Peripapillary Microvasculature in Branch Retinal Vein Occlusion (BRVO) Treated With Anti-VEGF: An OCTA Study

Abstract

Objective: Aim of this study is to evaluate the changes in peripapillary vessel density (VD) and peripapillary nerve fiber layer thickness (PPRNFL) after intravitreal anti-VEGF injections in patients with Branch Retinal Vein Occlusion (BRVO) with macular edema.
 Material and Methods: Sixty eyes of 30 patients with unilateral macular edema due to BRVO who underwent 3 dose loading anti-VEGF treatments were included in the study. The peripapillary capillary vessel density (RPCVD) and PPRNFL were evaluated with optical coherence tomography angiography (OCTA). The measurements were done before and at least one month after a loading dose of anti-VEGF. The measurements of BRVO eyes before treatment were compared with the healthy fellow eyes and the values measured after treatment.
 Results: There was a statistical difference between the pre-injection and post-injection periods at the inside disc and peripapillary VD parameters (p<0.001, p=0.01, respectively). Compared with the fellow eyes of the patients, the vessel density in the eyes with BRVO was significantly lower in the whole image, inside the disc, and peripapillary area. (p=0.015, p=0.020, p=0.027, respectively). There was no significant change in PPRNFL values before and after injections. When eyes with BRVO were compared with healthy eyes, eyes with BRVO showed reduced PPRNFL values initially but that was not statistically significant.
 Conclusion: Inside disc and peripapillary VD values were increased after injection. Even though anti-VEGF agents may contribute to neurodegeneration, we think that this increase in perfusion prevents possible neurodegeneration.