Importance of Central Retinal Sensitivity for Prediction of Visual Acuity after Intravitreal Bevacizumb in Eyes with Macular Edema Associated with Branch Retinal Vein Occlusion

Abstract

ObjectiveTo determine whether the baseline retinal sensitivity can predict the best-corrected visual acuity (BCVA) at 1 month after intravitreal bevacizumab (IVB) in eyes with macular edema (ME) associated with a branch retinal vein occlusion (BRVO).Subjects and MethodsWe evaluated 16 eyes of 16 patients who had ME associated with a BRVO. The mean ± standard deviation age was 69.1 ± 8.9 years, and all had a single IVB injection. The BCVA, central macular thickness (CMT), integrity of the ellipsoid zone (EZ) of the photoreceptors, and retinal sensitivity were determined before (baseline) and at 1 day, 1 week, and 1 month following the IVB. The average threshold retinal sensitivity (AT) within the central 10° was determined by Macular Integrity Assessment. The correlations between the BCVA at 1 month and the CMT, integrity of the EZ, and AT at each visit were determined.ResultsOne month after IVB, the BCVA improved significantly from 0.56 ± 0.27 logMAR units to 0.32 ± 0.28 logMAR units, and the CMT from 611.4 ± 209.3 μm to 258.7 ± 64.0 μm (P <0.05). The AT improved significantly from 17.9 ± 5.3 dB to 21.2 ± 5.0 dB (P <0.05). At 1 day after the treatment, both the integrity of the EZ (r = 0.59) and the retinal sensitivity (r = 0.76) were moderately correlated with the BCVA at 1 month.ConclusionThese results indicate that both the integrity of the EZ and the AT at 1 day after the IVB can predict the BCVA after treatment for ME associated with BRVO. There is a possibility that these parameters will predict the effectiveness of IVB for each case.

Effectiveness of microperimetry in evaluating anti-vascular endothelial growth factor therapy for diabetic macular edema patients with relatively good vision

“…[ 30 ] These examinations provide different aspects of visual function, and MP has the advantage of assessing additional information in the central area of 10° around the fovea quantitatively. [ 29 , 31 , 32 ] In addition, follow-up examinations have been useful to evaluate the effectiveness of treatments. [ 33 , 34 ] Here, we showed improved of RS in DME patients with comparatively good VA, although the BCVA did not improve significantly for patients with a BCVA >0.7.…”

The usefulness of the retinal sensitivity measurement with a microperimetry for predicting the visual prognosis of branch retinal vein occlusion with macular edema

“…There have been many studies which suggested the usefulness of the anti-VEGF therapy in eyes with BVO with ME [5][6][7][8][15][16][17][18][19]. For instance, Mylonas et al have reported that BCVA improved significantly at 3 months and 12 months after the anti-VEGF therapy in patients with BVO [15].…”

“…Sugimoto et al [8] suggested retinal sensitivity using MAIA at 1 day after the intravitreal bevacizumab was correlated with BCVA at 1 month in patients with BVO. Agreeing with this report [8], our results suggested that the retinal sensitivity at 1 month is a useful predictive factor of BCVA at 3 months, which was consistent with the previous report. More specifically, as a result of model selection, the optimal model for BCVA3m included BCVAbase, ΔBCVA1m, and ΔMS1m or ΔqMS1m.…”

“…In addition, the improvement of visual functional (BCVA and retinal sensitivity) is significantly associated with morphological (OCT-measured retinal thickness) improvement in RVO and ME eyes after the intravitreal anti-VEGF treatment [ 7 ]. Moreover, a recent study suggested that the retinal sensitivity measured with a microperimetry of MAIA (Center Vue, Padova, Italy) 1 day after the anti-VEGF treatment was significantly related with BCVA at 1 month in eyes with BVO with ME, suggesting the potential usefulness of retinal sensitivity in predicting the BCVA prognosis [ 8 ], although it was not investigated whether it is useful to measure retinal sensitivity, in addition to BCVA.…”

New Developments in the Classification, Pathogenesis, Risk Factors, Natural History, and Treatment of Branch Retinal Vein Occlusion

“…The management of macular edema secondary to branch retinal vein occlusion has greatly improved in recent times with the introduction of a therapy based on intravitreal injection of antivascular endothelial growth factor (VEGF) molecules and steroids [69]. Patient outcomes even with identical treatments can be vastly different due to disease, and patient heterogeneity prognostic factors for BRVO include patient age [70], baseline visual acuity and retinal thickness [51, 71, 72], early response to treatment [70], duration of macular edema [73, 74], posterior vitreous detachment [75], OCT characteristic [76–78], cytokine level [34, 79], central retinal sensitivity [80], leaking capillaries and microaneurysms in the perifoveal capillary network [60, 81, 82], retinal pigment epithelium (RPE) integrity [83, 84], serious retinal detachment [85], and subretinal hemorrhage [86]. Some of these prognostic factors are still controversial.…”