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U. E. Wolf-Schnurrbusch, C. Framme, S. P. Rothenbuehler, S. Wolf; Predictors for Visual Outcome Prior to Anti-VEGF Therapy in Vascular Occlusive Diseases. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4379.
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With high resolution SD-OCT it’s possible to distinguish the outer retina layer with the external limiting membrane (ELM), the inner/outer segment junction, and the RPE very well. Purpose of our study was to identify features as predictors for favorable visual outcome prior to Anti-VEGF therapy in patients with clinical significant macular edema (CSME) due to Central Retinal Vein Occlusion (CRVO) and Branch Retinal Vein Occlusion (BRVO).
Patients with CSME due to CRVO and BRVO were examined at BL (best corrected visual acuity (BCVA), biomicroscopy, fluorescein angiography and Spectralis HRA+OCT). If both eyes were eligible, one was randomly chosen as the study eye. Patients with intact ELM in the SL-OCT images were included into group 1, whereas patients with disturbances in the ELM were included into group 2. In addition size and configuration of cystoid spaces were analysed. BCVA was analysed 4 weeks after the initial intravitreal anti-VEGF therapy in respect to the layer integrity and to findings like the configuration, size and localisation of the cystoid spaces.
BRVO (n= 52): We distributed 28 eyes with BRVO to group 1 and 24 eyes to group 2. On average patients with intact ELM experienced a gain in BCVA of 8±3 letters, but patients with disturbances in ELM gained only 2±3 letters. CRVO (n= 32): We distribute 17 eyes with CRVO to group 1 and 15 eyes to group 2. On average the patients with the intact ELM experienced a visual gain of 7±4 letters, but patients with disturbants in ELM gained only 2±1 letters. The size of cystoid spaces was not related to BCVA, but there are differences regarding the configuration of those cystoid spaces.
Analysis of SD-OCT provides predictors for BCVA in patients with vascular occlusive diseases for a better selection prior to therapy.
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