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Kyle N Kaneko, Gregg T. Kokame, Raymond Wee, So Yung Choi, John J Chen, James C Lai; The Presence of Collateral Vessels is a Useful Prognostic Sign in Patients with Retinal Vein Occlusions. Invest. Ophthalmol. Vis. Sci. 2018;59(9):5439.
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Collateral vessels can sometimes develop in patients with retinal vein occlusions (RVO). However, the prognostic significance of their presence is unclear. We examined if the development of collateral vessels impacted treatment intervals between injections, visual acuity, and/or macular edema in patients with RVO.
Data was collected retrospectively through a chart review of patients seen by one retina specialist at the Retina Consultants of Hawaii from January 2000 through February 2017. 155 eyes of 155 patients were included in this study. Patients were included in this study if they had a history of macular edema secondary to RVO and at least 3 intravitreal anti-VEGF and/or steroid injections. Patients were excluded if they had diabetic macular edema, myopic degeneration, wet macular degeneration, neovascular glaucoma or a history of vitrectomy. We assessed treatment intervals, visual acuity, and central foveal thickness. Two tailed t-tests were used for statistical analysis.
Of the 155 eyes, 82 eyes (52.9%) developed collateral vessels. RVO eyes that had collateral vessels had a significantly longer treatment interval (11.33 ± 4.43 weeks) between injections as compared to RVO eyes that did not (6.74 ± 2.98 weeks) (p < 0.0001) (Figure). Collateral vessels were not found to be associated with improvements in visual acuity (p=0.95). The mean average decrease in central foveal thickness for eyes with and without collateral vessels were 142.1 µm and 144.7 µm respectively (p=0.9133).
Collateral vessel formation in patients with RVO is associated with longer treatment intervals between intravitreal injections. However, the presence of collateral vessels is not associated with improved visual acuity or decreased central foveal thickness. These findings may help guide management decisions for patients with RVO.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
Figure: Difference in Mean Treatment Intervals Between Injections for Retinal Vein Occlusion Patients With and Without Collateral Vessels
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