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The prognostic role of microcystic macular changes in patients with retinal vein occlusions treated with bevacizumab

Session Details

Session Title: Vascular Diseases I

Session Date/Time: Friday 27/09/2013 | 08:00-10:00

Paper Time: 09:20

Venue: Hall C (Level 1)

First Author: M.Rehak GERMANY

Co Author(s):    M. Dalcegio   E. Tilgner   P. Wiedemann   -. -     

Abstract Details

Purpose:

To evaluate the role of microcystic macular changes as a prognostic factors for the recurrence of macular edema (ME) in patients with retinal vein occlusion (RVO) treated with bevacizumab.

Setting:

We performed a retrospective chart analysis of 38 consecutive patients treated with intravitreal injection of bevacizumab for ME secondary to RVO at the Department of Ophthalmology of University Leipzig.

Methods:

At baseline and monthly follow-up visits over 6 months after first intravitreal injection a comprehensive ophthalmologic examination including best corrected visual acuity (BCVA) measured with ETDRS charts and volume scan of macula performed with spectral domain OCT (HRA-2) were done. The changes of BCVA and central retinal thickness (CRT) were analysed at all single time points and compared with baseline.

Results:

In total 74 events of macular microcystic changes detected by OCT without worsening of BCVA were indentified after the bevacizumab injections. All these patientes showed significant worsening of BCVA and CRT (p< 0.0001) in next 4-10 weeks. In mean, the significant increase of CRT and decrease of BCVA occurred 7.8 weeks after the first presence of microcystic macular changes. In the BRVO group BCVA decreased significantly from 0.33±0.22 logMar at visit with the first detection of microcystic changes to 0.42±0.27 logMar at follow-up visit with the increase of ME. In the CRVO group BCVA decreased from 0.43±0.36 to 0.65±0.35 LogMar. CRT significantly increased from 242.9±37.6 μm to 502.7±175.9 μm in BRVO group, and from 223.0 ± 43.1 μm to 705.6 ± 244.6 μm in the CRVO group.

Conclusions:

In RVO patients treated with bevacizumab the macular microcystic changes could be commonly detected after resolution of macular edema. The presence of these changes may be used as indicator for recurrence of ME and decrease of BCVA in the next weeks. Therefore in patients, in whom the microcystic changes were detected, the follow-up visit should be scheduled in next 4-6 weeks.

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