Abstract

BackgroundThe aim of this study was to evaluate the correlation between changes in the macular capillary network and macular edema (ME) recurrence with branch retinal vein occlusion (BRVO) using swept-source optical coherence tomography angiography (SS-OCTA).MethodsWe reviewed the data for 43 patients with treatment-naïve ME associated with BRVO. Patients who received intravitreal bevacizumab injection were divided into two groups based on ME recurrence at 6 months after edema resolution. The perifoveal capillary morphology and the macular capillary vessel density (VD) were retrospectively analyzed using en face SS-OCTA after ME resolution.ResultsThe perifoveal capillary ring loss in the superficial capillary plexus (SCP) and deep capillary plexus (DCP) was more common in the ME recurrence group (n = 22) than in the no ME recurrence group (p = 0.047 and p = 0.002). Relative to the findings in the no ME recurrence groups, the destruction of the perifoveal capillary ring was more severe in the DCP (30.0° vs 87.3°, p = 0.001) than in the SCP (17.3° vs 69.5°, p = 0.006) in the ME recurrence group. The hemi-VD disparity between the affected and the unaffected areas in the SCP and DCP showed significant differences (p = 0.031 and p = 0.017), while macular VD showed no differences between the groups.ConclusionsDestruction of the perifoveal capillary ring and hemi-VD disparity could be related to ME recurrence in BRVO. Therefore, these factors may be helpful in predicting ME recurrence.

Highlights

  • The aim of this study was to evaluate the correlation between changes in the macular capillary network and macular edema (ME) recurrence with branch retinal vein occlusion (BRVO) using swept-source optical coherence tomography angiography (SS-Optical coherence tomography (OCT) angiography (OCTA))

  • This study included a total of 43 patients: patients with no ME recurrence and patients with ME recurrence following intravitreal anti-Vascular endothelial growth factor (VEGF) injection therapy for BRVO-induced ME

  • The improvement in BCVA at 6 months after resolution of ME was significantly better in the no ME recurrence group than in the ME recurrence group (0.17 ± 0.21 vs. 0.33 ± 0.31, p = 0.037), while the mean number of injections until resolution of ME was higher in the recurrence group, (2.05 ± 1.12 vs. 2.86 ± 1.32, p = 0.028); this showed that the recurrence group required additional injections to achieve ME resolution

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Summary

Introduction

The aim of this study was to evaluate the correlation between changes in the macular capillary network and macular edema (ME) recurrence with branch retinal vein occlusion (BRVO) using swept-source optical coherence tomography angiography (SS-OCTA). Macular edema (ME) is the most common cause of visual loss in patients with branch retinal vein occlusion (BRVO). It is caused by physical destruction of the inner blood-retinal barrier due to elevated venous pressure as a result of vein occlusion at the arteriovenous crossing site [1, 2]. Increased levels of intravitreal VEGFs are associated with nonperfusion areas in the retinal capillaries and the severity of ME [5, 6]. Many cases still require re-treatment because of recurrence or persistence of ME despite intravitreal anti-VEGF and/or

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