Abstract
Purpose To analyze anatomic and functional retinal changes and their correlation after intravitreal dexamethasone implant (DEX implant) in patients with central retinal vein occlusion- (CRVO-) related macular edema (ME) using optical coherence tomography and microperimetry. Methods Fifteen treatment-naïve patients with functional impairment due to CRVO-related ME were enrolled in this prospective interventional case series. Main outcomes were best-corrected visual acuity (BCVA), retinal sensitivity (RS), and central retinal thickness (CRT). Secondary outcomes were ellipsoid zone (EZ) status and fixation behaviour. All patients underwent DEX implant and were retreated according to predefined criteria. Data were prospectively recorded at baseline and at month 1, 3, 6, 9, and 12. Correlation between main outcomes was analyzed. Results Fifteen eyes of 15 patients (9 men, 6 women; mean age 61.8 ± 10.9 years) were included. BCVA and CRT significantly improved at all follow-up visits, while RS significantly improved at 3, 6, 9, and 12 months. EZ status and fixation behaviour did not change significantly. Baseline CRT had a significant negative correlation with BCVA and RS at different follow-up visits (r=−0.52 to −0.63, p ≤ 0.04; r=−0.52, p=0.04; resp.). At all time points, there was not a significant correlation between CRT and BCVA and RS, while RS and BCVA showed a significant correlation, increasing over time (r=−0.72 to −0.89; p < 0.001). Conclusion DEX implant led to a significant morphofunctional improvement. Baseline CRT is predictive of changes of functional outcomes whose correlation increases over time after treatment.
Highlights
Macular edema (ME) is a common complication of central retinal vein occlusion (CRVO) causing vision loss [1]. e pathogenesis of ME in retinal vein occlusion is not completely understood but may result from a variety of factors, including hydrostatic effects from increased venous pressure, the presence of inflammatory cytokines, the dysregulation of endothelial tight junction proteins [2], or increased amounts of vascular permeability factors, such as vascular endothelial growth factor (VEGF) [3]
With regard to Retinal sensitivity (RS), we found the same trend with an early improvement of 2.77 ± 2.28 dB at 3 months, followed by a mild impairment at the sixth and ninth month compared to previous visits
We evaluated the correlation between morphologic and functional parameters as outcomes of intravitreal DEX implant administered on a pro re nata (PRN) regime for central retinal vein occlusion- (CRVO-)related ME
Summary
Alfredo Niro , Giancarlo Sborgia, Alessandra Sborgia, Luigi Sborgia, Claudio Furino, Nicola Recchimurzo, and Giovanni Alessio. To analyze anatomic and functional retinal changes and their correlation after intravitreal dexamethasone implant (DEX implant) in patients with central retinal vein occlusion- (CRVO-) related macular edema (ME) using optical coherence tomography and microperimetry. Fifteen treatment-naıve patients with functional impairment due to CRVO-related ME were enrolled in this prospective interventional case series. Main outcomes were best-corrected visual acuity (BCVA), retinal sensitivity (RS), and central retinal thickness (CRT). BCVA and CRT significantly improved at all follow-up visits, while RS significantly improved at 3, 6, 9, and 12 months. Baseline CRT had a significant negative correlation with BCVA and RS at different follow-up visits (r −0.52 to −0.63, p ≤ 0.04; r −0.52, p 0.04; resp.). Baseline CRT is predictive of changes of functional outcomes whose correlation increases over time after treatment
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