Abstract
Aims To confirm the therapeutic efficacy of conbercept for the treatment of macular edema (ME) secondary to retinal vein occlusion (RVO) by using optical coherence tomography angiography (OCTA) and to find out the differences in therapeutic efficacy between ischemic and nonischemic retinal vein occlusion (iRVO or non-iRVO) after conbercept treatment. Methods In this prospective, randomized, and comparative study, 60 unilateral eyes suffered from RVO combined with macular edema were included and fellow eye as controls. After an initial intravitreal injection of conbercept (IVIC), a pro re nata (PRN) strategy was adopted, and the follow-up time was 6 months. The foveal avascular zone (FAZ), vascular density of superficial capillary plexus (SCP), and vascular density of deep retinal capillary plexus (DCP), nonperfused areas (NPAs) were evaluated with OCTA on baseline and after treatment. Results The mean intravitreal injection number was 2.9 ± 0.89 times during six months in iRVO patients and 2.1 ± 0.86 times in non-iRVO patients, with statistically significant difference (p < 0.05). On baseline, central macular thickness (CMT) and FAZ were significantly thickened and enlarged compared to those of healthy fellow eyes; the vascular density of SCP and DCP were significantly decreased, and the differences were statistically significant (p < 0.05). Compared to baseline, after treatment, the best-corrected visual acuity (BCVA) was improved in either iRVO or non-iRVO (−0.601 ± 0.387, −0.241 ± 0.341 logMAR, p < 0.05). In iRVO, the improvement was more substantial than that of the non-iRVO group. FAZ in the non-iRVO group had significantly decreased compared to that in iRVO group (−0.044 ± 0.040 versus 0.014 ± 0.043 mm2, p < 0.05). CMT, the vascular density of SCP, and DCP had no significant difference. Conclusions The changes of microvascular structure can be quantitatively evaluated by using OCTA for the patients with RVO. Conbercept had a significant effect on treatment of RVO with macular edema. A more profound effect was achieved in the iRVO group on visual improvement and FAZ reduction in the non-iRVO group after conbercept treatment.
Highlights
Retinal vein occlusion (RVO) is the second most common cause of retinal vascular disease and causes haemorrhage and macular edema, leading to significant loss of vision after diabetic retinopathy [1]
Exclusion criteria were as follows: (1) the patients declined to join the study; (2) vitrectomy, retinal laser photocoagulation, glucocorticoid, and anti-vascular endothelial growth factor (VEGF) therapy were performed before participating in this study; (3) other retinal vascular diseases or eye diseases affecting vision; (4) severe systemic disease; (5) female patients during lactation or pregnancy; and (6) those who were unable to cooperate with the study or withdraw during the study
Healthy fellow eyes were used as controls. 32 eyes with ischemic type were included in group 1; 28 patients with nonischemic type
Summary
Retinal vein occlusion (RVO) is the second most common cause of retinal vascular disease and causes haemorrhage and macular edema, leading to significant loss of vision after diabetic retinopathy [1]. The main treatment modalities include laser therapy, intravitreal injections of steroids, and vascular endothelial growth factor (VEGF) inhibitors. Compared to grid laser and steroids, patients treated with VEGF inhibitors demonstrated excellent visual gain and anatomic improvement; in recent years, the anti-VEGF therapy has become more prevalent in the treatment of visual loss associated with macular edema (ME) [2]. The side effects of blocking VEGF remain a concern; one of BioMed Research International which is whether anti-VEGF therapy impairs retinal blood circulation and facilitates retinal vascular occlusion in eyes with diabetic retinopathy and RVO [6, 7]
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