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TIME COURSE OF CHANGES IN METAMORPHOPSIA FOLLOWING INTRAVITREAL RANIBIZUMAB INJECTION FOR BRANCH RETINAL VEIN OCCLUSION

Sugiura, Yoshimi, MD; Okamoto, Fumiki, MD; Morikawa, Shohei, MD; Okamoto, Yoshifumi, MD; Hiraoka, Takahiro, MD; Oshika, Tetsuro, MD

doi: 10.1097/IAE.0000000000001740
Original Study

Purpose: To evaluate the effects of intravitreal ranibizumab injection (IVR) on metamorphopsia in patients with branch retinal vein occlusion (BRVO) and to assess the relationship between retinal microstructure and metamorphopsia.

Methods: Subjects were 39 eyes of 39 patients with branch retinal vein occlusion. The severity of metamorphopsia was quantified using the M-CHARTS before and 1, 2, 3, 4, 5, and 6 months after treatment. Based on optical coherence tomography (OCT) images, we assessed central retinal thickness (CRT) and status of the external limiting membrane (ELM) and ellipsoid zone (EZ). The association between retinal microstructure and metamorphopsia was analyzed in 24 eyes with treatment-naïve branch retinal vein occlusion.

Results: Intravitreal ranibizumab injection treatment significantly improved best-corrected visual acuity (BCVA) and central retinal thickness (P < 0.0001, P < 0.0001, respectively), but metamorphopsia did not improve by treatment. Posttreatment metamorphopsia scores showed a significant correlation with duration of symptoms (P < 0.05) and pretreatment metamorphopsia scores (P < 0.01). Posttreatment metamorphopsia score was significantly worse in patients with disruption of external limiting membrane (P < 0.05).

Conclusions: In patients with branch retinal vein occlusion, intravitreal ranibizumab injection treatment significantly improved best-corrected visual acuity and central retinal thickness, but not metamorphopsia. The severity of posttreatment metamorphopsia was significantly associated with duration of symptoms, degree of pretreatment metamorphopsia, and posttreatment integrity of external limiting membrane.

In patients with branch retinal vein occlusion, visual acuity and central retinal thickness were significantly improved by intravitreal ranibizumab injection, but metamorphopsia was not improved. The severity of posttreatment metamorphopsia was significantly associated with duration of symptoms, degree of pretreatment metamorphopsia, and posttreatment integrity of external limiting membrane.

Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan.

Reprint requests: Yoshimi Sugiura, MD, Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki, 305-8575 Japan; e-mail: yoshimis@md.tsukuba.ac.jp

None of the authors has any financial/conflicting interests to disclose.

Conception and Design of the study (Y.S., F.O.); Analysis and interpretation (Y.S., F.O.); Writing the article (Y.S., F.O.); Critical revision of the article (T.O.); Final approval of the article (Y.S., F.O., Y.O., T.H., T.O.); Data collection (Y.S.).

The authors have no individual or family investments, stock or business ownership exceeding 1% of a company's worth, consulting, retainers, patents, or other commercial interests in the product or company described in the current article. There is no involvement in the marketing of any product, drug, instrument, or piece of equipment discussed in the manuscript that could cause or be perceived to be a conflict of interest.

© 2018 by Ophthalmic Communications Society, Inc.