CLINICAL FINDINGS OF EYES WITH MACULAR EDEMA ASSOCIATED WITH BRANCH RETINAL VEIN OCCLUSION REFRACTORY TO RANIBIZUMAB

Retina. 2018 Jul;38(7):1347-1353. doi: 10.1097/IAE.0000000000001703.

Abstract

Purpose: To determine the relationship between the clinical findings and the response to ranibizumab therapy in eyes with macular edema associated with branch retinal vein occlusion.

Methods: We reviewed the medical records of 68 patients with macular edema associated with a branch retinal vein occlusion. The patients were placed in the refractory group if the central foveal thickness remained more than 250 μm throughout the 6-month study period despite the ranibizumab therapy; otherwise, they were placed in the responsive group.

Results: Sixty (88.2%) of 68 eyes were placed in the responsive group and the other 8 eyes (11.8%) were placed in the refractory group. At the pretreatment examination, fluorescein angiography showed extensive leakage from occluded vessels in 52 (86.7%) of the 60 eyes in the responsive group and focal leakages from microaneurysms or dilated capillaries in the other 8 eyes (13.3%). In the refractory group, 7 (87.5%) of 8 eyes had only focal leakage and 1 eye (12.5%) had extensive leakage (P < 0.0001). The mean initial subfoveal choroidal thickness in the eyes with branch retinal vein occlusion in the responsive group was significantly thicker than that in the fellow eyes (278.0 ± 90.5 μm, 249.9 ± 94.4 μm; P < 0.0001). On the other hand, the mean initial subfoveal choroidal thickness in the refractory group was not significantly different from that of the fellow eyes (P = 0.4002).

Conclusion: The dye leakage pattern in the fluorescein angiography images and choroidal thickness may be associated with response to ranibizumab therapy.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Angiogenesis Inhibitors / administration & dosage
  • Choroid / pathology*
  • Drug Tolerance*
  • Female
  • Fluorescein Angiography / methods*
  • Fundus Oculi
  • Humans
  • Intravitreal Injections
  • Macular Edema / diagnosis*
  • Macular Edema / etiology
  • Male
  • Ranibizumab / administration & dosage*
  • Retinal Vein Occlusion / complications*
  • Retinal Vein Occlusion / diagnosis
  • Retinal Vein Occlusion / drug therapy
  • Retrospective Studies
  • Tomography, Optical Coherence / methods*
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors

Substances

  • Angiogenesis Inhibitors
  • Vascular Endothelial Growth Factor A
  • Ranibizumab