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J. J. Tseng, S. Kandula, L. K. Chang, K. Freund; Effects of Anti-VEGF Treatment on Retinal Vasculature in Retinal Vein Occlusion as Determined by Ultra-Wide Field Fluorescein Angiography. Invest. Ophthalmol. Vis. Sci. 2010;51(13):3577.
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To investigate the effect of inhibition of anti-vascular endothelial growth factor (VEGF) therapy for macular edema in the setting of retinal vein occlusion (RVO) on central and peripheral retinal circulation.
Two patients with macular edema, one with central retinal vein occlusion (CRVO) and one with branch retinal vein occlusion (BRVO) underwent ultra-wide field (200-degree) photography and fluorescein angiography (FA) at the time of diagnosis. The patient with CRVO received an intravitreal injection of ranibizumab (0.5 mg/0.05 ml). The patient with BRVO received an intravitreal injection of bevacizumab (1.25mg/0.05 ml). Both eyes were reevaluated with ultra-wide field photography and FA at 1 week and 5 weeks post-treatment. Photographs and FA were analyzed for post-treatment changes in arteriovenous (AV) transit time, vessel caliber, vessel leakage, peripheral capillary nonperfusion, retinal hemorrhages, and nerve fiber layer infarcts.
In both eyes, there were no changes in AV transit time or peripheral capillary nonperfusion at 1 and 5 weeks after anti-VEGF therapy. Decreased vessel caliber and reduction in intraretinal hemorrhages and nerve fiber layer (NFL) infarcts were observed in both eyes at the 5-week examination. In the patient with CRVO, a recurrence of vascular leakage was noted at 5 weeks.
Anti-VEGF therapy in the setting of RVO may initially decrease vessel caliber, retinal hemorrhages, and NFL infarcts but does not appear to affect AV transit time or areas of peripheral capillary nonperfusion. The beneficial effects of anti-VEGF therapy in RVO appear transient, and multiple injections may be required for control of macular edema.
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