The main effective factors for the visual outcome of macular edema secondary to central retinal vein occlusion_Chinese Journal of Ocular Fundus Diseases

Authors：

Xue Cancan ,  Dou Hongliang

Peking University Third Hospital, Peking University Eye Center, Beijing 100191, China;

Corresponding author：

Dou Hongliang, Email: douhl@aliyun.com

Keywords：

Retinal vein occlusion/complications; Macular edema; Vision; Prognostic factors

DOI：

10.3760/cma.j.issn.1005-1015.2018.03.022

Video：

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Abstract Full text Figures/Tables Video References Cited by

Macular edema (ME) secondary to central retinal vein occlusion（CRVO) often cause severe visual impairment. Intravitreal anti-vascular endothelial growth factor agents and steroids can effectively eliminate ME and improve visual function, but the visual outcome is affected by multiple factors. Retinal blood flow, especially the macular microcirculation, has significant correlation with visual outcome. Ischemic CRVO, especially patients with severe damage in the deep and superficial vascular layer of the macular zone, usually have poor visual outcome. In addition, the integrity of the multi-layer retinal structure closely correlates with the visual outcome. Patients with intact ellipsoid zone, external limit membrane beneath the fovea have good visual recovery. Additionally, good baseline visual acuity, positive response to treatment in early phase, young age and timely treatment usually brings about better visual outcome.

Citation： Xue Cancan, Dou Hongliang. The main effective factors for the visual outcome of macular edema secondary to central retinal vein occlusion. Chinese Journal of Ocular Fundus Diseases, 2018, 34(3): 291-295. doi: 10.3760/cma.j.issn.1005-1015.2018.03.022 Copy

1.	Buehl W, Sacu S, Schmidt-Erfurth U. Retinal vein occlusions[J]. Dev Ophthalmol, 2010, 46:54-72.DOI: 10.1159/000320009.
2.	Campochiaro PA, Bhisitkul RB, Shapiro H, et al. Vascular endothelial growth factor promotes progressive retinal nonperfusion in patients with retinal vein occlusion[J]. Ophthalmology, 2013,120(4):795-802.DOI:10.1016/j.ophtha.2012.09.032.
3.	Pulido JS, Flaxel CJ, Adelman RA, et al. Retinal vein occlusions preferred practice Pattern® guidelines[J].Ophthalmology,2016,123(1):182-208.DOI:10.1016/j.ophtha.2015.10.045.
4.	Evaluation of grid pattern photocoagulation for macular edema in central vein occlusion. The Central Vein Occlusion Study Group M report[J]. Ophthalmology,1995,102(10):1425-1433.
5.	A randomized clinical trial of early panretinal photocoagulation for ischemic central vein occlusion. The Central Vein Occlusion Study Group N report[J]. Ophthalmology, 1995, 102 (10):1434-1444.
6.	Haller JA, Bandello F, Belfort RJ, et al. Dexamethasone intravitreal implant in patients with macular edema related to branch or central retinal vein occlusion twelve-month study results [J].Ophthalmology,2011,118(12):2453-2460.DOI:10.1016/j.ophtha.2011.05.014.
7.	Brown DM, Campochiaro PA, Singh RP, et al. Ranibizumab for macular edema following central retinal vein occlusion: six-month primary end point results of a phase Ⅲ study[J]. Ophthalmology,2010,117(6):1124-1133.DOI:10.1016/j.ophtha.2010.02.022.
8.	Brown DM, Heier JS, Clark WL, et al. Intravitreal aflibercept injection for macular edema secondary to central retinal vein occlusion: 1-year results from the phase 3 COPERNICUS study[J]. Am J Ophthalmol,2013,155(3):429-437.DOI:10.1016/j.ajo.2012.09.026.
9.	Korobelnik JF, Holz FG, Roider J, et al. Intravitreal aflibercept injection for macular edema resulting from central retinal vein occlusion: one-year results of the phase 3 GALILEO study[J]. Ophthalmology,2014,121(1):202-208.DOI:10.1016/j.ophtha.2013.08.012.
10.	Campochiaro PA, Hafiz G, Mir TA, et al. Scatter photocoagulation does not reduce macular edema or treatment burden in patients with retinal vein occlusion: the RELATE trial[J]. Ophthalmology,2015,122(7):1426-1437.DOI: 10.1016/j.ophtha.2015.04.006.
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16.	Matsumoto M, Suzuma K, Yamada Y, et al. Retinal blood flow after intravitreal bevacizumab is a predictive factor for outcomes of macular edema associated with central retinal vein occlusion[J]. Retina,2018,38(2):283-291.DOI: 10.1097/IAE.0000000000001531.
17.	Boyer D, Heier J, Brown DM, et al. Vascular endothelial growth factor Trap-Eye for macular edema secondary to central retinal vein occlusion: six-month results of the phase 3 COPERNICUS study[J]. Ophthalmology,2012,119(5):1024-1032.DOI: 10.1016/j.ophtha.2012.01.042.
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1. Buehl W, Sacu S, Schmidt-Erfurth U. Retinal vein occlusions[J]. Dev Ophthalmol, 2010, 46:54-72.DOI: 10.1159/000320009.
2. Campochiaro PA, Bhisitkul RB, Shapiro H, et al. Vascular endothelial growth factor promotes progressive retinal nonperfusion in patients with retinal vein occlusion[J]. Ophthalmology, 2013,120(4):795-802.DOI:10.1016/j.ophtha.2012.09.032.
3. Pulido JS, Flaxel CJ, Adelman RA, et al. Retinal vein occlusions preferred practice Pattern® guidelines[J].Ophthalmology,2016,123(1):182-208.DOI:10.1016/j.ophtha.2015.10.045.
4. Evaluation of grid pattern photocoagulation for macular edema in central vein occlusion. The Central Vein Occlusion Study Group M report[J]. Ophthalmology,1995,102(10):1425-1433.
5. A randomized clinical trial of early panretinal photocoagulation for ischemic central vein occlusion. The Central Vein Occlusion Study Group N report[J]. Ophthalmology, 1995, 102 (10):1434-1444.
6. Haller JA, Bandello F, Belfort RJ, et al. Dexamethasone intravitreal implant in patients with macular edema related to branch or central retinal vein occlusion twelve-month study results [J].Ophthalmology,2011,118(12):2453-2460.DOI:10.1016/j.ophtha.2011.05.014.
7. Brown DM, Campochiaro PA, Singh RP, et al. Ranibizumab for macular edema following central retinal vein occlusion: six-month primary end point results of a phase Ⅲ study[J]. Ophthalmology,2010,117(6):1124-1133.DOI:10.1016/j.ophtha.2010.02.022.
8. Brown DM, Heier JS, Clark WL, et al. Intravitreal aflibercept injection for macular edema secondary to central retinal vein occlusion: 1-year results from the phase 3 COPERNICUS study[J]. Am J Ophthalmol,2013,155(3):429-437.DOI:10.1016/j.ajo.2012.09.026.
9. Korobelnik JF, Holz FG, Roider J, et al. Intravitreal aflibercept injection for macular edema resulting from central retinal vein occlusion: one-year results of the phase 3 GALILEO study[J]. Ophthalmology,2014,121(1):202-208.DOI:10.1016/j.ophtha.2013.08.012.
10. Campochiaro PA, Hafiz G, Mir TA, et al. Scatter photocoagulation does not reduce macular edema or treatment burden in patients with retinal vein occlusion: the RELATE trial[J]. Ophthalmology,2015,122(7):1426-1437.DOI: 10.1016/j.ophtha.2015.04.006.
11. Yeh S, Kim SJ, Ho AC, et al. Therapies for macular edema associated with central retinal vein occlusion: a report by the American Academy of Ophthalmology[J]. Ophthalmology, 2015, 122(4):769-778.DOI: 10.1016/j.ophtha.2014.10.013.
12. Hayreh SS, Podhajsky PA, Zimmerman MB. Natural history of visual outcome in central retinal vein occlusion[J]. Ophthalmology,2011,118(1):119-133.DOI: 10.1016/j.ophtha.2010.04.019.
13. The Central Vein Occlusion Study Group.Natural history and clinical management of central retinal vein occlusion[J]. Arch Ophthalmol,1997,115(4):486-491.
14. Brogan K, Precup M, Rodger A, et al. Pre-treatment clinical features in central retinal vein occlusion that predict visual outcome following intravitreal ranibizumab[J]. BMC Ophthalmol,2018,18(1):37. DOI: 10.1186/s12886-018-0701-x.
15. Gerding H, Mones J, Tadayoni R, et al. Ranibizumab in retinal vein occlusion: treatment recommendations by an expert panel[J]. Br J Ophthalmol,2015,99(3):297-304.DOI: 10.1136/bjophthalmol-2014-305041.
16. Matsumoto M, Suzuma K, Yamada Y, et al. Retinal blood flow after intravitreal bevacizumab is a predictive factor for outcomes of macular edema associated with central retinal vein occlusion[J]. Retina,2018,38(2):283-291.DOI: 10.1097/IAE.0000000000001531.
17. Boyer D, Heier J, Brown DM, et al. Vascular endothelial growth factor Trap-Eye for macular edema secondary to central retinal vein occlusion: six-month results of the phase 3 COPERNICUS study[J]. Ophthalmology,2012,119(5):1024-1032.DOI: 10.1016/j.ophtha.2012.01.042.
18. Ko J, Kwon OW, Byeon SH. Optical coherence tomography predicts visual outcome in acute central retinal vein occlusion[J]. Retina,2014,34(6):1132-1141.DOI: 10.1097/IAE.0000000000000054.
19. Hayreh SS, Klugman MR, Beri M, et al. Differentiation of ischemic from non-ischemic central retinal vein occlusion during the early acute phase[J]. Graefe’s Arch Clin Exp Ophthalmol,1990,228(3):201-217.
20. Casselholmde SM, Kvanta A, Amren U, et al. Optical coherence tomography angiography in central retinal vein occlusion: correlation between the foveal avascular zone and visual acuity [J]. Invest Ophthalmol Vis Sci,2016,57(9):242-246.DOI:10.1167/iovs.15-18819.
21. Balaratnasingam C, Inoue M, Ahn S, et al. Visual acuity is correlated with the area of the foveal avascular zone in diabetic retinopathy and retinal vein occlusion[J]. Ophthalmology, 2016,123(11):2352-2367.DOI: 10.1016/j.ophtha.2016.07.008.
22. Ghashut R, Muraoka Y, Ooto S, et al. Evaluation of macular ischemia in eyes with central retinal vein occlusion: an optical coherence tomography angiography study[J/OL]. Retina, 2017, 2017:E1[2017-06-30].https://insights.ovid.com/pubmed?pmid=28671896. DOI:10.1097/IAE.0000000000001749. [published online ahead of print].
23. Kang JW, Yoo R, Jo YH, et al. Correlation of microvascular structures on optical coherence tomography angiography with visual acuity in retinal vein occlusion[J]. Retina, 2017,37(9): 1700-1709. DOI: 10.1097/IAE.0000000000001749.
24. Chatziralli I, Theodossiadis G, Parikakis E, et al. Long-term anatomical and functional outcomes in patients with ischemic central retinal vein occlusion treated with anti-vascular endothelial growth factor agents[J]. Ophthalmic Res,2017,58(4):203-208.DOI: 10.1159/000462976.
25. Campochiaro PA, Sophie R, Pearlman J, et al. Long-term outcomes in patients with retinal vein occlusion treated with ranibizumab: the RETAIN study[J]. Ophthalmology, 2014, 121(1): 209-219.DOI: 10.1016/j.ophtha.2013.08.038.
26. Heier JS, Campochiaro PA, Yau L, et al. Ranibizumab for macular edema due to retinal vein occlusions: long-term follow-up in the HORIZON trial[J]. Ophthalmology,2012,119(4): 802- 809.DOI:10.1016/j.ophtha.2011.12.005.
27. Bhisitkul RB, Campochiaro PA, Shapiro H, et al. Predictive value in retinal vein occlusions of early versus late or incomplete ranibizumab response defined by optical coherence tomography[J]. Ophthalmology,2013,120(5):1057-1063.DOI:10.1016/j.ophtha.2012.11.011.
28. Moon CH, Ahn SI, Ohn Y, et al. Visual prognostic value of photopic negative response and optical coherence tomography in central retinal vein occlusion after anti-VEGF treatment[J]. Doc Ophthalmol,2013,126(3):211-219.DOI:10.1007/s10633-013-9379-9.
29. Chatziralli I, Theodossiadis G, Chatzirallis A, et al. Ranibizumab for retinal vein occlusion: predictive factors and long-term outcomes in real-life data[J]. Retina,2018,38(3):559-568. DOI:10.1097/IAE.0000000000001579.
30. Fujihara-Mino A, Mitamura Y, Inomoto N, et al. Optical coherence tomography parameters predictive of visual outcome after anti-VEGF therapy for retinal vein occlusion[J]. Clin Ophthalmol,2016,10:1305-1313.DOI: 10.1111/aos.13396.
31. Wolf-Schnurrbusch UE, Ghanem R, Rothenbuehler SP, et al. Predictors of short-term visual outcome after anti-VEGF therapy of macular edema due to central retinal vein occlusion[J]. Invest Ophthalmol Vis Sci,2011,52(6):3334-3337.DOI:10.1167/iovs.10-6097.
32. Cella W, Avila M. Optical coherence tomography as a means of evaluating acute ischaemic retinopathy in branch retinal artery occlusion[J]. Acta Ophthalmol Scand, 2007, 85(7): 799- 801.DOI: 10.1111/j.1600-0420.2007.00936.x.
33. Park SP, Ahn JK, Mun GH. Aqueous vascular endothelial growth factor levels are associated with serous macular detachment secondary to branch retinal vein occlusion[J]. Retina, 2010, 30(2):281-286.DOI:10.1097/IAE.0b013e3181b9f153.
34. Elbay A, Ozdemir H, Koytak A, et al. Intravitreal dexamethasone implant for treatment of serous macular detachment in central retinal vein occlusion[J]. J Ocul Pharmacol Ther, 2017, 33(6):473-479.DOI:10.1089/jop.2016.0187.
35. Gallego-Pinazo R, Dolz-Marco R, Pardo-Lopez D, et al. Ranibizumab for serous macular detachment in branch retinal vein occlusions[J]. Graefe’s Arch Clin Exp Ophthalmol, 2013, 251(1):9-14.DOI: 10.1007/s00417-012-2240-0.
36. Hoeh AE, Ruppenstein M, Ach T, et al. OCT patterns of macular edema and response to bevacizumab therapy in retinal vein occlusion[J]. Graefe’s Arch Clin Exp Ophthalmol, 2010,248(11):1567-1572.DOI: 10.1007/s00417-010-1419-5.
37. Tilgner E, Dalcegio FM, Tuisl M, et al. Macular cystic changes as predictive factor for the recurrence of macular oedema in branch retinal vein occlusion[J]. Acta Ophthalmol, 2017, 95(7):592-596.DOI:10.1111/aos.13396.
38. Honda S, Hirose M, Matsumiya W, et al. Efficacy and visual prognostic factors of intravitreal bevacizumab as needed for macular edema secondary to central retinal vein occlusion[J]. Clin Ophthalmol,2014,8:2301-2305.DOI:10.2147/OPTH.S74888.
39. Pikkel J, Chassid O, Busool Y, et al. Bevacizumab for CRVO associated CME: effect of timing and frequency of injections on final visual outcome[J/OL]. J Ophthalmol, 2013, 2013: 974670[2013-12-04].http://dx.doi.org/10.1155/2013/974670. DOI: 10.1155/2013/974670.
40. Zhang S, An N, Ha W, et al. Factors correlated with the resolution of macular oedema after one dose injection of intravitreal triamcinolone acetonide treatment in branch retinal vein occlusion[J]. J Int Med Res,2016,44(3):685-697.DOI: 10.1177/0300060515617386.
41. Yoon YH, Kim HK, Yoon HS, et al. Improved visual outcome with early treatment in macular edema secondary to retinal vein occlusions: 6-month results of a Korean RVO study[J]. Jpn J Ophthalmol,2014,58(2):146-154.DOI: 10.1007/s10384-014-0305-9.
42. Mcintosh RL, Rogers SL, Lim L, et al. Natural history of central retinal vein occlusion: an evidence-based systematic review[J]. Ophthalmology,2010,117(6):1113-1123.DOI: 10.1016/j.ophtha.2010.01.060.
43. Wai KM, Khan M, Srivastava S, et al. Impact of initial visual acuity on anti-VEGF treatment outcomes in patients with macular oedema secondary to retinal vein occlusions in routine clinical practice[J]. Br J Ophthalmol,2017,101(5):574-579.DOI: 10.1136/bjophthalmol-2016-308727.
44. Januschowski K,Feltgen N, Pielen A,et al. Predictive factors for functional improvement following intravitreal bevacizumab injections after central retinal vein occlusion[J]. Graefe’s Arch Clin Exp Ophthalmol,2017,255(3):457-462.DOI: 10.1007/s00417-016-3471-2.
45. Thach AB, Yau L, Hoang C, et al. Time to clinically significant visual acuity gains after ranibizumab treatment for retinal vein occlusion: BRAVO and CRUISE trials[J]. Ophthalmology,2014,121(5):1059-1066.DOI:10.1016/j.ophtha.2013.11.022.
46. Adelman RA, Parnes AJ, Bopp S, et al. Strategy for the management of macular edema in retinal vein occlusion: the European VitreoRetinal Society macular edema study[J/OL]. Biomed Res Int,2015,2015:870987[2015-01-29].http://dx.doi.org/10.1155/2015/870987. DOI: 10.1155/2015/870987.
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