Dataset Information

Relationship between perifoveal capillaries and pathomorphology in macular oedema associated with branch retinal vein occlusion.

ABSTRACT:

Purpose

To study the relationship between macular ischaemia on fluorescein angiography (FA) and pathomorphology at the foveal centre delineated by spectral-domain optical coherence tomography (OCT) in macular oedema (MO) associated with branch retinal vein occlusion (BRVO).

Methods

One hundred and five consecutive eyes of 105 patients with MO (centre point thickness (CPT) ? 300 ?m) associated with BRVO in which FA using Heidelberg Retinal Angiography 2 and Spectralis OCT were performed on the same day were retrospectively reviewed. We evaluated the foveal pathomorphology using OCT images and the association with macular ischaemia.

Results

Within 1 year from symptom onset, 94 eyes were classified with perfused macula (34 eyes) or non-perfused macula (60 eyes). Eyes with perfused macula had better visual acuity and less CPT than those with non-perfused macula (P=0.024 and P<0.001, respectively). Fourteen eyes with perfused macula had serous retinal detachment (SRD) alone at the presumed foveal centre (SRD type); seven, a sponge-like swelling at that area (retinal swelling type); 11, foveal cystoid spaces alone (cystoid MO (CMO) type), and 2, with both SRD and foveal cystoid spaces (SRD+CMO type). However, 58 eyes with non-perfused macula had foveal cystoid spaces (42 of CMO type and 16 of SRD+CMO type), with a significant association between them (P<0.001). Among 11 eyes with symptoms exceeding 1 year, 6 eyes had perfused macula, and none had the SRD type.

Conclusion

Most eyes without foveal cystoid spaces have perfused macula in MO associated with BRVO.

SUBMITTER: Murakami T

PROVIDER: S-EPMC3376306 | biostudies-literature | 2012 Jun

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Relationship between perifoveal capillaries and pathomorphology in macular oedema associated with branch retinal vein occlusion.

Murakami T T Tsujikawa A A Miyamoto K K Sakamoto A A Ota M M Ogino K K Yoshimura N N

Eye (London, England) 20120601 6

<h4>Purpose</h4>To study the relationship between macular ischaemia on fluorescein angiography (FA) and pathomorphology at the foveal centre delineated by spectral-domain optical coherence tomography (OCT) in macular oedema (MO) associated with branch retinal vein occlusion (BRVO).<h4>Methods</h4>One hundred and five consecutive eyes of 105 patients with MO (centre point thickness (CPT) ≥ 300 μm) associated with BRVO in which FA using Heidelberg Retinal Angiography 2 and Spectralis OCT were perf ...[more]

PMID: 22653519

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Project description:OBJECTIVE:To compare the efficacy and safety of approved treatments for macular oedema secondary to branch retinal vein occlusion (BRVO). DESIGN:Randomised controlled trials (RCTs) evaluating the efficacy and safety of approved treatments for macular oedema secondary to BRVO were identified from an updated systematic review. SETTING:A Bayesian network meta-analysis of RCTs of treatments for macular oedema secondary to BRVO. INTERVENTIONS:Ranibizumab 0.5 mg pro re nata, aflibercept 2 mg monthly (2q4), dexamethasone 0.7 mg implant, laser photocoagulation, ranibizumab+laser, or sham intervention. Bevacizumab and triamcinolone were excluded. OUTCOME MEASURES:Efficacy outcomes were mean change in best corrected visual acuity (Early Treatment Diabetic Retinopathy Study scale) and the percentage of patients gaining ? 15 letters. Safety outcome was the percentage of patients with increased intraocular pressure (IOP)/ocular hypertension (OH). RESULTS:8 RCTs were identified for inclusion with 1743 adult patients. The probability of being the most efficacious treatment at month 6 or 12 based on letters gained was 54% for ranibizumab monotherapy, 30% for aflibercept, 16% for ranibizumab plus laser (adjunctive or prompt), and 0% for dexamethasone implant, laser or sham. The probability of being the most efficacious treatment for patients gaining ? 15 letters was 39% for aflibercept, 35% for ranibizumab monotherapy, 24% for ranibizumab plus laser, 2% for dexamethasone implant, and less than 1% for laser or sham. There was no statistical difference between ranibizumab monotherapy and aflibercept for letters gained (+1.4 letters for ranibizumab vs aflibercept with 95% credible interval (CrI) of -5.2 to +8.5 letters) or the OR for gaining ? 15 letters: 1.06 (95% CrI 0.16 to 8.94)). Dexamethasone implant was associated with significantly higher IOP/OH than antivascular endothelial growth factor agents (OR 13.1 (95% CrI 1.7 to 116.9)). CONCLUSIONS:There was no statistically significant difference between ranibizumab and aflibercept.

Project description:ObjectiveTo indirectly compare aflibercept, bevacizumab, dexamethasone, ranibizumab and triamcinolone for treatment of macular oedema secondary to central retinal vein occlusion using a network meta-analysis (NMA).Design nma data sourcesThe following databases were searched from January 2005 to March 2013: MEDLINE, MEDLINE In-process, EMBASE; CDSR, DARE, HTA, NHSEED, CENTRAL; Science Citation Index and Conference Proceedings Citation Index-Science.Eligibility criteria for selecting studiesOnly randomised controlled trials assessing patients with macular oedema secondary to central retinal vein occlusion were included. Studies had to report either proportions of patients gaining ?3 lines, losing ?3 lines, or the mean change in best corrected visual acuity. Two authors screened titles and abstracts, extracted data and undertook risk of bias assessment. Bayesian NMA was used to compare the different interventions.ResultsSeven studies, assessing five drugs, were judged to be sufficiently comparable for inclusion in the NMA. For the proportions of patients gaining ?3 lines, triamcinolone 4?mg, ranibizumab 0.5?mg, bevacizumab 1.25?mg and aflibercept 2?mg had a higher probability of being more effective than sham and dexamethasone. A smaller proportion of patients treated with triamcinolone 4?mg, ranibizumab 0.5?mg or aflibercept 2?mg lost ?3 lines of vision compared to those treated with sham. Patients treated with triamcinolone 4?mg, ranibizumab 0.5?mg, bevacizumab 1.25?mg and aflibercept 2?mg had a higher probability of improvement in the mean best corrected visual acuity compared to those treated with sham injections.ConclusionsWe found no evidence of differences between ranibizumab, aflibercept, bevacizumab and triamcinolone for improving vision. The antivascular endothelial growth factors (VEGFs) are likely to be favoured because they are not associated with steroid-induced cataract formation. Aflibercept may be preferred by clinicians because it might require fewer injections.Systematic review registrationNot registered.

Dataset Information

Relationship between perifoveal capillaries and pathomorphology in macular oedema associated with branch retinal vein occlusion.

Purpose

Methods

Results

Conclusion

Publications

Relationship between perifoveal capillaries and pathomorphology in macular oedema associated with branch retinal vein occlusion.

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