Macular edema secondary to retinal vein occlusion in a real-life setting: a multicenter, nationwide, 3-year follow-up st
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Macular edema secondary to retinal vein occlusion in a real-life setting: a multicenter, nationwide, 3-year follow-up study Jorge Vasco Costa 1 & Nuno Moura-Coelho 2 & Ana Carolina Abreu 3 & Pedro Neves 4 & Mário Ornelas 4 & Maria João Furtado 3 Received: 27 July 2020 / Revised: 30 August 2020 / Accepted: 10 September 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose To evaluate the presence of macular edema secondary to retinal vein occlusion (RVO)—both central retinal vein occlusion (CRVO) and branch retinal vein occlusion (BRVO)—3 years after diagnosis in patients who underwent intravitreal therapy and to identify potential prognostic factors and biomarkers of persistent macular edema. Methods National multicenter, observational, exploratory, retrospective cohort study of 104 consecutive patients with macular edema secondary to RVO diagnosed from January 2014 to December 2015 with minimum 3-year follow-up time. Data analyzed included best-corrected visual acuity (BCVA), clinical and demographic data, and spectral domain optical coherence tomography parameters. Results At final observation, median baseline central retinal thickness significantly improved from baseline 538 to 290 μm (p < 0.001) and complete macular edema resolution was achieved in 51.0% of patients (56.3% and 42.5% in BRVO and CRVO patients, respectively). BCVA also improved (p < 0.01). Logistic regression analysis revealed a relationship between recurrence of macular edema and disorganization of retinal inner layers (DRIL) at baseline (odds ratio = 2.88; p = 0.013). Conclusion Good long-term anatomical and functional outcomes are achieved with intravitreal treatments in RVO patients. Anatomical success and visual gains seen in the first year were maintained throughout the entire follow-up, though DRIL is a major risk factor for recurrence. Keywords Retinal vein occlusion . Chronic macular edema . Intravitreal injections . Anti-VEGF . Disorganization of retinal inner layers . Vision loss
Introduction Retinal venous occlusion (RVO) is the second most common vision-impairing vascular retinopathy, affecting from 5.2 to 16 per 1000 patients [1, 2] and an estimated 16 million patients around the world [3]. Branch retinal vein occlusion
* Jorge Vasco Costa [email protected] 1
Ophthalmology Department, Hospital de Braga, Sete Fontes – São Vítor, 4710-243 Braga, Portugal
2
Ophthalmology Department, Centro Hospitalar Universitário Lisboa Central, Alameda Santo António dos Capuchos, 1169-050 Lisboa, Portugal
3
Ophthalmology Department, Centro Hospitalar Universitário do Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
4
Ophthalmology Department, Centro Hospitalar de Setúbal, R. Camilo Castelo Branco 175, 2910-549 Setúbal, Portugal
(BRVO) is much more prevalent than central retinal vein occlusion (CRVO) [1]. Macular edema (ME) is a major complication of RVO that results in significant visual impairment [4]. Macular edema treatment modalities include LASER therapy, vitreoretinal sur
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