Abstract
Purpose: :
CVO reperfusion following successful laser-induced anastomosis occurs after a prolonged interval of vascular remodeling, during which an irreversible pigmentary maculopathy frequently occurs prior to the eventual reversal of macular edema. We examined the potential for intravitreal ranibizumab to control CVO macular edema during this evolution interval, and thereby inhibit or limit pigmentary maculopathy.
Methods: :
Consecutive cases with macular edema from perfused CVO that were managed with various combinations of intravitreal ranibizumab and laser-induced anastomosis, were reviewed retrospectively.
Results: :
Twenty three eyes of 23 patients were studied. Following multiple attempts, at least one functioning anastomosis site was eventually present in each eye. No major hemorrhagic or neovascular treatment complications were encountered. All eyes retained perfused CVO status. Reversal of macular edema with mild or no pigmentary maculopathy occurred in 18 eyes.
Conclusions: :
In this small study, intravitreal ranibizumab was useful in minimizing the pigmentary maculopathy frequently associated with successful laser-induced anastomosis reperfusion therapy. Intravitreal ranibizumab appeared to modulate the extent and duration of CVO macular edema during the evolution of the reperfusion anastomosis and did not appear to inhibit the angiogenic growth factors required for anastomosis formation.
Keywords: vascular occlusion/vascular occlusive disease • laser • vascular endothelial growth factor