Main Article Content
Objective: Aim of this study is to evaluate the changes in peripapillary vessel density (VD) and peripapillary nerve fiber layer thickness (PPRNFL) after intravitreal anti-VEGF injections in patients with Branch Retinal Vein Occlusion (BRVO) with macular edema.
Material and Methods: Sixty eyes of 30 patients with unilateral macular edema due to BRVO who underwent 3 dose loading anti-VEGF treatments were included in the study. The peripapillary capillary vessel density (RPCVD) and PPRNFL were evaluated with optical coherence tomography angiography (OCTA). The measurements were done before and at least one month after a loading dose of anti-VEGF. The measurements of BRVO eyes before treatment were compared with the healthy fellow eyes and the values measured after treatment.
Results: There was a statistical difference between the pre-injection and post-injection periods at the inside disc and peripapillary VD parameters (p<0.001, p=0.01, respectively). Compared with the fellow eyes of the patients, the vessel density in the eyes with BRVO was significantly lower in the whole image, inside the disc, and peripapillary area. (p=0.015, p=0.020, p=0.027, respectively). There was no significant change in PPRNFL values before and after injections. When eyes with BRVO were compared with healthy eyes, eyes with BRVO showed reduced PPRNFL values initially but that was not statistically significant.
Conclusion: Inside disc and peripapillary VD values were increased after injection. Even though anti-VEGF agents may contribute to neurodegeneration, we think that this increase in perfusion prevents possible neurodegeneration.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
2. Kang JW, Yoo R, Jo YH, Kim HC. Correlation of microvascular Structures on Optical Coherence Tomography Angiography with Visual Acuity in Retinal Vein Occlusion. Retina 2017;37:1700-1709.
3. Suzuki N, Hirano Y, Tomiyasu T, Esaki Y, Uemura A, Yasukawa T, et al. Retinal Hemodynamics Seen on Optical Coherence Tomography Angiography before and after treatment of Retinal Vein Occlusion. Invest Ophthalmol Vis Sci. 2016;57:5681-5687.
4. Campochiaro PA, Bhisitkul RB, Shapiro H, Rubio RG. Vascular Endothelial Growth Factor Promotes Progressive Retinal Nonperfusion in Patients with Retinal Vein Occlusion. Ophthalmology 2013;120:795-802.
5. Liu L, Wang Y, Liu HX, Gao J. Peripapillary Region Perfusion and Retinal Nerve Fiber Layer Thickness Abnormalities in Diabetic Retinopathy Assessed by OCT Angiography. Trans Vis Sci Technol 2019;8:14.
6. Wang X, Jiang C, Kong X, Yu x, Sun X. Peripapillary Retinal Vessel Density in Eyes with Acute Primary Angle Closure: An Optical Coherence Tomography Angiography Study. Graefes Arch Exp Ophthalmol. 2017;255:1013-1018.
7. Kim SB, Lee EJ, Han JC, Kee C. Comparison of peripapillary vessel density between preperimetric and perimetric glaucoma evaluated by OCT-Angiography. Plos ONE 2017;12:e0184297.
8. Coscas F, Glacet-Bernard A, Miere A, Caillaux V, Uzzan J, Lupidi M, et al. Optical Coherence Tomography Angiography in Retinal Vein Occlusion: Evaluation of Superficial and Deep Capillary Plexa. Am J Ophthalmol 2016;161:160-171.
9. Seknazi D, Coscas F, Sellam A, Rouimi F, Coscas G, Souied EH, et al. Optical Coherence Tomography Angiography in Retinal Vein Occlusion: Correlations between macular vascular density, visual acuity, and peripheral nonperfusion area on fluorescein angiography. Retina 2018;38:1562-1570.
10. Samara W.A, Shahlaee A, Sridhar J, Khan MA, Ho AC, Hsu J. Quantitative Optical Coherence Tomography Angiography Features and Visual Function in Eyes with Branch retinal vein occlusion. Am J Ophthalmol. 2016;166:76-83.
11. Adhi M, Bonin Filho MA, Louzada RN, Kuehlewein L, De Carlo TE, Baumal CR, et al. Retinal Capillary Network and Foveal Avascular Zone in Eyes with Vein Occlusion and Fellow Eyes Analyzed with Optical Coherence Tomography Angiography. Invest Ophthalmol Vis Sci 2016;59:486-494.
12. Rehak J, Rehak M. Branch retinal vein occlusion: pathogenesis, visual prognosis, and treatment modalities. Curr Eye Res. 2008;33:111-31.
13. Sellam A, Glacet-Bernard A, Coscas F, Miere A, Coscas G, Souied E. Qualitative And Quantitative Follow-up Using Optical Coherence Tomography Angiography Of Retinal Vein Occlusion Treated With Anti-VEGF: Optical Coherence Tomography Angiography Follow-up of Retinal Vein Occlusion. Retina. 2017 Jun;37(6):1176-84.
14. Glacet-Bernard A, Sellam A, Coscas F, Coscas G, Souied EH. Optical Coherence tomography angiography in retinal vein occlusion treated with dexamethasone implant: a new test for follow-up evaluation. Eur J Ophthalmol. 2016; 26:460-8.
15. Mir TA, Kherani S, Hafiz G, Scott AW, Zimmer-Galler I, Wenick AS, et al. Changes in retinal nonperfusion associated with suppression of vascular endothelial growth factor in retinal vein occlusion. Ophthalmology. 2016;123:625-34.
16. Sondell M, Lundborg G, Kanje M. Vascular endothelial growth factor has neurotrophic activity and stimulates axonal outgrowth, enhancing cell survival and Schwann cell proliferation in the peripheral nervous system. J Neurosci 1999 Jul 15;19(14):5731–5740
17. Demirel S, Batioğlu F, Özmert E, Erenler F. The effect of multiple injections of ranibizumab on retinal nerve fiber layer thickness in patients with age-related macular degeneration. Curr Eye Res 2015 Jan;40(1):87–92.
18. Martinez-de-la-Casa JM, Ruiz-Calvo A, Saenz-Frances F, Reche-Frutos J, Calvo-Gonzalez C, Donate-Lopez J, et al. Retinal nerve fiber layer thickness changes in patients with age-related macular degeneration treated with intravitreal ranibizumab. Invest Ophthalmol Vis Sci 2012 Sep 4;53(10):6214–6218.
19. Horsley MB, Mandava N, Maycotte MA, Kahook MY. Retinal nerve fiber layer thickness in patients receiving chronic antivascular endothelial growth factor therapy. Am J Ophthalmol 2010 Oct;150(4):558–561.
20. Shin Y, Nam KY, Lee SE, Lim HB, Lee MW, Jo YJ, et al. Changes in peripapillary microvasculature and retinal thickness in the fellow eyes of patients with unilateral retinal vein occlusion: An OCTA study. Invest Ophthalmol Vis Sci 2019;60:823-829.
21. Moghimi S, Zangwill LM, Penteado RC, Hasenstab K, Ghahari E, Hou H, et al. Macular and optic nerve head vessel density and progressive retinal nerve fiber layer loss in glaucoma. Ophthalmology 2018;125:1720-1728.