Real – life functional impact of baseline anatomical biomarkers in retinal edema secondary to branch vein occlusion treated with Dexamethasone implant.

Author: Clara Monferrer-Adsuara (Spain)

Co-authors: Verónica Castro-Navarro, Lidia Remolí- Sargues, Catalina Navarro- Palop, Javier Montero-Hernández, Enrique Cervera-Taulet

Purpose

To analyze functional impact of baseline anatomical biomarkers and anatomical outcomes among ME (macular edema) in BRVO (branch retinal vein occlusion) treated with a single Dexamethasone implant (DEX).

Setting/Venue

Retrospective study performed in Hospital General de Valencia (Spain)

Methods

Forty eyes with ME secondary to BRVO treated with DEX implant were analyzed. Among them, n=19 were naïve and n=21 were previously treated with antivascular endothelial growth factor (antiVEGF). SD-OCT images performed at baseline assessed the presence of various morphologic features including the presence of subretinal fluid (SRF), cystoid changes in the outer nuclear layer (ONL) and in the inner nuclear layer (INL); presence of disorganization of retinal inner layers (DRIL), presence of hyperreflective foci (HRF) (number and location); and external limiting membrane (ELM) continuity. Other examinations included best corrected visual acuity (BCVA) and macular thickness (CMT) at 2, 4 and 6 months. Statistical significance was defined as (p<0.05).

Results

BCVA improved from 57.58±19.7 ETDRS to 64.83±17.46 at 2 months (p=0.001), to 62.74±19.37 ETDRS at 4 months (p=0.12) and to 61.67± 20.02 ETDRS at 6 months (p=0.104) and CMT changed from 498.58 ± 165.35 to 317.97 ± 127.62µ (p=0.00) at deadline. Anatomical biomarkers were assessed at baseline. The presence of SRF was found in 22 eyes (55%). Cystoid changes in the ONL appeared in 6 eyes (15%), while 33 of the eyes (82.5%) presented IRF in the ONL/INL. DRIL was present in 20 eyes (50%). Fourteen eyes presented less than 10 HRF, 16 among 10-20HRF and 10 more than 20HRF. HRF were located in 30% of the patients in INL, in 2,5% in ONL and in 67.5% of among all the retinal layers. Regarding the MLE an intact MLE was found in 11 eyes (27.5%), partially disrupted in 18 eyes (45%) and disrupted in 11 eyes (27.5%). A significant correlation was found between final BCVA and BCVA (Rs=-0.424, p=0.007), DRIL (Rs=-0.456, p=0.004) and MLE discontinuity (Rs=-0.411, p=0.009).

Conlusions

DEX implant is effective for ME in BRVO with sustained functional and morphologic gains in the first 6 months. Anatomical baseline biomarkers such as DRIL presence or MLE integrity may influence the prognosis.

Financial Disclosure

none

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