Department of Ophthalmology, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka, 573-1191, Japan.
BMC Ophthalmol. 2023 Sep 20;23(1):385. doi: 10.1186/s12886-023-03138-2.
Intravitreal anti-vascular endothelial growth factor (VEGF) is a mainstream treatment for reducing ME secondary to BRVO (BVO-ME). Regrettably, most reports of intravitreal anti-VEGF for BVO-ME have disclosed only short-term outcomes. Here, we characterized long-term indicators for the visual prognosis of patients with BVO-ME, including the correlation between retinal structure by OCT and visual acuity.
Patients with BVO-ME were retrospectively recruited based on clinical records in Kansai Medical University Hospital from June 2012 to March 2022. This study enrolled patients with vision loss who received intravitreal injection of anti-VEGF for BVO-ME. Inclusion criteria were that patients received intravitreal injection of anti-VEGF as their first treatment and were followed for at least 36 months. Exclusion criteria were those patients with ocular disease other than BRVO or who had been previously treated for BVO-ME. Patients were divided into two groups according to BCVA at the final visit: Group A (≥ 0.7) and Group B (< 0.7).
Forty-seven eyes from 45 patients were assessed. The mean follow-up period from initial to final visit was 64.38 ± 15.07 (range, 38-100) months. BCVA in Group A (n = 32) was significantly greater than in Group B (n = 15) at all timepoints. The ratio that the number of eyes which the EZ band and the foveal bulge were intact in Group A was higher than in Group B (p = 0.0004 and p = 0.0002, respectively). The ratio that the number of eyes which recurrence SRD was observed by the final visit in Group A was lower than in Group B (p = 0.0485).
The integrity of the EZ band and an intact foveal bulge were significant predictors for visual acuity. In contrast, recurrent SRD led to poor visual acuity in the long term, even if BCVA was good in the short term.
玻璃体内抗血管内皮生长因子（VEGF）是减少 BRVO（BVO-ME）引起的 ME 的主流治疗方法。遗憾的是，大多数关于 BVO-ME 的玻璃体内抗 VEGF 的报告仅披露了短期结果。在这里，我们描述了 BVO-ME 患者的长期视力预后指标，包括 OCT 视网膜结构与视力之间的相关性。
根据 2012 年 6 月至 2022 年 3 月在关西医科大学医院的临床记录，回顾性招募了 BVO-ME 患者。本研究纳入了因 BVO-ME 接受玻璃体内抗 VEGF 注射而导致视力下降的患者。纳入标准为患者接受玻璃体内抗 VEGF 注射作为其首次治疗，并至少随访 36 个月。排除标准为除 BRVO 以外的眼部疾病或曾接受过 BVO-ME 治疗的患者。根据最终随访时的 BCVA 将患者分为两组：A 组（≥0.7）和 B 组（<0.7）。
评估了 45 名患者的 47 只眼。从初始到最终随访的平均随访时间为 64.38±15.07（范围，38-100）个月。A 组（n=32）的 BCVA 在所有时间点均显著大于 B 组（n=15）。A 组中 EZ 带和黄斑隆凸完整的眼数比例高于 B 组（p=0.0004 和 p=0.0002）。A 组中最终随访时观察到复发性 SRD 的眼数比例低于 B 组（p=0.0485）。
EZ 带的完整性和黄斑隆凸的完整是视力的显著预测指标。相比之下，即使短期内 BCVA 良好，长期来看复发性 SRD 也会导致视力不佳。
