Department of Vitreoretina and Ocular Oncology, Sankara Eye Hospital, Bengaluru, Karnataka, India.
Sankara College of Optometry, Bengaluru, Karnataka, India.
Indian J Ophthalmol. 2022 Dec;70(12):4370-4375. doi: 10.4103/ijo.IJO_1330_22.
To assess and analyze the visual outcomes of patients with retinal vein occlusions in a real-world setting with a long-term follow-up of more than 5 years.
Retrospective analysis of 56 patients having retinal vein occlusions from a tertiary eye center, with a mean follow-up of 7 years was performed. Primary outcome measures were mean change in best-corrected visual acuity (BCVA) from baseline at 6 months, 1 year, 2 years, 3 years, and final visit (≥5 years), proportion of patients having BCVA better than 20/40 and worse than 20/200, and mean number of injections. Secondary outcome measures were change in central macular thickness (CMT), development of subsequent retinal vein occlusion (RVO) in same eye or the other eye, and development of neovascular complications.
The mean change in letter score was + 11.84 in branch RVO (BRVO), +7.14 in non-ischemic central RVO (CRVO), and -9.5 in ischemic CRVO at 1 year, which changed to + 8.57, -5 and - 24, respectively, at the end of follow-up. CMT had improved from 506 ± 98.8 μm, 576.44 ± 149 μm, and 618 ± 178.27 μm, respectively, at baseline to 267 ± 94 μm, 345.20 ± 122.61 μm, and 265.50 ± 107.75 μm, respectively, in BRVO, non-ischemic, and ischemic hemi RVO (HRVO)/CRVO groups. The total mean number of injections given in BRVO, non-ischemic CRVO, and ischemic CRVO groups were 4.6, 6.6, and 4.1, respectively. None of the patients with BRVO developed neovascular glaucoma (NVG). Non-ischemic to ischemic HRVO/CRVO conversion was noted in 4/11 eyes at a mean duration of 12.6 months. NVG was noted in 7/9 eyes (77.8%) in initial ischemic CRVO/HRVO group and 3/4 (75%) converted eyes.
Patients with BRVO have good visual outcomes with anti-VEGF, while in CRVO results may vary considerably owing to patient compliance and treatment burden on long-term follow-up in a real-world setting.
在现实环境中进行长期（超过 5 年）随访，评估和分析视网膜静脉阻塞患者的视力结果。
对来自一家三级眼科中心的 56 例视网膜静脉阻塞患者进行回顾性分析，平均随访 7 年。主要观察指标是：6 个月、1 年、2 年、3 年和最后一次就诊（≥5 年）时最佳矫正视力（BCVA）的平均变化；BCVA 优于 20/40 和差于 20/200 的患者比例；以及平均注射次数。次要观察指标是中央视网膜厚度（CMT）的变化、同眼或对侧眼新发视网膜静脉阻塞（RVO）的发生、新生血管并发症的发生。
分支视网膜静脉阻塞（BRVO）的字母评分平均增加 11.84，非缺血性中央视网膜静脉阻塞（CRVO）增加 7.14，缺血性 CRVO 下降 9.5，1 年后分别变为+8.57、-5 和-24，随访结束时分别变为+8.57、-5 和-24。CMT 分别从基线时的 506±98.8μm、576.44±149μm 和 618±178.27μm 改善至 BRVO、非缺血性和缺血性半侧 RVO/CRVO 组的 267±94μm、345.20±122.61μm 和 265.50±107.75μm。BRVO、非缺血性 CRVO 和缺血性 CRVO 组的平均总注射次数分别为 4.6、6.6 和 4.1。BRVO 组无患者发生新生血管性青光眼（NVG）。非缺血性到缺血性 RVO/CRVO 转换发生在 11 只眼中的 4 只（平均 12.6 个月）。初始缺血性 CRVO/HRVO 组的 7/9 只眼（77.8%）和转换眼的 3/4 只眼（75%）发生 NVG。
BRVO 患者接受抗血管内皮生长因子治疗后视力良好，而在 CRVO 中，由于患者依从性和长期随访治疗负担的差异，结果可能有很大差异。
