Tomographic Parameters of Recurrent Macular Edema Due to Retinal Vein Occlusion during Antiangiogenic Therapy

Abstract

Purpose: to establish the tomographic parameters to predict the recurrent of macular edema due to retinal vein occlusion.Patients and methods. This is a retrospective study of 54 patients (54 eyes) with macular edema, no more than 3 months old, who had recurrent of macular edema after 3 intravitreal injections of aflibercept. Standard ophthalmological examination, spectral optical coherence tomography, intravitreal injections of aflibercept according to instruction, and statistical analysis of the data were conducted.Results. Recurrence of macular edema developed on average 6.3 ± 1.2 weeks after three injections of aflibercept. We identified of the most significant prognostic tomographic parameters affecting the recurrent of macular edema during intravitreal injections of aflibercept — central foveal thickness > 500 μm (OR 2.1, p = 0.01), the presence of serous retinal detachment (OR 5.1, p = 0.001), the presence of hyperreflective foci (OR 3.7, p = 0.03), alteration of external limiting membrane (OR 4.7, p = 0.01), disruption of the photoreceptor innersegment/outer segment junction (OR 3.4, p = 0.01), disruption of retinal pigment epithelium (OR 2.1, p = 0.02).Conclusion: the recurrent of macular edema with retinal vein occlusion during antiangiogenic therapy depends on baseline tomographic parameters. Our results can be important in predicting the duration and effectiveness of antiangiogenic therapy in a particular patient at the beginning of the disease, which makes the approach to management more personalized, promising in economic, social and psychological aspects.