Abstract
BackgroundThe influence of serous retinal detachment (SRD) on visual acuity, macular sensitivity, and macular thickness is unclear after intravitreal injection of triamcinolone acetonide (IVTA) for macular edema with branch retinal vein occlusion (BRVO).MethodsTwenty-one eyes of 21 BRVO patients with macular edema received IVTA. Patients were divided into two groups by optical coherence tomography findings: 11 patients who had cystoid macular edema (CME) with SRD (SRD (+) group) and 10 patients who had CME without SRD (SRD (−) group). Microperimetry was performed with a Micro Perimeter 1 before and at 3 and 6 months after IVTA. Macular thickness was measured by optical coherence tomography. We exchanged the superior and inferior regions to separate the regions into those with and without occlusion. As a result, the superior region was always the occluded region and the inferior region was non-occluded.ResultsIn both the SRD (−) group and the SRD (+) group, the mean macular thickness within the central 4° field and the 10° and 20° fields of the occluded region decreased significantly from baseline to 3 and 6 months after IVTA (all P <0.01). Visual acuity also improved significantly in both groups from baseline to 3 and 6 months after IVTA (both P <0.05). In both groups, the mean macular sensitivity (measured with by microperimetry) within the central 4° field and the 10° and 20° fields of the occluded region showed a significant increase from baseline to 3 and 6 months after IVTA (all P <0.05). The trend profiles of macular thickness within the 10° and 20° fields of the occluded region showed significant differences, but there were no significant differences with respect to the trend profiles of visual acuity and macular sensitivity within the central 4° field and the 10° and 20° fields of the occluded region.ConclusionsThese results suggest that IVTA may achieve more marked improvement of macular morphology in BRVO patients with SRD than in those without SRD, while this therapy may have a similar effect on macular function in BRVO patients with or without SRD.
Highlights
The influence of serous retinal detachment (SRD) on visual acuity, macular sensitivity, and macular thickness is unclear after intravitreal injection of triamcinolone acetonide (IVTA) for macular edema with branch retinal vein occlusion (BRVO)
We previously reported that vascular endothelial growth factor (VEGF) and inflammatory factors may contribute to the pathogenesis of macular edema associated with BRVO [6,7,8,9], which provides a rationale supporting the efficacy of intravitreal triamcinolone (IVTA) and anti-VEGF therapy
IVTA was performed as part of standard care because it has been reported that macular edema and visual acuity can be improved in BRVO patients by this procedure [4]
Summary
The influence of serous retinal detachment (SRD) on visual acuity, macular sensitivity, and macular thickness is unclear after intravitreal injection of triamcinolone acetonide (IVTA) for macular edema with branch retinal vein occlusion (BRVO). Branch retinal vein occlusion (BRVO) is a common retinal vascular disease that often leads to macular edema, which is the chief reason for visual impairment in BRVO patients [1,2]. Recent randomized, controlled clinical trials have evaluated several treatment modalities, including intravitreal triamcinolone acetonide [4] and anti-vascular endothelial growth factor (VEGF) therapy [5] for macular edema in patients with BRVO, and both treatments have been reported to improve visual acuity after 12 months. Previous clinical studies only employed measurement of visual acuity to evaluate visual function, even though macular edema usually involves the larger macular area and not just the fovea. We have previously found that retinal thickness and retinal volume are more closely related to retinal sensitivity than to visual acuity in BRVO patients who have macular edema [12]
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