Retinal Functional Changes Measured by Microperimetry after Intravitreal Ranibizumab Injection and Sulfotanshinone Sodium Injection for Macular Edema Secondary to Retinal Vein Occlusion

Bingwen Lu,Xingwei Wu

doi:10.4236/cm.2015.63020

Abstract

Objectives: To study the visual field changes after intravitreal ranibizumab (IVR) injection and sulfotanshinone sodium (SS) injection for macular edema (ME) secondary to retinal vein occlusion (RVO), and discuss the value of microperimetry as a routine diagnostic test in the follow-up of RVO patients. Methods: This was a retrospective, interventional, case-series study. Twelve eyes of 12 RVO patients, including 6 eyes with central RVO (CRVO) and 6 eyes with branch RVO (BRVO) were included. The eyes were treated with IVR (0.5 mg) injections and SS injections (20 mg per day, one week consecutively in one month). The outcomes measured included best corrected visual acuity (BCVA), central retinal thickness (CRT), mean defect (MD), pattern standard deviation (PSD), macular light sensitivity of the central 16 points in CRVO group and the central 8 points in BRVO group before and after the treatment. Statistical analyses were then performed on the main outcome measures. Results: An improvement of BCVA was found in all patients after treatment with significant difference (t = 7.74, p p p p > 0.05). All RVO patients had their macular light sensitivity of the involved part improved significantly (t = 5.03, p p p < 0.01). The Pearson’s correlation was calculated among BCVA, MD, macular light sensitivity and CRT. No obvious significance was found between CRT and BCVA outcomes, whereas MD and mean macular light sensitivity outcomes were closely related to BCVA results in the BRVO group and the latter showed a more intimate correlation. No similar correlation was found in RVO and CRVO group. Conclusion: IVR injection and SS injection together could effectively improve the therapeutic effect in RVO patients with ME. Microperimetry could be used as a routine diagnostic test and a possible valuable tool in the follow-up of patients with RVO, especially in BRVO.

Highlights

Retinal vein occlusion (RVO) is estimated to be the second most common cause of retinal vascular disease [1]
Since the Branch Vein Occlusion Study Group reported the efficacy of grid laser photocoagulation, it has been recognized as the standard treatment for Macular edema (ME) resulting from branch RVO (BRVO) [3]
An increasing number of reports have shown the efficacy of new methods on ME resulting from RVO, such as intravitreal injections of triamcinolone acetonide, bevacizumab, or ranibizumab [4]-[6]

Summary

Introduction

Retinal vein occlusion (RVO) is estimated to be the second most common cause of retinal vascular disease [1]. Macular edema (ME) is a frequent cause of visual acuity loss [2]. Since the Branch Vein Occlusion Study Group reported the efficacy of grid laser photocoagulation, it has been recognized as the standard treatment for ME resulting from branch RVO (BRVO) [3]. Initial visual acuity (VA) is the most reliable prognostic factor of visual prognosis [3] and quantitative measurement of central retinal thickness (CRT) using optical coherence tomography (OCT) is generally used to evaluate both the severity of the ME and the effect of the treatment [6]. OCT measurements may detect a significant edema reduction while the visual acuity fails [8]. Microperimetry has been reported recently to be a valuable additional diagnostic measure for macular diseases [8]

Objectives

Methods

Conclusion