Author: Aylin Karalezli (Turkey)
Co-authors: Cansu Kaya, Sema Kaderli, Sabahattin Sul
Purpose
To compare the effect of intravitreal ranibizumab (IVR) or intravitreal dexamethasone implants (IVD) on regression of hyperreflective dots (HRDs) in branch retinal vein occlusion (BRVO).
Setting/Venue
Mugla Sitki Kocman University
Methods
37 eyes of 37 patients with cystoid macular edema who received IVR or IVD for at least 12 months were included in this study. The patients were divided into three groups according to intravitreal treatment. Group1 consisted 12 eyes who received only IVD, group 2 consisted 10 eyes who received only IVR and group3 consisted 15 eyes who received both IVD and IVR. IVD implant was administered at baseline, month 3, and month 6 in group1 and group 3. OCT parameters (CMT, number of HRDs) and best-corrected visual acuity (BCVA) were compared between the groups and over the follow-up time. HRDs were categorized as HRD in inner retinal layers (from the internal limiting membrane to the inner nuclear layer) or HRD in outer retinal layers (from the outer plexiform layer to the outer border of the photoreceptor layer).
Results
There was no significant difference between groups in terms of BCVA, CMT, HRDs in the inner retinal layers and the outer retinal layers at baseline. (For all p˃0.05) Compared to the baseline values in all groups, a significant decrease was observed in CMT in the first year. (For group 1; p=0.013, group 2; p=0.010; group 3, p<0.001) The BCVA was significantly increased after 1 year in group1 and group3. (p=0.001, p<0.001) The mean number of HRDs in inner and outer retinal layers were significantly decreased in group 1 and group 3. (For p=0.001, p=0.008 for group 3; p=0.001, p=0.008) However, there was no significant change in terms of the mean number of HRDs in inner and outer retinal layers group 2. (p=0.496, p=0.06) At the first year, the CMT and number of HRDs in inner and outer retinal layers was significantly lower in group1 and group 3 than group 2. (p=0.03, p=0.001, p=0.001) The BCVA was higher in group 1 and group 3 than in group2. (p<0.001). There was no significant difference in terms of post treatment CMT and the number of HRDs between group 1 and group 3 in posthoc tests(p=0.621, p=0.571, and p=0.831).
Conlusions
The reduction in HRDs at 12 months and better BCVA after IVD intimates that the HRDs should be considered as inflammatory markers in the follow-up of CME in BRVO. Thus, IVD injection could be more appropriate for patients with higher HRDs after BRVO.
Financial Disclosure
no financial disclosure
Comments
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