectiveness of intravitreal anti-vascular endothelial growth factor therapy and dexamethasone intravitreal implant is promising. Information on the treatment patterns and cost of RVO is extremely limited with one retrospective analysis of secondary insurance payment data identified and limited to the United States population only. A better understanding of the economic and societal impact of RVO will help decision makers evaluate emerging medical interventions for this sight-threatening disease.

Figure 1

Schematic of literature selection.

Figure 2

The 1-year resource use associated with retinal vein occlusion. Source, Fekrat et al. BRVO, branch retinal vein occlusion; CRVO, central retinal vein occlusion; FA, fluorescein angiography; IVI, intravitreal injection; LP, laser photocoagulation; OCT, optical coherence tomography. In all, 6% of patients in the hypertension cohort had other retinal disease which required use of OCT.

Figure 3

The 1-year and 3-year costs associated with retinal vein occlusion compared with hypertension and glaucoma. Source, Fekrat et al. BRVO, branch retinal vein occlusion; CRVO, central retinal vein occlusion.