Department of Ophthalmology, Juntendo University Urayasu Hospital, Urayasu City, Japan,
Department of Ophthalmology, Juntendo University Urayasu Hospital, Urayasu City, Japan.
Ophthalmic Res. 2021;64(3):363-368. doi: 10.1159/000512357. Epub 2020 Oct 16.
The role of vascular endothelial growth factor in macular edema (ME) due to branch retinal vein occlusion (BRVO) by enhancing vascular permeability has been well studied. ME due to BRVO often recurs; however, there has been no report on the relationship between this recurrence and choroidal thickness (CT), considering the high vascularity of the choroid. This study was designed to investigate this relationship.
In this retrospective consecutive case series, patients with recurrence of ME within 6 months of receiving intravitreal aflibercept injection treatment for naive ME due to BRVO at Juntendo University Urayasu Hospital were included. Retinal thickness (RT) and CT were measured in the fovea and on the occlusion, non-occlusion, nasal, and temporal sides at baseline, after the first intravitreal aflibercept administration, and before and after recurrence. We also examined the change for each side before and after reinjection.
This study included 11 patients and 11 eyes. The subfoveal CT and RT at baseline were 261.9 ± 93.4 μm and 691.5 ± 254.4 μm, respectively, which significantly decreased to 208.5 ± 70.3 μm and 188.6 ± 33.8 μm, respectively, at 1 month after the first injection (p = 0.001 and p < 0.01, respectively). These values also significantly decreased at all the other sites after treatment. There were 14 recurrences within the 6 months following intravitreal aflibercept injection; RT significantly changed at all sites before and after recurrence and reinjection. CT significantly changed at the subfovea and on the occlusion and non-occlusion sides; however, there was no significant change on the nasal and temporal sides.
In patients with BRVO, the CT around the macula after initial treatment was significantly reduced; however, at the time of ME recurrence and reinjection, there were site-dependent differences in the changes observed in the CT. These findings suggest that the pathologies of ME at initial occurrence and at the time of recurrence are different.
血管内皮生长因子通过增加血管通透性在分支视网膜静脉阻塞（BRVO）引起的黄斑水肿（ME）中起重要作用。BRVO 引起的 ME 经常复发；然而，由于脉络膜的高度血管化，尚未有关于这种复发与脉络膜厚度（CT）之间关系的报道。本研究旨在探讨这种关系。
本回顾性连续病例系列研究纳入了在日本独协医科大学浦安医院接受初次玻璃体内阿柏西普注射治疗 BRVO 引起的单纯性 ME 后 6 个月内 ME 复发的患者。在基线、第一次玻璃体内阿柏西普给药后以及复发前后，在黄斑中心凹和阻塞、非阻塞、鼻侧和颞侧测量视网膜厚度（RT）和 CT。我们还检查了每次侧位在再注射前后的变化。
本研究纳入了 11 名患者的 11 只眼。基线时，黄斑中心凹下 CT 和 RT 分别为 261.9 ± 93.4μm 和 691.5 ± 254.4μm，首次注射后 1 个月分别显著下降至 208.5 ± 70.3μm 和 188.6 ± 33.8μm（p = 0.001 和 p < 0.01）。治疗后所有其他部位的这些值也显著下降。玻璃体内阿柏西普注射后 6 个月内有 14 例复发；RT 在复发前后的所有部位均显著变化，且在再注射后也显著变化。CT 在黄斑中心凹和阻塞、非阻塞侧显著变化；然而，鼻侧和颞侧没有明显变化。
在 BRVO 患者中，初始治疗后黄斑周围 CT 明显减少；然而，在 ME 复发和再注射时，观察到 CT 变化存在部位依赖性差异。这些发现表明，初始发生和复发时 ME 的病理学是不同的。
