Importance of Central Retinal Sensitivity for Prediction of Visual Acuity after Intravitreal Bevacizumb in Eyes with Macular Edema Associated with Branch Retinal Vein Occlusion

<div><p>Objective</p><p>To determine whether the baseline retinal sensitivity can predict the best-corrected visual acuity (BCVA) at 1 month after intravitreal bevacizumab (IVB) in eyes with macular edema (ME) associated with a branch retinal vein occlusion (BRVO).</p><p>Subjects and Methods</p><p>We evaluated 16 eyes of 16 patients who had ME associated with a BRVO. The mean ± standard deviation age was 69.1 ± 8.9 years, and all had a single IVB injection. The BCVA, central macular thickness (CMT), integrity of the ellipsoid zone (EZ) of the photoreceptors, and retinal sensitivity were determined before (baseline) and at 1 day, 1 week, and 1 month following the IVB. The average threshold retinal sensitivity (AT) within the central 10° was determined by Macular Integrity Assessment. The correlations between the BCVA at 1 month and the CMT, integrity of the EZ, and AT at each visit were determined.</p><p>Results</p><p>One month after IVB, the BCVA improved significantly from 0.56 ± 0.27 logMAR units to 0.32 ± 0.28 logMAR units, and the CMT from 611.4 ± 209.3 μm to 258.7 ± 64.0 μm (<i>P</i> <0.05). The AT improved significantly from 17.9 ± 5.3 dB to 21.2 ± 5.0 dB (<i>P</i> <0.05). At 1 day after the treatment, both the integrity of the EZ (r = 0.59) and the retinal sensitivity (r = 0.76) were moderately correlated with the BCVA at 1 month.</p><p>Conclusion</p><p>These results indicate that both the integrity of the EZ and the AT at 1 day after the IVB can predict the BCVA after treatment for ME associated with BRVO. There is a possibility that these parameters will predict the effectiveness of IVB for each case.</p></div

Correlation between final best-corrected visual acuity in logMAR units and parameters at early state.

<p>Correlation between final best-corrected visual acuity in logMAR units and parameters at early state.</p

Demographic data of short pulse duration PC group and conventional PC group.

<p>Data are shown as the mean ± standard deviation. Unpaired t-test or Chi-squared test was used to compare between the groups. eGFR, estimated glomerular filtration rate; PRP, pan-retinal photocoagulation; VH, vitreous hemorrhage; DME, diabetic macular edema; PDR, proliferative diabetic retinopathy; RD, retinal detachment; PEA + IOL, phacoemulsification and IOL implantation.</p><p>*<i>P</i> < 0.05.</p><p>Demographic data of short pulse duration PC group and conventional PC group.</p

Fundus photograph of eye after short pulse duration high-power laser PC on postoperative day 1.

<p>Small PC spots of short pulse duration high power laser PC are seen (black arrow heads). Spot size during surgery was determined to be strong enough to cause a white spot. The degenerated spots are due to photocoagulation created at an outpatient clinic before being examined in our clinic (white arrow heads).</p

Laser flare cell values before, and at 1 day, 1 week, 4 week, and 12 weeks postoperatively for the short pulse duration PC group and the conventional PC group.

<p>The laser flare cell values were significantly lower in the short pulse duration PC group than in the conventional PC group at 1 week, 4 weeks and 12 weeks <i>(P <</i>0.05). Data are presented as Box–whisker plot and analyzed with Unpaired <i>t</i> tests.</p

Areas of macular area assessed by Macular Integrity Assessment (MAIA) to obtain retinal sensitivity map.

<p>Thirty-seven sites within the 10° central area were assessed. The average of the 37 points was used as the retinal sensitivity for the statistical analyses.</p

Data of laser photocoagulation (PC) in short pulse duration PC group and conventional PC group during surgery.

<p>Data are expressed as the means ± standard deviations. Unpaired t-tests were used to determine the significance of differences between two groups.</p><p>*<i>P</i> < 0.05.</p><p>Data of laser photocoagulation (PC) in short pulse duration PC group and conventional PC group during surgery.</p