First Author: Y.Miwa JAPAN
Co Author(s): S. Ooto T. Murakami Y. Muraoka Y. Iida K. Suzuma A. Tsujikawa
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To investigate the association between vitreoretinal interface status and the efficacy of intravitreous ranibizumab (IVR) for macular edema (ME) secondary to branch retinal vein occlusion (BRVO) at 1 year.
A non-randomized prospective interventional study was conducted.
Forty-five eyes of 45 treatment-naive patients with ME secondary to BRVO (best-corrected visual acuity [BCVA] worse than 20/32; age, >50 years) who received IVR treatment at Kyoto University Hospital between September 2013 and September 2015 were included this study. All the patients received initial 3-monthly intravitreal injections of ranibizumab and were followed up every month. Further injections of ranibizumab were given when ME recurred with a concomitant decrease in visual acuity. Ophthalmic examination, including BCVA and optical coherence tomography (OCT), were performed at each visit. Central retinal thickness (CRT) was measured automatically by using built-in software. The presence of posterior vitreous detachment (PVD) and vitreomacular adhesion (VMA) was assessed by using vitreous-enhanced B scans.
The mean (SD) age of the patients was 71.4±7.9 years. At baseline, PVD was observed in 29 eyes (PVD+ group) but not in 16 eyes (PVD− group). In the PVD− group, VMA was observed in 4 eyes. No significant differences in mean age, BCVA, and CRT were found between the two groups (P=0.264, 0.15, and 0.773, respectively). At month 12, the mean LogMAR BCVA was improved significantly from that at baseline (from 0.357 to 0.063, P<0.001). No significant differences in mean BCVA, CRT, and number of injections were found between the two groups (P=0.805, 0.109, and 0.898, respectively). In the PVD− group, PVD was observed in 9 eyes (56.3%) within one year after the intimal injection. Eyes with PVD development had significantly lower CRT (P=0.047) and needed fewer additional injections than the eyes without PVD (1.3 vs. 2.9, P=0.061). In the PVD− group, the mean LogMAR BCVA was significantly better in the eyes with VMA than in those without VMA (−0.079 vs. 0.10, P=0.001).
Although baseline vitreoretinal interface status did not affect 1-year visual prognosis, the eyes with PVD development needed fewer additional ranibizumab injections for ME secondary to BRVO. In the eyes without PVD, VMA was associated with better visual prognosis.