Disorganization of the Retinal Inner Layers after Anti-VEGF Treatment for Macular Edema due to Branch Retinal Vein Occlusion

Nakano, Eri; Ota, Toru; Jingami, Yoko; Nakata, Isao; Hayashi, Hisako; Yamashiro, Kenji

doi:10.1159/000490809

Cited by 11 publications

(8 citation statements)

References 22 publications

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“…Alternative or additional pathways may contribute to visual outcomes. Previous studies regarding visual outcomes have focused on the outer layers of the retina, such as the ELM, EZ, and IZ [15][16][17][18]20]. In contrast, there were no significant differences between the recurrence of macular edema and the incidences of ELM or EZ disruption in the current study.…”

Section: Discussioncontrasting

confidence: 81%

“…A recent report stated that disorganization of the retinal inner layer (DRIL) may influence improvement of visual acuity in patients with central retinal vein occlusion (CRVO) or BRVO after 6 intravitreal injections of bevacizumab delivered monthly [19]. Conversely, 2 additional reports have shown that DRIL is not related to visual outcome in BRVO [20,21]. However, these prior studies did not assess recurrence.…”

Section: Introductionmentioning

confidence: 99%

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Predicting recurrences of macular edema due to branch retinal vein occlusion during anti-vascular endothelial growth factor therapy

Suzuki

Nagai

Minami

et al. 2019

Graefes Arch Clin Exp Ophthalmol

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Section: Discussioncontrasting

confidence: 81%

Section: Introductionmentioning

confidence: 99%

Predicting recurrences of macular edema due to branch retinal vein occlusion during anti-vascular endothelial growth factor therapy

Suzuki

Nagai

Minami

et al. 2019

Graefes Arch Clin Exp Ophthalmol

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“…In this study, the blockage of BRVO accounts for 65.52% in the supratemporal area and 34.48% in the infratemporal area. The obstruction was not found in the nasal side, which showed consistency with the proportion reported by Nakano E and Samara WA [ 24 , 25 ].…”

Section: Discussionsupporting

confidence: 91%

Analysis of the Cytokine Expression in the Aqueous Humor of Individuals with BRVO-Associated Macular Edema

Zhu¹,

Pan²,

Qian³

et al. 2022

Journal of Ophthalmology

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Purpose. This study aimed to determine the expression levels of vascular endothelial growth factor (VEGF), interleukin-6 (IL-6), intercellular adhesion molecule-1 (ICAM-1), and vascular cell adhesion molecule-1 (VCAM-1) in the aqueous humor of patients with macular edema (ME) caused by branch retinal vein occlusion (BRVO), as well as to investigate the relationship between the cytokines as mentioned earlier and best-corrected visual acuity (BCVA), ME, and the degree of ME from the molecular level. Methods. In a prospective observational study, fluorescein fundus angiography (FFA) and optical coherence tomography (OCT) were used to classify 58 patients with non-ischemic BRVO-ME into three groups according to the degree of ME: 14-mild, 17-moderate, and 27-severe. The specific concentration of IL-6, VEGF, ICAM-1, and VCAM-1 in the aqueous humor was detected using the BD CSCanto™ II Flow Cytometer (US). Spearman or Pearson correlation analysis was used to test the correlation between the levels of BCVA and severity of ME and the expression levels of IL-6, VEGF, ICAM-1, and VCAM-1 in the aqueous humor. Results. According to the obtained data, BCVA did not correlate with the severity of ME, and these four cytokines expression levels in patients’ aqueous humor ( P > 0.05 ). Moreover, BCVA did not correlate with mild, moderate, or severe ME as well ( P > 0.05 ). However, the levels of these four cytokines were correlated with the severity of the ME. These underlined cytokines were linked to the mild, moderate, and severe degrees of ME. VEGF was also significantly correlated (r > 0.8, P < 0.0001 ) with the severity of ME. Conclusions. This study suggests that the severity of ME in BRVO-ME patients is significantly correlated with the expression levels of IL-6, VEGF, ICAM-1, and VCAM-1 in the aqueous humor. Lowering the level of disease-associated cytokines may potentially reduce the degree of ME. Therefore, an in-depth study of the levels and the relationship may provide some evidence for the pathogenesis, treatment, and prevention of BRVO-ME.

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“…Previously most studies focus on utilizing the loss of baseline indexes such as CMT, disorganization of the retinal inner layer (DRIL), subretinal fluid (SRF), hyperreflective foci (HF), external limiting membrane (ELM), ellipsoid zone (EZ), and interdigitation zone (IZ) to predict the long-term efficacy in RVO-ME (10,(17)(18)(19)(20)(21). However, due to blockade of retinal hemorrhage before treatment, large CMT, and poor ocular fixation due to poor visual function, the quality of the retinal interlayer structure obtained from OCT images is far from satisfactory.…”

Section: Discussionmentioning

confidence: 99%

Two-Week Central Macular Thickness Reduction Rate >37% Predicts the Long-Term Efficacy of Anti-vascular Endothelial Growth Factor Treatment for Macular Edema Secondary to Retinal Vein Occlusion

Zhou

et al. 2022

Front. Med.

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ObjectiveTo determine if the early response assessments can predict the long-term efficacy of anti-vascular endothelial growth factor (VEGF) treatment for macular edema secondary to retinal vein occlusion (RVO-ME).MethodsA retrospective study of patients with diagnosis of RVO-ME and intravitreal anti-VEGF treatment was conducted. Clinical characteristics including age, gender, disease subtype and disease duration were recorded at baseline. The best corrected visual acuity (BCVA and logMAR), intraocular pressure (IOP), and central macular thickness (CMT) were recorded at baseline, 2 weeks, and every month (months 1–6) after injection. Further, we compared the early response assessments between the cured group (6-month CMT ≤ 250 μm) and the uncured group (6-month CMT > 250 μm).ResultsA total of 164 eyes in 164 patients (77 male and 87 female) were included. At each post-injection time point, both BCVA and CMT are significantly decreased from baseline (all P < 0.001). Spearman’s test showed that 2-week CMT reduction rate after the first injection was negatively correlated with BCVA at 6 months (r = −0.359, P < 0.001). Compared with the uncured group (47 cases), the cured group (117 cases) was younger (59.53 ± 11.68 vs. 65.19 ± 13.10 years old, P < 0.01), had more BRVO patients (76.1% vs. 44.7%, P < 0.01), a shorter disease duration (1.92 ± 2.43 vs. 5.05 ± 4.32 months, P < 0.01), lower baseline CMT (527.09 ± 154.95 vs. 768.96 ± 287.75 μm, P < 0.01), and lower baseline BCVA (0.86 ± 0.44 vs. 1.31 ± 0.51, P < 0.01). At each post-injection time point, the cured group had lower CMT and BCVA values when compared to the uncured group (all P < 0.01), and the 2-week CMT reduction rate was identified as the earliest response time to predict the long-term treatment efficacy. Moreover, ROC curve analysis indicated that a 2-week CMT reduction rate >37% yielded the best cut-off point for predicting the long-term cure of anti-VEGF treatment at 6 months (P < 0.001). Multivariable logistic regression confirmed that the 2-week CMT reduction rate >37% was independently associated with the 6-month cured rate (OR = 9.639, 95% Cl = 1.030–90.227, P = 0.047).ConclusionAge, disease duration, baseline CMT, and baseline BCVA are associated with visual outcomes at 6-month of anti-VEGF treatment for RVO-ME. The “2-week CMT reduction rate >37%” after the first injection is an independent factor to predict better long-term outcomes.

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Disorganization of the Retinal Inner Layers after Anti-VEGF Treatment for Macular Edema due to Branch Retinal Vein Occlusion

Cited by 11 publications

References 22 publications

Predicting recurrences of macular edema due to branch retinal vein occlusion during anti-vascular endothelial growth factor therapy

Predicting recurrences of macular edema due to branch retinal vein occlusion during anti-vascular endothelial growth factor therapy

Analysis of the Cytokine Expression in the Aqueous Humor of Individuals with BRVO-Associated Macular Edema

Two-Week Central Macular Thickness Reduction Rate >37% Predicts the Long-Term Efficacy of Anti-vascular Endothelial Growth Factor Treatment for Macular Edema Secondary to Retinal Vein Occlusion

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