Abstract:AIM: To observe the the effect of vitreomacular adhesion on the anti- vascular endothelial growth factor(VEGF)treatment in patients with macular edema(ME)induced by branch retinal vein occlusion(BRVO).
METHODS: A retrospective clinical study. Totally 58 patients(60 eyes)were induced in this study during April 2014 to May 2016, who were diagnosed with macular edema due to branch retinal vein occlusion. All subjects were assigned to 2 groups according to the examination of optical coherence tomography(OCT): combined with vitreomacular adhesion groups(Group A)and uncombined with vitreomacular adhesion groups(Group B). The basic situation of the two groups was as follows: Group A: 23 cases(24 eyes), the average age was 55.91±7.34, the mean disease course was 3.4±1.01mo, the mean macular central retinal thickness(CMT)was 463.26±53.73μm and the average BCVA was 0.63±0.11; Group B: 35 cases(36 eyes), the average age was 56.33±5.34, the mean disease course was 2.82±1.33mo, the mean CMT was 482.90±37.43μm and the average BCVA was 0.59±0.12. All cases received vitreous injection of 0.5mg Conbercept. Injections were repeated based on the visual changes and the OCT findings. The follow-up time was more than 6mo. BCVA, CMT, and the numbers of injections of two groups were recorded at pre-operation and postoperative 1, 6mo and the statistical analysis was conducted.
RESULTS: BCVA and CMT of the most patients were improved compared to prior treatment and the difference had statistical significance(P<0.05). There were significant differences on CMT between two groups at 1 and 6mo after treatment(t=9.13, 10.01; P<0.05). While BCVA between two groups at 1 and 6mo after treatment was not statistically different(t=2.13, 5.32; P>0.05). At 6mo after treatment, the average numbers of injections in combined vitreomacular adhesion groups were 4.38±0.97 times and the average numbers of injections in uncombined vitreomacular adhesion groups were 3.56±0.71 times. The difference had statistical significance(t=4.56, P<0.05). Systematic adverse reactions and persistent intraocular pressure elevation, retinal detachment, endophthalmitis, vitreous hemorrhage were never found in the follow-up period.
CONCLUSION: Vitreous injection of anti-VEGF treatment for macular edema induced by branch retinal vein occlusion has good clinical results. However, if there is merged with vitreomacular adhesion at the same time, the treatment effect of anti-VEGF will be weakened to some extent.