An Seoung Hyun, Jeong Woo Jin
Department of Ophthalmology, Dong-A University Hospital, Busan, Republic of Korea.
Eur J Ophthalmol. 2020 Mar;30(2):370-375. doi: 10.1177/1120672119827857. Epub 2019 Feb 5.
To investigate the effect of early-scatter laser photocoagulation on the formation of collateral vessels in branch retinal vein occlusion.
The medical records of 40 cases (40 patients) of branch retinal vein occlusion with macular edema were retrospectively reviewed. Of them, 23 patients were treated with intravitreal bevacizumab injection and 17 patients underwent intravitreal bevacizumab injection with additional laser treatment. Early-scatter laser photocoagulation was applied for capillary non-perfusion areas, regardless of retinal neovascularization. Collateral vessel presence, recurrence rate of macular edema, and number of intravitreal bevacizumab injections were compared between the groups.
During the follow-up period, collateral vessel formation was noted in 10/23 eyes (43.5%) in the intravitreal bevacizumab injection group and 15/17 eyes (88.2%) in the laser combined treatment group ( = 0.004). The recurrence rate of macular edema was lower in the laser combined treatment group (29.4%) than in the intravitreal bevacizumab injection group (65.2%); this difference was statistically significant ( = 0.025). The average numbers of intravitreal bevacizumab injections were 3.57 ± 3.23 in the intravitreal bevacizumab group and 2.14 ± 2.26 in the laser combined treatment group ( = 0.044).
Early-scatter laser photocoagulation promotes collateral vessel formation; the presence of collateral vessels seemed to affect the course of macular edema in branch retinal vein occlusion. Combined early-scatter laser photocoagulation treatment after intravitreal bevacizumab injection lowered the recurrence rate of macular edema and number of intravitreal bevacizumab injections in the cases of branch retinal vein occlusion.
探讨早期散射激光光凝对视网膜分支静脉阻塞时侧支血管形成的影响。
回顾性分析40例（40眼）伴有黄斑水肿的视网膜分支静脉阻塞患者的病历资料。其中23例患者接受玻璃体内注射贝伐单抗治疗，17例患者在玻璃体内注射贝伐单抗的基础上联合激光治疗。无论有无视网膜新生血管，均对毛细血管无灌注区进行早期散射激光光凝。比较两组间侧支血管的存在情况、黄斑水肿复发率及玻璃体内注射贝伐单抗的次数。
随访期间，玻璃体内注射贝伐单抗组10/23眼（43.5%）出现侧支血管形成，激光联合治疗组15/17眼（88.2%）出现侧支血管形成（P = 0.004）。激光联合治疗组黄斑水肿复发率（29.4%）低于玻璃体内注射贝伐单抗组（65.2%）；差异有统计学意义（P = 0.025）。玻璃体内注射贝伐单抗组玻璃体内注射贝伐单抗的平均次数为3.57±3.23次，激光联合治疗组为2.14±2.26次（P = 0.044）。
早期散射激光光凝可促进侧支血管形成；侧支血管的存在似乎影响视网膜分支静脉阻塞时黄斑水肿的病程。玻璃体内注射贝伐单抗后联合早期散射激光光凝治疗可降低视网膜分支静脉阻塞病例中黄斑水肿的复发率及玻璃体内注射贝伐单抗的次数。
