Department of Ophthalmology, Tokyo Medical University, Tokyo, Japan.
PLoS One. 2023 Jan 3;18(1):e0278968. doi: 10.1371/journal.pone.0278968. eCollection 2023.
To investigate the 2-year healing rate of macular edema (ME) secondary to branch retinal vein occlusion (BRVO) treated initially with intravitreal ranibizumab (IVR) and later combined with other treatment as needed, and the characteristics of refractory cases.
130 patients (130 eyes) with BRVO-ME who received IVR initially were studied. Anti-vascular endothelial growth factor drug was additionally administered when ME relapsed or persisted. Photocoagulation was performed when the non-perfusion area (NPA) was ≥5 disc diameter (DD), and/or when ME relapsed due to microaneurysm. Patients were classified into a healed group [ME resolved in <2 years or mild ME remained without best-corrected visual acuity (BCVA) loss for ≥6 months] or refractory group (ME persisted for ≥2 years).
110 eyes were classified into the healed group, and 20 eyes into the refractory group. The healed group and refractory group had, respectively, mean follow-up periods of 21.2 and 37.4 months, and frequencies of NPA ≥5 DD of 55.5 and 25.0% (p = 0.015). In the healed group, mean BCVA (logMAR) improved significantly compared to baseline in all the periods until 24 months after treatment initiation and at the last visit (p<0.001). In the refractory group, mean BCVA improved significantly compared to baseline until 12 months after treatment initiation (p<0.05 for all periods), but was not significantly different at 18 or 24 months or at the last visit.
In patients with BRVO-ME treated initially with IVR and later given additional treatments as needed, the healing rate was 84.6%. In eyes that healed within 2 years, BCVA improved relative to baseline throughout 24 months and at the last visit. In refractory eyes, BCVA improved only until 12 months, and thereafter deteriorated to baseline level at the last examination.
研究初始接受玻璃体内雷珠单抗（IVR）治疗的分支视网膜静脉阻塞（BRVO）继发黄斑水肿（ME）患者的 2 年愈合率，以及需要时联合其他治疗的愈合率，并探讨难治性病例的特点。
研究了 130 例（130 只眼）接受初始 IVR 治疗的 BRVO-ME 患者。当 ME 复发或持续存在时，给予抗血管内皮生长因子药物。当非灌注区（NPA）≥5 个视盘直径（DD），或由于微动脉瘤导致 ME 复发时，行光凝治疗。将患者分为愈合组[ME 在 2 年内消退或轻度 ME 持续存在但最佳矫正视力（BCVA）无损失≥6 个月]或难治组（ME 持续≥2 年）。
110 只眼归入愈合组，20 只眼归入难治组。愈合组和难治组的平均随访时间分别为 21.2 和 37.4 个月，NPA≥5 DD 的频率分别为 55.5%和 25.0%（p=0.015）。在愈合组，所有治疗开始后 24 个月和最后一次随访时，BCVA（logMAR）均较基线显著改善（p<0.001）。在难治组，治疗开始后 12 个月内，BCVA 较基线显著改善（所有时期均 p<0.05），但 18 个月、24 个月或最后一次随访时无显著差异。
在初始接受 IVR 治疗且随后根据需要给予其他治疗的 BRVO-ME 患者中，愈合率为 84.6%。在 2 年内愈合的眼中，BCVA 从基线开始在 24 个月内和最后一次随访时均得到改善。在难治性眼中，BCVA 仅在 12 个月内改善，此后在最后一次检查时恢复到基线水平。
