Nagaoka Taiji, Sogawa Kenji, Yoshida Akitoshi
Department of Ophthalmology, Asahikawa Medical University, Asahikawa, Japan.
Retina. 2014 Oct;34(10):2037-43. doi: 10.1097/IAE.0000000000000172.
To investigate the effect of intravitreal bevacizumab (IVB) injections for macular edema secondary to acute branch retinal vein occlusion on the retinal microcirculation.
The study was a prospective, interventional case series. Central macular thickness using spectral-domain optical coherence tomography and retinal blood flow (RBF) in untreated eyes with macular edema secondary to acute branch retinal vein occlusion in occluded (V1) and opposite venules in affected eyes (V2) and the equivalent venules in contralateral eyes (V3), using laser Doppler velocimetry during follow-up and after IVB injection, were measured.
In 33 eyes with acute branch retinal vein occlusion of <2 months of duration at the first visit, changes in the retinal microcirculation for 1 month was observed; the macular edema improved spontaneously, and the RBF was unchanged in 15 of 33 eyes, and the RBF increased by 23.3% in 18 eyes with persistent macular edema. Twenty-four eyes received an IVB injection (1.25 mg per 0.05 mL). The RBF did not change significantly during follow-up. In 8 of 24 eyes (33%) with improved macular edema 3 months after the treatment, the average RBF values before injection were significantly higher compared with that of eyes with recurrent edema.
One IVB injection might have little effect on the retinal microcirculation in patients with macular edema secondary to acute branch retinal vein occlusion at least 3 months after the injection. However, the increased RBF in the occluded venules before injection might be associated with improved macular edema after the IVB injection.
探讨玻璃体内注射贝伐单抗(IVB)治疗急性视网膜分支静脉阻塞继发黄斑水肿对视网膜微循环的影响。
本研究为前瞻性干预性病例系列研究。使用光谱域光学相干断层扫描测量中心黄斑厚度,并在随访期间及IVB注射后,使用激光多普勒测速仪测量急性视网膜分支静脉阻塞继发黄斑水肿的未治疗眼的阻塞静脉(V1)、患眼对侧小静脉(V2)及对侧眼相应小静脉(V3)的视网膜血流(RBF)。
首次就诊时病程小于2个月的33只急性视网膜分支静脉阻塞眼,观察了1个月内视网膜微循环的变化;黄斑水肿自发改善,33只眼中15只眼的RBF无变化,18只持续性黄斑水肿眼的RBF增加了23.3%。24只眼接受了IVB注射(每0.05 mL含1.25 mg)。随访期间RBF无明显变化。治疗3个月后黄斑水肿改善的24只眼中,8只眼(33%)注射前的平均RBF值显著高于复发水肿眼。
至少在注射后3个月,单次IVB注射对急性视网膜分支静脉阻塞继发黄斑水肿患者的视网膜微循环可能影响不大。然而,注射前阻塞小静脉中RBF的增加可能与IVB注射后黄斑水肿的改善有关。