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Sandra Rezar, Katharina Eibenberger, Wolf Buehl, Michael Georgopoulos, Guenther Weigert, Ursula Schmidt-Erfurth, Stefan Sacu; Extension of peripheral non-perfusion in retinal vein occlusion treated with intravitreal dexamethasone implant. Invest. Ophthalmol. Vis. Sci. 2017;58(8):3671.
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To investigate differences between eyes with ischemic and non-ischemic retinal vein occlusion (RVO) and evaluate the change of peripheral non-perfusion area (PNP) during intravitreal dexamethasone treatment.
Forty eyes of 40 consecutive patients with macular edema (ME) due to either branch- or central retinal vein occlusion (25 BRVO; 15 CRVO) were included for analysis. At baseline all patients were treated with an intravitreal dexamethasone implant (Ozurdex®) and re-treated if indicated earliest after 4 months. Ischemic RVO was defined as evidence of >10 disc diameter of PNP at baseline as seen on 200° wide-field fluorescein angiography. Eyes included for follow-up analysis were quantified manually for the total area of PNP by calculating the percentage of the total visible retina (ischemic index).
Eighteen eyes showed evidence of PNP and were graded as ischemic RVO. At baseline and at final follow-up best-corrected visual acuity (BCVA) and central retinal thickness (CRT) did not differ between ischemic/non-ischemic RVO patients (61±14/65±15 letters and 536±172/531±131µm at baseline; 69±15/70±18 letters and 298±107/305±61 µm month 6). No difference regarding the time of dexamethasone re-treatment was identified between patients with ischemic/non-ischemic RVO (11/11 received re-treatment at month 4, 3/5 at month 5, 3/4 at month 6). In the ischemic RVO eyes, the mean area of PNP (ischemic index) was calculated to be 14.7% at baseline. One month after initial dexamethasone treatment the mean area of PNP was 13.7% and after three months 16.9% (p=0.8; p=0.4). After re-treatment total PNP area was 16.7% (month 6; p=0.8 in comparison to baseline). In eyes graded as non-ischemic the mean PNP area was 0.3% at baseline, 0.6% after one month, 0.6% after three months and 0.6% after six months, respectively (p>0.05). A significant negative correlation between the total area of PNP and VA was identified (p=0.03).
Using wide-field fluorescein angiography the ischemic index was shown to remain stable under intravitreal Ozurdex® treatment. Functional and anatomical outcomes did not differ between patients with ischemic and non-ischemic RVO.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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