Abstract
PurposeTo determine the predictive factors for recurrent macular edema due to branch retinal vein occlusion (BRVO) during intravitreal ranibizumab (IVR) monotherapy.MethodsClinical records were retrospectively reviewed for 65 patients (mean age 66.5 years, 65 eyes) who were diagnosed with macular edema due to BRVO and treated with IVR monotherapy for 12 months at the Medical Retina Division, Department of Ophthalmology, Keio University Hospital between October 2013 and August 2017. Best-corrected visual acuity (BCVA), fundus findings, and sectional optical coherence tomography (OCT) images were analyzed.ResultsOverall BCVA and central retinal thickness (CRT) improved (all p < 0.01). BCVA at 12 months was significantly worse in patients with recurrent macular edema (40 eyes [61.5%]) (p < 0.01) than in those without, while CRT decreased and was comparable in both groups at 12 months. Logistic regression analyses showed association of recurrence with disorganization of the retinal inner layer (DRIL) temporal to the fovea at baseline (odds ratio = 7.74; 95% confidence interval 1.62–37.08, p = 0.01), after adjusting for age, gender, and initial CRT.ConclusionRecurrent macular edema due to BRVO affects visual outcome and is associated with initial DRIL temporal to the fovea, evaluated using OCT sectional images before treatments. DRIL may facilitate determination of follow-up schedules in clinical practice.
Highlights
Branch retinal vein occlusion (BRVO) is a common retinal disease [1,2,3] that causes sudden impairment of visual function
Best-corrected visual acuity (BCVA) best-corrected visual acuity, CRT central retinal thickness, CCT central choroidal thickness, BRVO branch retinal vein occlusion, DRIL disorganization of the retinal inner layer was observed in 40 eyes (61.5%) during the 12-month followup period (Table 2)
The mean age of the patients was older (68.8 ± 10.0 years vs. 62.7 ± 9.6 years; p = 0.01); the mean CRT was greater (563.3 ± 194.3 μm vs. 380.2 ± 117.2 μm; p < 0.001); and the incidences of DRIL nasal (73% vs. 28%; p < 0.001), inferior (73% vs. 32%; p = 0.001), and temporal to (80% vs. 24%; p < 0.001) the fovea were higher, relative to those in eyes without recurrence
Summary
Branch retinal vein occlusion (BRVO) is a common retinal disease [1,2,3] that causes sudden impairment of visual function. Anti-vascular endothelial growth factor (VEGF) therapy has been used to rapidly reduce macular edema [4,5,6,7,8,9]. It would be useful to determine which patients should receive frequent follow-up or be treated with a treat and extend regimen to avoid recurrent macular edema. Researchers must develop methods to predict recurrence of macular edema due to BRVO
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