Abstract
Purpose: To investigate the relationship between retinal blood flow, presence or absence of recurrence of macular edema, and levels of cytokines, after intravitreal ranibizumab injection (IRI) in patients with branch retinal vein occlusion (BRVO). Methods: In 47 patients with BRVO and macular edema, we used laser speckle flowgraphy (LSFG) to measure the relative flow volume (RFV) of the retinal arteries and veins passing through the optic disc in the occluded and non-occluded regions of the retina before and after IRI. Aqueous humor samples were obtained at the time of IRI. Levels of vascular endothelial growth factor (VEGF), soluble VEGF receptor (sVEGFR)-1, sVEGFR-2, placental growth factor (PlGF), platelet-derived growth factor (PDGF)-AA, soluble intercellular adhesion molecule (sICAM)-1, monocyte chemoattractant protein 1 (MCP-1), interleukin (IL)-6, IL-8, IL-12 (p70), IL-13 and interferon-inducible 10-kDa protein (IP-10) were measured by the suspension array method. Patients were categorized into two groups on the basis of whether or not macular edema recurred at 2 months after IRI: the nonrecurrent group, n = 24; and the recurrent group, n = 23. Results: In the veins of the occluded region, RFV showed a significant difference between baseline and 1 month after IRI (p < 0.001) in the recurrent group and the percent change of RFV showed a significant difference between the recurrent and nonrecurrent groups (p = 0.005). Furthermore, we found a significant negative correlation between RFV in the veins of the occluded region and aqueous levels of MCP-1, IL-8 and IP-10 at baseline (p = 0.029, p = 0.035, and p = 0.039, respectively). In the recurrent group, the arteries and veins of the non-occluded and occluded regions showed no significant association between RFV and the aqueous levels of any factors. Conclusions: These findings suggested that a decrease in RFV in the veins of the occluded region might be associated with the recurrence of macular edema and that the recurrence might depend on the change in RFV in the veins of the occluded region rather than the levels of cytokines.
Highlights
Branch retinal vein occlusion (BRVO) is a common retinal vascular condition in patients with lifestyle-related diseases such as hypertension and arteriosclerosis
We found no significant differences in the baseline values of any clinical parameters between the nonrecurrent and recurrent groups (Table 1)
The veins of the non-occluded region showed significant differences in relative flow volume (RFV) between baseline and 1 month after intravitreal ranibizumab injection (IRI) (p = 0.501), but the veins of the occluded region did not (* p = 0.029). (B) In the group with no recurrence of macula edema, we found no significant differences of RFV between baseline and 1 month after IRI in the arteries and veins of the non-occluded and occluded regions. (C) In the group with recurrence of macular edema, we found no significant differences in RFV
Summary
The patients with BRVO included 27 men and 20 women aged 65.2 ± 9.8 years (mean ± SD). The mean duration of macular edema was 42.5 ± 23.3 days (range, 9–20 days). Thirty-four of the 47 patients (72%) had hypertension, which was defined as current treatment with antihypertensive drugs or a blood pressure greater than 140/90 mmHg, and 22 of the 47 patients (47%) had hyperlipidemia. The mean SBP, DBP, MBP and OPP were 142 ± 16 mmHg, 85 ± 12 mmHg, 104 ± 11 mmHg, and 56 ± 7.8 mmHg, respectively. The mean baseline BCVA was logMAR 0.45 ± 0.37, and the mean baseline CMT was 638 ± 200 μm. We found no significant differences in the baseline values of any clinical parameters (age, sex, duration of macular edema, hypertension, SBP, DBP, hyperlipidemia, BCVA, CMT, MAP and OPP) between the nonrecurrent and recurrent groups (Table 1)
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