Complex assessment of retinal ischemic damage in patients with retinal vein occlusion

Abstract

To evaluate the effectiveness of treatment and the possibility of restoring visual functions in patients with retinal vein occlusion (RVO) depending on the initial degree of macular ischemia. The study included 84 patients with RVO. The main inclusion criteria were the presence of macular edema in the setting of RVO with the duration of no more than 3 months and without any previous treatment. All patients underwent intravitreal injections of an angiogenesis inhibitor, followed by laser treatment when necessary. A comparative analysis of the results was carried out in groups that were opposite in terms of the clinical effect - before the start of the therapy, after 1 month, and after 12 months. All patients and the control group members underwent standard ophthalmological examination as well as electroretinography, fluorescence angiography, optical coherence tomography (OCT), and OCT angiography. Based on data obtained during 12 months of the follow-up, the comparative analysis of the initial ophthalmic status of patients with RVO with opposite clinical effect resulted in derivation of 3 clinical groups that correspond to the degrees of macular ischemia - mild, moderate and severe. Determination of the degree of macular ischemia at the stage of primary diagnosis can improve the treatment effectiveness and inform the patients about the sequence and duration of anti-VEGF therapy. Intravitreal injections of ranibizumab in retinal vein occlusion are carried out before the elimination of macular edema and further in the on-demand mode, while the number of injections can vary from one to monthly injections during the year.