scholarly journals Peripapillary Microvasculature in Branch Retinal Vein Occlusion (BRVO) Treated With Anti-VEGF: An OCTA Study

2020 ◽  
Vol 7 (1) ◽  
pp. 368-372
Author(s):  
Emine Çiloğlu
Keyword(s):  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Branch Retinal Vein Occlusion ◽  
Vessel Density ◽  
Fiber Layer ◽  
Nerve Fiber Layer Thickness ◽  
Vein Occlusion ◽  
Anti Vegf ◽  
Before And After ◽  
Fellow Eyes

Objective: Aim of this study is to evaluate the changes in peripapillary vessel density (VD) and peripapillary nerve fiber layer thickness (PPRNFL) after intravitreal anti-VEGF injections in patients with Branch Retinal Vein Occlusion (BRVO) with macular edema. Material and Methods: Sixty eyes of 30 patients with unilateral macular edema due to BRVO who underwent 3 dose loading anti-VEGF treatments were included in the study. The peripapillary capillary vessel density (RPCVD) and PPRNFL were evaluated with optical coherence tomography angiography (OCTA). The measurements were done before and at least one month after a loading dose of anti-VEGF. The measurements of BRVO eyes before treatment were compared with the healthy fellow eyes and the values measured after treatment. Results: There was a statistical difference between the pre-injection and post-injection periods at the inside disc and peripapillary VD parameters (p<0.001, p=0.01, respectively). Compared with the fellow eyes of the patients, the vessel density in the eyes with BRVO was significantly lower in the whole image, inside the disc, and peripapillary area. (p=0.015, p=0.020, p=0.027, respectively). There was no significant change in PPRNFL values before and after injections. When eyes with BRVO were compared with healthy eyes, eyes with BRVO showed reduced PPRNFL values initially but that was not statistically significant. Conclusion: Inside disc and peripapillary VD values were increased after injection. Even though anti-VEGF agents may contribute to neurodegeneration, we think that this increase in perfusion prevents possible neurodegeneration.

scholarly journals Correlation between macular vessel density and number of intravitreal anti-VEGF agents for macular edema associated with branch retinal vein occlusion

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Ryo Tomita ◽  
Takeshi Iwase ◽  
Kensuke Goto ◽  
Kentaro Yamamoto ◽  
Eimei Ra ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Branch Retinal Vein Occlusion ◽  
Vessel Density ◽  
Intravitreal Injections ◽  
Systemic Hypertension ◽  
Vein Occlusion ◽  
Anti Vegf ◽  
The Mean

Abstract We evaluated whether the reduction of macular vessel density was correlated with the number of intravitreal injections of anti-vascular endothelial growth factor (VEGF) agents in eyes with a branch retinal vein occlusion (BRVO). The mean vessel density was determined by optical coherence tomography angiography in 29 eyes with macular edema associated with a BRVO. Our results showed that the mean vessel density in the group that had a resolution of the macular edema after one anti-VEGF injection was significantly higher than group that had a recurrence of the macular edema (P = 0.028). Single regression analysis showed that the number of intravitreal injections was significantly correlated with the reduction of the modified vessel density (r = −0.421, P = 0.023) and systemic hypertension (r = 0.377, P = 0.044). Multiple stepwise regression analysis showed that the reduction of the modified vessel density (β = −0.442, P = 0.009) and hypertension (β = 0.403, P = 0.016) were independent factors associated with the number of intravitreal injections. We conclude that the vessel density reduction can be used to predict whether recurrences of the macular edema will develop after the initial anti-VEGF injection in eyes with macular edema associated with a BRVO.

scholarly journals Incomplete Treatment Response, Treatment Resistance, Pharmaceutical Changes and Combined Treatments in Branch Retinal Vein Occlusion and Macular Edema

2019 ◽  
pp. 108-111
Keyword(s):  
Macular Edema ◽  
Treatment Response ◽  
Retinal Vein Occlusion ◽  
Branch Retinal Vein Occlusion ◽  
Vision Loss ◽  
Combined Treatment ◽  
Treatment Resistance ◽  
Vein Occlusion ◽  
Anti Vegf ◽  
Incomplete Treatment

Branch retinal vein occlusion (BRVO) is the second most common retinal vascular disease after diabetic retinopathy. Vision loss varies depending on the affected area. The main causes of vision loss in BRVO are macular edema and macular ischemia. Anti-VEGF agents are preferred in the treatment of macular edema due to BRVO because of the increase in visual acuity. Although anti-VEGF therapy provides an early response, in some cases macular edema is resistant to the treatment. In this review, incomplete treatment response, treatment resistance, pharmaceutical changes, and combined treatment are mentioned in cases with BRVO and macular edema.

Treatment of Macular Edema following Branch Retinal Vein Occlusion

2013 ◽  
Vol 06 (02) ◽  
pp. 148 ◽  
Author(s):  
Raafay Sophie ◽  
Peter A Campochiaro ◽  
◽  
Keyword(s):  
Disease Activity ◽  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Branch Retinal Vein Occlusion ◽  
Foveal Avascular Zone ◽  
Rapid Improvement ◽  
Persistent Disease ◽  
Vein Occlusion ◽  
Anti Vegf

Branch retinal vein occlusion (BRVO) is a relatively prevalent cause of reduced vision primarily due to macular edema. Vascular endothelial growth factor (VEGF) is the major stimulator of excessive vascular leakage and also contributes to retinal hemorrhages and progressive retinal nonperfusion (RNP). Progressive RNP results in worsening of retinal ischemia further increasing levels of VEGF, resulting in a positive feedback loop for disease worsening over time. Aggressive early treatment with a specific antagonist of VEGF causes rapid improvement in edema and visual acuity, speeds resolution of hemorrhages, and stabilizes or improves RNP. Therefore, first-line treatment of acute BRVOs is monthly injections of an anti-VEGF agent for at least 6 months. After that, a period of monthly follow up with anti-VEGF treatment, only if there is recurrent edema, can be used to gauge persistent disease activity and the need for grid laser photocoagulation to diffuse leakage in the macula outside the foveal avascular zone. Following grid laser, another period of monthly follow up with anti-VEGF treatment only if there is recurrent edema provides a measure of persistent disease activity, and if frequent injections are still needed to control edema, the benefits and risks for switching to dexamethasone implants should be discussed with the patient.

Branch Retinal Vein Occlusion Causes Topographic Optic Neuropathy and Retrograde Maculopathy

2019 ◽  
Author(s):  
Siqing Yu ◽  
Mathias Abegg ◽  
Xuan Liu ◽  
Martin S. Zinkernagel ◽  
Marion R. Munk ◽  
...  
Keyword(s):  
Ganglion Cell ◽  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Branch Retinal Vein Occlusion ◽  
Plexiform Layer ◽  
Inner Plexiform Layer ◽  
Internal Reference ◽  
Fiber Layer ◽  
Vein Occlusion ◽  
Anterograde Degeneration

Abstract Background To evaluate retinal ganglion cell (RGC) loss and axonal affection in branch retinal vein occlusion (BRVO).Methods 13 eyes of 12 non-glaucomatous BRVO patients were included. Thickness of peripapillary and macular retinal nerve fiber layer (pRNFL, mRNFL), ganglion cell-inner plexiform layer (GCIPL), inner nuclear layer, outer and total retina were measured at baseline and after a mean follow-up of 14 months. We compared the thickness between the affected and their internal reference regions. Additionally, pRNFL thickness was compared between the occluded and the healthy fellow eyes in the 11 unilateral cases.Results Significant degeneration of the pRNFL was observed in the affected sector of the BRVO eyes (P < 0.01 versus reference sector and versus fellow eye). In contrast, mRNFL and GCIPL thickness showed no difference between affected and reference regions and no correlation with pRNFL thickness. Degenerative microcystic macular edema (MME) was present in 25% of the eyes with macular edema following BRVO.Conclusion Axonal degeneration occurs in pRNFL, which suggests that anterograde degeneration is the mechanism of RGC affection in BRVO. Our results emphasized the importance of pRNFL monitoring in BRVO treatment, and considering degenerative MME in persistent edema following BRVO.

scholarly journals OCT angiography features associated with macular edema recurrence after intravitreal bevacizumab treatment in branch retinal vein occlusion

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Kwang-Eon Choi ◽  
Cheolmin Yun ◽  
Jaehyung Cha ◽  
Seong-Woo Kim
Keyword(s):  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Branch Retinal Vein Occlusion ◽  
Intravitreal Bevacizumab ◽  
Intravitreal Bevacizumab Injection ◽  
Vein Occlusion ◽  
Anti Vegf ◽  
Bevacizumab Treatment ◽  
Capillary Plexus ◽  
Endothelial Growth Factor

Abstract We aimed to evaluate the relationship between the capillary abnormalities including nonperfusion area (NPA) in optical coherence tomography angiography (OCTA) images and the recurrence of macular edema (ME) secondary to branch retinal vein occlusion (BRVO) after intravitreal injection of anti-vascular endothelial growth factor (anti-VEGF; bevacizumab). The records of 40 patients who underwent intravitreal bevacizumab injection for ME secondary to BRVO and had at least six months of follow-up were reviewed. Central retinal thickness (CRT; μm) and macular edema type were evaluated prior to treatment. After ME resolution, nonperfusion areas in the 1 mm (NPA1) and 1–3 mm (NPA3) zones on the Early Treatment Diabetic Retinopathy Study (ETDRS) circle within the superficial capillary plexus (SCP) and deep capillary plexus (DCP) were measured using OCTA images. Furthermore, other microvascular abnormalities in the both SCP and DCP were compared between groups. ME recurred in 25 of 40 (62.5%) eyes. The NPA1 of the SCP and DCP (p = 0.002, 0.004, respectively), NPA3 of the SCP and DCP (p = 0.002, 0.008, respectively), and initial CRT (p = 0.022) differed significantly between eyes with and without ME recurrence. In multivariate logistic regression analyses, the NPA1 of the DCP (OR: 344.718; p = 0.029) and NPA3 of the SCP (OR: 4.072; p = 0.018) were significantly associated with ME recurrence. Other microvascular abnormalities were not significantly different between two groups. The central NPA and parafoveal NPA of the SCP in OCTA images correlated strongly with ME recurrence in BRVO patients after intravitreal anti-VEGF injection.

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