Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, Japan.
Department of Ophthalmology, Kagawa University Faculity of Medicine, Kagawa, Japan.
Sci Rep. 2019 Apr 25;9(1):6569. doi: 10.1038/s41598-019-42982-5.
This prospective study examined 58 eyes with branch retinal vein occlusion (BRVO) to investigate the effects of the nonperfusion area (NPA), clinical subtype, and crossing pattern on the 2-year outcomes of ranibizumab therapy for the macular edema (ME). All eyes received three initial monthly injections, followed by additional pro re nata (PRN) injections. The final best corrected visual acuity (BCVA) and ranibizumab injection number were not associated with the macular NPA or total NPA at baseline or month 12, and they showed no significant differences between the clinical subtypes. However, the incidence of neovascular changes was higher in the major BRVO group than in the macular BRVO group (P = 0.030). Twelve and 19 of the 34 eyes with major BRVO exhibited arterial overcrossing and venous overcrossing, respectively. At baseline, the total NPA did not differ according to the crossing pattern, however, the total NPA was significantly larger in the venous overcrossing group at month 12 (P = 0.047). At month 24, the incidence of neovascular changes was higher in the venous overcrossing group (P = 0.030). Following ranibizumab therapy for BRVO-associated ME, the clinical subtype and the arteriovenous crossing pattern may be associated with neovascular changes.
本前瞻性研究检查了 58 只患有分支视网膜静脉阻塞（BRVO）的眼睛，以研究无灌注区（NPA）、临床亚型和交叉模式对雷珠单抗治疗黄斑水肿（ME）的 2 年结果的影响。所有眼睛均接受了三次初始每月注射，随后进行了额外的按需（PRN）注射。最终最佳矫正视力（BCVA）和雷珠单抗注射次数与基线或第 12 个月的黄斑 NPA 或总 NPA 无关，且在不同临床亚型之间无显著差异。然而，主要 BRVO 组的新生血管变化发生率高于黄斑 BRVO 组（P=0.030）。34 只主要 BRVO 眼中有 12 只和 19 只分别出现动脉交叉和静脉交叉。在基线时，根据交叉模式，总 NPA 无差异，但在第 12 个月时静脉交叉组的总 NPA 明显更大（P=0.047）。在第 24 个月时，静脉交叉组的新生血管变化发生率更高（P=0.030）。BRVO 相关 ME 接受雷珠单抗治疗后，临床亚型和动静脉交叉模式可能与新生血管变化有关。
