Criteria for the possibility of recovery of visual acuity after anti-VEGF therapy in patients with macular edema secondary to retinal vein occlusion
84 patients with macular edema on the background of occlusion of retinal veins were examined; the average age was 60.7±7.5 years. All patients underwent 2 intravitreal injections of 0.5 mg ranibizumab at intervals of 1 month. Further, anti-VEGF therapy was performed in a "pro re nata" regimen.
The control group consisted of 30 patients, with visual acuity ≥0.8, average age was 60±6.1 years.
Prior to intravitreal injection and one month later before the re-injection the OCT, the ISCEV-based electrophysiological examination were performed, the concentration of cytokines in the aqueous humor (Bio-Plex Protein Assay System, Bio-Rad, USA) was determined using commercial human 27-Plex test systems.
Depending on the degree of change in visual acuity 12 months after the first injection of ranibizumab, all patients were divided into 2 groups - with sufficient effect (increased visual acuity by 0.1 and more) and insufficient effect (visual acuity did not improve).
A comparative analysis of the initial state of patients of two groups was carried out.
Results
53 patients were in the first group with visual acuity improvement from 0.19 to 0.45. In 32 cases for complete resorption of macular edema, 1.0 ranibizumab injection was required. In the 21st case, persistent macular edema and an increase in retinal ischemia required 2.3 intravitreal injections and followed laser treatment.
The second group consisted of 31 patients with an 0.05 initial visual acuity, which was 0.04 after 12 months. During the year, 9.4 intravitreal injections of ranibizumab were performed, which were combined with laser treatment.
Comparative analysis of the initial state of patients of the two groups allowed developing the prognostic criteria for the recovery of visual functions.
Prognostic criteria for a sufficient clinical effect of anti-VEGF therapy for macular edema in retinal vein occlusion:
Prognostic criteria for the insufficient clinical effect of anti-VEGF therapy for macular edema in retinal vein occlusion:
Andrey Shchuko - 1,3, Igor Zlobin - 1, Tatiana Iureva - 1,2
1 - Irkutsk Branch of S. Fyodorov Eye Microsurgery Federal State Institution;
2 - ISMAPgE – Branch Campus of the FSBEI FPE RMACPE MOH Russia;
3 - Irkutsk State Medical University.