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Matus Rehak, Maria Tuisl, Peter MH Wiedemann; The Prognostic Role of Microcystic Macular Changes in Patients with Retinal Vein Occlusions Treated with Ranibizumab. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3389.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the role of microcystic macular changes as prognostic factors for the recurrence of macular edema (ME) in patients with retinal vein occlusion (RVO) treated with ranibizumab.
We performed a retrospective chart analysis of 78 consecutive patients treated with intravitreal injection of ranibizumab for ME secondary to RVO at the Department of Ophthalmology of University Leipzig.At baseline and monthly follow-up visits over 12 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 were done. In patients who received at least 3 initial injections and ME resolved (central retinal thickness; CRT<250μm) the prevalence of microcystic macular changes was evaluated. Further, the changes of BCVA and CRT were analysed at all single time points and compared with baseline.
: In total 102 events in 51 patients the presence of macular microcystic changes without worsening of BCVA were detected by OCT during the analyzed follow-up time. In 99 of 102 events (97%) a significant worsening of BCVA and CRT (p< 0.0001) within next 4-10 weeks was observed. In mean, the significant increase of CRT and decrease of BCVA occurred 7.1 weeks after the first presence of macular microcysts. In the BRVO group BCVA decreased significantly from 0.31±0.21 logMar at visit with the first detection of microcystic changes to 0.44±0.27 logMar at follow-up visit with the increase of ME. In the CRVO group BCVA decreased from 0.42±0.31 to 0.62±0.29 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.
In RVO patients treated with ranibizumab the macular microcystic changes could be commonly detected after resolution of macular edema. The presence of these changes may be used as an early indicator for recurrence of ME and decrease of BCVA in the next weeks. In these patients the follow-up visit should be scheduled within 4-6 weeks.
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