Abstract

PurposeTo investigate longitudinal changes in metamorphopsia associated with branch retinal vein occlusion.MethodsIn this prospective observational case series, we included 32 eyes (32 patients) with branch retinal vein occlusion and acute macular edema. Eyes were treated as needed with intravitreal ranibizumab injections for 12 months. At baseline and 1, 6, and 12 months after initiating treatment, metamorphopsia was quantified using M-CHARTS. Retinal morphology was examined through optical coherence tomography.ResultsLogarithm of the minimum angle of resolution visual acuity progressively improved from 0.342 ± 0.304 (Snellen equivalent: 20/44) at baseline to 0.199 ± 0.259 (20/32) and 0.118 ± 0.195 (20/26) at 1 and 12 months, respectively (both P < 0.001). The M-CHARTS score significantly decreased from 0.63 ± 0.61 at baseline to 0.45 ± 0.50 at 1 month (P = 0.044), but no further improvement was achieved with 1 year of additional treatment (6 months: 0.47 ± 0.53 [P = 0.094] and 12 months: 0.50 ± 0.44 [P = 0.173]). Three (13.6%) of 22 eyes with baseline metamorphopsia had complete metamorphopsia resolution. At 12 months, the M-CHARTS score was correlated with baseline foveal thickness (r = 0.373, P = 0.035) and the baseline M-CHARTS score (r = 0.503, P = 0.003). A multiple regression analysis revealed that only the baseline M-CHARTS score was correlated with the 12-month M-CHARTS score (β = 0.460, P = 0.027).ConclusionsEyes with branch retinal vein occlusion often have persistent metamorphopsia, even when visual acuity and retinal morphology improve. Metamorphopsia at 12 months was correlated with metamorphopsia and foveal thickness at baseline.

Highlights

  • Macular edema (ME) is one of the most vision-threatening complications associated with branch retinal vein occlusion (BRVO) [1]

  • Logarithm of the minimum angle of resolution visual acuity progressively improved from 0.342 ± 0.304 (Snellen equivalent: 20/44) at baseline to 0.199 ± 0.259 (20/32) and 0.118 ± 0.195 (20/26) at 1 and 12 months, respectively

  • The M-CHARTS score significantly decreased from 0.63 ± 0.61 at baseline to 0.45 ± 0.50 at 1 month (P = 0.044), but no further improvement was achieved with 1 year of additional treatment (6 months: 0.47 ± 0.53 [P = 0.094] and 12 months: 0.50 ± 0.44 [P = 0.173])

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Summary

Introduction

Macular edema (ME) is one of the most vision-threatening complications associated with branch retinal vein occlusion (BRVO) [1]. In the Ranibizumab for Treatment of Macular Edema following BRVO (BRAVO) study, injections of ranibizumab (0.5 mg) were administered on an as-needed basis to patients with BRVO for 6 months. In our previous report on acute BRVO, 26 (89.7%) of 29 patients with metamorphopsia at baseline had persistent metamorphopsia 1 month after a single intravitreal ranibizumab injection [12]. To the best of our knowledge, no previous reports have described long-term changes in metamorphopsia associated with BRVO. It remains unclear whether BRVO-induced symptomatic metamorphopsia regresses when ME is continuously treated. The current study evaluated BRVO-associated metamorphopsia using M-CHARTS to determine long-term changes in metamorphopsia and identify prognostic factors

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