To determine the relationship between the clinical findings and the response to ranibizumab therapy in eyes with macular edema associated with branch retinal vein occlusion.
We reviewed the medical records of 68 patients with macular edema associated with a branch retinal vein occlusion. The patients were placed in the refractory group if the central foveal thickness remained more than 250 μm throughout the 6-month study period despite the ranibizumab therapy; otherwise, they were placed in the responsive group.
Sixty (88.2%) of 68 eyes were placed in the responsive group and the other 8 eyes (11.8%) were placed in the refractory group. At the pretreatment examination, fluorescein angiography showed extensive leakage from occluded vessels in 52 (86.7%) of the 60 eyes in the responsive group and focal leakages from microaneurysms or dilated capillaries in the other 8 eyes (13.3%). In the refractory group, 7 (87.5%) of 8 eyes had only focal leakage and 1 eye (12.5%) had extensive leakage (P < 0.0001). The mean initial subfoveal choroidal thickness in the eyes with branch retinal vein occlusion in the responsive group was significantly thicker than that in the fellow eyes (278.0 ± 90.5 μm, 249.9 ± 94.4 μm; P < 0.0001). On the other hand, the mean initial subfoveal choroidal thickness in the refractory group was not significantly different from that of the fellow eyes (P = 0.4002).
The dye leakage pattern in the fluorescein angiography images and choroidal thickness may be associated with response to ranibizumab therapy.
Eyes with only focal leakages from microaneurysms or dilated capillaries in the fluorescein angiographic images tend to resist an intravitreal ranibizumab injection for macular edema associated with a branch retinal vein occlusion.
Department of Ophthalmology, Tokyo Women's Medical University, Shinjuku, Tokyo, Japan.
Reprint requests: Taiji Hasegawa, MD, Department of Ophthalmology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan; e-mail: firstname.lastname@example.org
T. Hasegawa, I. Maruko, H. Koizumi, and T. Iida received lecture fees from several companies, including Novartis Pharma K.K, Santen Pharmaceutical Inc., Bayer Yakuhin. I. Maruko, H. Koizumi, and T. Iida received financial support from Pfizer, Novartis Pharma K.K, Bayer Yakuhin. The remaining author has no any financial/conflicting interests to disclose