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Makiko Matsumoto, Kiyoshi Suzuma, Eiko Tsuiki, Takashi Kitaoka; Retinal blood flow following treatment of ischemic central retinal vein occlusion with anti-VEGF therapy and pan-retinal photocoagulation.. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4260.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate whether retinal blood flow levels after treatment with anti-vascular endothelial growth factor (VEGF) therapy and pan-retinal photocoagulation (PRP) correlate with outcomes in patients with macular edema secondary to ischemic central retinal vein occlusion (CRVO).
This retrospective observational case study enrolled 37 ischemic CRVO cases who first visited Nagasaki University Hospital between January 2011 and June 2017. In each patient, best-corrected visual acuity (BCVA), central retinal thickness (CRT), and mean blur rate (MBR), which was measured by laser speckle flowgraphy and represents retinal blood flow velocity, were examined. We investigated the period from onset to initial anti-VEGF therapy administration (period 1), and the period from initial anti-VEGF administration to initial PRP (period 2). We excluded cases of angiogenic glaucoma already at their first visit.
Mean CRT significantly decreased (first visit: 596 ± 154 μm, final visit: 320 ± 187μm, P<0.01) and mean logMAR BCVA significantly improved (first visit: 1.08 ± 0.65, final visit: 0.82 ± 0.53, P<0.01) but with no significant changes in mean MBR. However, there was no correlation between BCVA and CRT changes (P = 0.07), but there was a significant correlation between change in BCVA and MBR rate (R = 0.43, P = 0.01).There were 7 cases in which recurrence of macular edema did not occur for more than half a year after the final treatment (no recurrence group). There were 10 cases in which treatment was continued for more than 2 years due to recurrence of macular edema (recurrence group). Significant differences were observed between the 2 groups in period 1 (no recurrence group: 0.5 ± 0.5, recurrence group: 1.6 ± 1.3 months, P = 0.03), and in period 2 (no recurrence group: 2.2 ± 2.8, recurrence group: 8.6 ± 4.6 months, P = 0.003).
Correlation between visual acuity and blood flow velocity was observed in ischemic CRVO treated with anti-VEGF therapy and PRP. Early initiation of both anti-VEGF therapy and PRP contributed to prevention of the recurrence of macular edema.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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