First Author: J.Coelho PORTUGAL
Co Author(s): V. Lages A. Abreu M. Furtado M. Gomes A. Meireles M. Lume
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To evaluate the progression of subfoveal choroidal thickness (SCT) and central macular thickness (CMT) after intravitreal anti–vascular endothelial growth factor (VEGF) therapy - bevacizumab - in eyes with branch retinal vein occlusion (BRVO) and macular edema.
Department of Ophthalmology of a tertiary referral centre in Oporto, Portugal - Centro Hospitalar Universitário do Porto.
Single centre retrospective observational case series of patients with BRVO and macular edema treated with 3 monthly intravitreal injections of bevacizumab, an anti–vascular endothelial growth factor (VEGF). Patients' demographic data, best-corrected visual acuity (BCVA) measured with an ETDRS chart and spectral-domain optical coherence tomography (SD-OCT) were analysed at baseline and after the 3 monthly intravitreal injections. A good functional response was defined as a BCVA gain of 10 or more ETDRS letters at the 3rd month follow-up visit.
26 eyes from 26 patients, mean age of 66,7±12,0 years were included. Initial mean SCT in eyes diagnosed with BRVO was significantly greater than their fellow eye, 309,9±84,9µm vs 251,2±77,5µm; P<0,05. Similarly, baseline mean CMT was greater in the eye with BRVO 576,7±167,9µm compared to the fellow eye, 274,5±32,5µm; P<0.001. After 3 months of follow-up, in eyes with BRVO mean SCT and CMT decreased by 41,0±49,8µm (P=0,002) and 233,2±216,2µm (P<0,001), respectively. Mean BCVA improved significantly in the BRVO eyes following treatment from 43,7±22,1 to 63,0±16,1 ETDRS letters (p<0,001). Moreover, 17 out of 26 eyes (65,4%) were functional responders. At baseline mean SCT and CMT was similar for functional responders and nonresponders (P>0,05). After treatment, mean SCT significantly decreased for functional responders (306,8±94,3 to 262,6±75,6µm; P<0,001) but not for functional non-responders (282,6±72,2 to 265,2±67,5 µm; P=0.061). At 3 months follow-up, it was seen in functional responders and nonresponders a mean CMT decrease of 268,3±251,9µm (P<0,001) and 177,0±95,5µm (P=0,001) respectively. No changes in SCT and CMT were seen during follow-up in the fellow eyes of either responders or nonresponders (P>0,05).
Our results support that choroidal thickness is altered in eyes with BRVO and macular edema and that SD-OCT is an effective method to evaluate the choroidal thickness changes after treatment. In eyes with BRVO, SCT and CMT values are greater than in fellow eyes and decrease significantly following 3 monthly intravitreal injections of bevacizumab. During follow-up a significant decreased in SCT was only seen in eyes with good functional response. Our study support that choroidal thickness changes could be used as a prognosis factor for a good functional response to short-term anti-VEGF therapy.