Changes of Optical Coherence Tomography Biomarkers in Macular Edema Secondary to Retinal Vein Occlusion After Anti-VEGF and Anti-Inflammatory Therapies

Abstract

Purpose This study aimed to assess the short-term changes of macular microstructures following anti-VEGF and anti-inflammatory therapies in patients with macular edema secondary to retinal vein occlusion (RVO-ME). Patients and Methods In this retrospective study, 70 eyes of 70 patients with RVO-ME were divided into the anti-VEGF (Group A, 35 eyes) and anti-inflammatory (Group B, 35 eyes) treatment groups. All patients underwent best-corrected visual acuity (BCVA) assessment, intraocular pressure (IOP) assessment, slit lamp, fundus fluorescein angiography (FA), scanning laser ophthalmoscopy (SLO), and spectral-domain optical coherence tomography (SD-OCT). Group A received intravitreal injection of 0.05 mL anti-VEGF antibodies (Lucentis ® or Aflibercept ® ) monthly for 3 consecutive months, while Group B received 0.7 mg dexamethasone (Ozurdex ® ) single intravitreal injection. BCVA and SD-OCT biomarkers were recorded at baseline and 3 months after the first injection. Changes of BCVA and SD-OCT biomarkers following these treatments were compared between the two groups. Results BCVA and SD-OCT biomarkers, except choroidal thickness, in both groups were significantly improved after treatment (all P < 0.01). At 3 months, the height of serous retinal detachment (SRD) was markedly lower ( P = 0.006), with significantly less hyperreflective dots (HRD, P = 0.037) in Group B compared with Group A. Other SD-OCT biomarkers and BCVA were not significantly different between the two groups (all P > 0.05). Conclusion Anti-VEGF and anti-inflammatory therapies are both effective in RVO-ME, with improvement in BCVA and SD-OCT biomarkers. Anti-inflammatory therapy may be more effective than anti-VEGF therapy in SRD and HRD resolution.

Changes of the Aqueous Cytokine Factors Levels and Optical Coherence Tomography in serous retinal detachment secondary to retinal vein occlusion

“…It has been suggested that dexamethasone implant may be more effective in the early stage of RVO-SRD patients because the morphology of the macula is soon recovered 28 . Anti-VEGF therapy preserved the macular structure and had the better visual outcome in the late stage [28][29][30][31] . Therefore, anti-in ammatory treatment combined with anti-VEGF therapy might be the best choice for RVO-SRD.…”

“…It has been reported that the expression of IL-6 and MCP-1 in aqueous humor in RVO were not affected after injected Ranibizumab 43 .Therefore, we proposed that the upregulation of MCP-1 might in uence the development and recurrence of SRD. Anti-in ammatory therapies may be an important treatment for SRD and could prevent the recurrence of SRD in RVO 28,31 . To improve visual acuity, we recommend anti-in ammatory therapies in combination with the anti-VEGF injection when a high expression of MCP-1 is detected.…”