Outer retinal edema as a risk factor for poor visual outcome after bevacizumab therapy for macular edema with branch retinal vein occlusion

Abstract

Purpose: To evaluate the baseline OCT morphology of macular edema (ME) associated with branch retinal vein occlusion (BVO) for visual outcome after intravitreal bevacizumab injection (IVB).

Methods: Seventy one eyes of 71 patients with ME due to BVO who were received primary IVB (40 male, 31 female, mean ages 67) were retrospectively reviewed. The baseline morphology of ME was classified to inner retinal edema, outer retinal edema and serous retinal detachment (SRD) using spectral-domain optical coherence tomography (SD-OCT). Best corrected visual acuity (BCVA; log MAR) and central retinal thickness (CRT) were measured at each visits. Additional photocoagulation and IVB were performed for recurrence of ME. The visual outcome for each pattern of edema was evaluated at 12 months after primary IVB.

Results: Visual acuity at base line was not different with or without outer retinal edema. At 12 months, BCVA of BVO without outer retinal edema ( Mean 0.19±0.33: n=43) was significantly better than that with outer retinal edema (0.29±0.24: n=28) (P=0.026). The ratio of VA over 0.7(decimal visual acuity) was 67% in patients without outer retinal edema , it was significantly higher (43%) than that with outer retinal edema(P=0.043). The result of univariate logistic regression analysis showed that the outer retinal edema was a significant risk factor for poor BCVA after IVB (OR, 2.8; P=0.040). There was no difference in VA after IVB between BVO with and without inner retinal edema or SRD.

Conclusions: Our results suggest that the outer retinal edema was a predictor factor for poor visual outcome after IVB for BVO with ME.

Keywords: 585 macula/fovea • 748 vascular endothelial growth factor • 688 retina