Ophthalmology in China

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Morphologic predictors of visual outcome in patients with macular edema secondary to retinal vein occlusion treated with anti-VEGF therapy

MA Dan-dan,  CAO Kai,  XIAO Yuan-yuan,  SUN Di,  LI Yi-bin   

  1. Beijing Institute of Ophthalmology,  Beijing Tongren Eye Center,  Beijing Tongren Hospital,  Capital Medical University,  Beijing Key Laboratory of Ophthalmology and Visual Sciences,  Beijing 100005, China
  • Received:2018-01-04 Online:2018-03-25 Published:2018-03-24
  • Contact: LI Yi-bin, Email:yibinlee@yahoo.com


Objective To evaluate the associations between baseline fundus fluorescence angiography (FFA) and optical coherent tomography (OCT) characteristics and visual outcome of patients treated using anti-VEGF therapy for macular edema (ME) secondary to retinal vein occlusion (RVO). Design Retrospective case series. Participants 125 Patients with ME second to RVO,  who received intravitreal injection of ranibizumab ( IVR ) and had good response in Beijing Tongren Hospital. Methods All the patients received monthly IVR till the ME resolved,  and underwent routine FFA and OCT examination using Spetralis HRA-OCT. Baseline changes in FFA and OCT were semi-automatically analyzed. The binary logistic regression was used to analyze the relationship between morphologic changes and best corrected visual acuity (BCVA) at final visit. Main Outcome Measures BCVA,  parafoveal capillary perfusion,  central retinal thickness,  central retinal volume,  the integrity of each retinal layers in OCT. Results Among 125 patients,  the percentage of them with BCVA ≥0.5 at baseline was 5.6% (7/125),  while 34.4% (43/125) at final visit. The   parafoveal capillary non-perfusion in FFA (P=0.01,  OR=0.213),  obscure  inner plexiform layer (IPL) (P=0.005,  OR=0.225),  and external limiting membrane (ELM) rupture in OCT (P=0.001,  OR=0.16) hindered patients from gaining good vision prognosis after treatment. Conclusion For patients with ME secondary to RVO,  parafoveal capillary non-perfusion in FFA,  obscure IPL,  and ELM disruption in OCT might predict poor vision after anti-VEGF therapy.(Ophthalmol CHN,  2018, 27:111-115)

Key words: retinal vein occlusion, macular edema, fundus fluorescence angiography, optical coherent tomography, anti-VEGF therapy