Zhao Lin, Li Bingzhen, Feng Kang, Han Liang, Ma Zhizhong, Liu Yuling
Department of Ophthalmology, Peking University Third Hospital; Peking University Eye Center, Key Laboratory of Vision Loss and Restoration, Ministry of Education , Beijing , P.R. China.
Curr Eye Res. 2015 Jul;40(7):752-6. doi: 10.3109/02713683.2014.952827. Epub 2014 Oct 20.
The purpose of this study was to compare the efficacy of intravitreal bevacizumab (IVB) in the treatment of acute (<3 months [mo]. duration) macular edema (ME), with or without subretinal hemorrhage (SRH), resulting from branch retinal vein occlusion (BRVO).
We conducted a retrospective review of 33 consecutive patients (n = 33 eyes) with ME caused by acute BRVO. All patients received an injection of IVB at baseline examination. All patients were followed monthly, with administration of additional IVB injections if there was persistent or recurrent ME. Specific patterns of ME were investigated using spectral-domain optical coherence tomography (SD-OCT).
SD-OCT revealed serous retinal detachments in the fovea of 15 eyes, 10 of which had accompanying foveal SRH. Based on initial detection of foveal SRH, patients were divided into SRH-negative (n = 23 eyes) or SRH-positive (n = 10 eyes) groups. Initial best-corrected visual acuity (BCVA) did not differ between the two groups. In the SRH-negative group, both BCVA and central macular thickness (CMT) improved significantly after IVB injections (mean, 2.3 injections) at the 6-mo. follow-up examination. In the SRH-positive group, there was no significant improvement in BCVA after IVB injections (mean, 2.0 injections), although there was a significant decrease in CMT. The final BCVA of the SRH-positive group was significantly poorer than that of the SRH-negative group (p = 0.001).
The presence of foveal SRH may be a negative predictor of IVB treatment outcomes for BRVO patients with ME.
本研究旨在比较玻璃体内注射贝伐单抗（IVB）治疗视网膜分支静脉阻塞（BRVO）所致急性（病程<3个月）黄斑水肿（ME）伴或不伴视网膜下出血（SRH）的疗效。
我们对33例连续性急性BRVO所致ME患者（n = 33只眼）进行了回顾性研究。所有患者在基线检查时接受IVB注射。所有患者每月随访一次，若存在持续性或复发性ME，则给予额外的IVB注射。使用频域光学相干断层扫描（SD-OCT）研究ME的特定模式。
SD-OCT显示15只眼的黄斑中心凹有浆液性视网膜脱离，其中10只伴有黄斑中心凹SRH。根据黄斑中心凹SRH的初始检测情况，将患者分为SRH阴性组（n = 23只眼）和SRH阳性组（n = 10只眼）。两组的初始最佳矫正视力（BCVA）无差异。在SRH阴性组，IVB注射（平均2.3次注射）后，6个月随访时BCVA和中心黄斑厚度（CMT）均显著改善。在SRH阳性组，IVB注射（平均2.0次注射）后BCVA无显著改善，尽管CMT有显著下降。SRH阳性组的最终BCVA显著低于SRH阴性组（p = 0.001）。
黄斑中心凹SRH的存在可能是BRVO合并ME患者IVB治疗结果的负性预测指标。
