J Korean Ophthalmol Soc.  2017 Dec;58(12):1367-1375. 10.3341/jkos.2017.58.12.1367.

Factors Related to Refractory Macular Edema in Branch Retinal Vein Occlusion

• Park JH
• Park JM

• KMID: 2397851
• DOI: http://doi.org/10.3341/jkos.2017.58.12.1367

Abstract

PURPOSE
To evaluate the factors associated with refractory macular edema (ME) secondary to branch retinal vein occlusion (BRVO) after three times of intravitreal bevacizumab (IVB) injections.
METHODS
Ninety eyes of Ninety patients, who were retrospectively reviewed, were treated with IVB of 1.25 mg (0.05 mL) for ME secondary to BRVO, repeated three times at 4-week intervals and then followed-up for at least 4 months after the IVB. The patients were classified as refractory if there was an increase in the mean retinal thickness >150 µm when measured 1 month after the three injections. The patients were divided into two groups: a responsive group (46 eyes) and a refractory group (44 eyes).
RESULTS
In univariate logistic regression analyses, age, diabetes mellitus, hypertension, visual acuity, maximal combined response b wave amplitude (Max B amp), maximal combined response B/A ratio (Max B/A), cone response b wave amplitude, subfoveal choroidal thickness (SFCT), and the number of hyperreflective foci (HF) were risk factors for refractory ME of BRVO (p = 0.045, p = 0.010, p = 0.037, p = 0.034, p = 0.003, p = 0.004, p = 0.001, p = 0.001 and p = 0.001, respectively). In backward multivariate logistic regression analyses, age, Max B amp, Max B/A, SFCT and number of HF were risk factors for refractory ME of BRVO (p = 0.024, p = 0.004, p = 0.047, p = 0.033 and p = 0.049, respectively).
CONCLUSIONS
Baseline age, Max B amp, Max B/A, SFCT and number of HF predicted the probability of refractory ME secondary to BRVO after IVB.

Keyword

Bevacizumab; Branch retinal vein occlusion; Electroretinogram; Hyperreflective foci; Subfoveal choroidal thickness

MeSH Terms

Bevacizumab
Choroid
Diabetes Mellitus
Humans
Hypertension
Logistic Models
Macular Edema*
Retinal Vein Occlusion*
Retinal Vein*
Retinaldehyde*
Retrospective Studies
Risk Factors
Visual Acuity
Bevacizumab
Retinaldehyde

Figure

• 

  Figure 1 Horizontal sectional image of optical coherence tomography (OCT) in macular edema secodary to branch retinal vein occlusion. The OCT shows sparse exudates. Yellow arrow shows exudate smaller than 20 µm, blue arrows show exudates bigger than 40 µm and red arrows show exudates 20 µm to 40 µm, hyperreflective foci.

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