Six-month results of intravitreal ranibizumab for macular edema after branch retinal vein occlusion in a single-center prospective study: visual outcomes and microaneurysm formation

Figures & data

Table 1 Baseline characteristics

Age (years; mean±SD)	67.7±10.1
Gender (male/female)	6/14
Subtype (major/macular)	10/10
Ischemic/nonischemic	10/10
Time of initial injection from symptoms (months; mean±SD)	1.80±1.1
≤3 months, n (%)	18 (90)
>3 months, n (%)	2 (10)
Best-corrected visual acuity (ETDRS letters; mean±SD)	63.1±13.1
≤70 letters, n (%)	6 (30)
>70 letters, n (%)	14 (70)
Central retinal thickness (µm; mean±SD)	500±105
≤500 µm, n (%)	10 (50)
>500 µm, n (%)	10 (50)

Abbreviation: ETDRS, Early Treatment Diabetic Retinopathy Study.

Figure 1 The mean BCVA and the mean change from the baseline BCVA over time to month 6. (A) The mean BCVA improved significantly 1 month after an IVR injection, and the improvement continued through month 6. (B) The mean change from the baseline BCVA. The ETDRS gain from baseline significantly and gradually increased over time through month 6. Error bars represent SDs. *P<0.05 vs baseline, **P<0.01 vs baseline.

Abbreviations: BCVA, best-corrected visual acuity; IVR, intravitreal ranibizumab; ETDRS, Early Treatment Diabetic Retinopathy Study.

Table 2 Change from baseline best-corrected visual acuity at month 6

ETDRS letters gain (mean±SD)	15.2±10.3
ETDRS letters gain ≥15 (%)
Month 1	35
Month 3	40
Month 6	50
Best-corrected visual acuity (Snellen equivalent ≥20/40; %)
Baseline	30
Month 1	80
Month 3	80
Month 6	90
Best-corrected visual acuity (Snellen equivalent ≥20/20; %)
Baseline	0
Month 1	5
Month 3	15
Month 6	15

Abbreviation: ETDRS, Early Treatment Diabetic Retinopathy Study.

Table 3 Factors associated with best-corrected visual acuity (ETDRS letters) at month 6

Factors	R	P-value
Age	−0.184	0.437
Gender	0.274	0.242
Subtype	−0.280	0.232
Duration between symptoms and initial therapy	0.402	0.0793
Baseline BCVA (ETDRS letters)	0.622	0.00342**
Baseline CRT	−0.343	0.139
Number of injections	0.517	0.0195*

Notes:

* P<0.05;

** P<0.01.

Abbreviations: ETDRS, Early Treatment Diabetic Retinopathy Study; BCVA, best-corrected visual acuity; CRT, central retinal thickness.

Figure 2 The mean CRT and the mean change from the baseline CRT over time to month 6. (A) The mean CRT decreased significantly and rapidly 1 month after intravitreal injection of ranibizumab and continued to do so through month 6. (B) The CRT reduction at month 1 from baseline was significant, and the reduction continued through month 6. Error bars represent SDs. **P<0.01 vs baseline.

Abbreviation: CRT, central retinal thickness.

Table 4 Residual macular edema, microaneurysm, and total number of injections at month 6

Residual macular edema, n (%)	17 (85)
CRT≧250 µm, n (%)	10 (50)
CRT≧300 µm, n (%)	3 (15)
Microaneurysm, n (%)	7 (35)
Total number of injections (mean±SD)	4.05±1.05
1, n (%)	0 (0)
2, n (%)	0 (0)
3, n (%)	8 (40)
4, n (%)	5 (25)
5, n (%)	5 (25)
6, n (%)	2 (10)

Abbreviation: CRT, central retinal thickness.

Table 5 Factors associated with residual macular edema at month 6

Factors	OR (95% CI)	P-value
Age	1.2 (0.97–1.4)	0.0998
Gender	–	–
Subtype	0.44 (0.034–5.9)	0.538
Duration between symptoms and initial therapy	0.81 (0.28–2.3)	0.694
Baseline BCVA (ETDRS letters)	1.0 (0.95–1.1)	0.359
Baseline CRT	0.99 (0.97–1.0)	0.133
Number of injections	0.51 (0.15–1.7)	0.280

Abbreviations: OR, odds ratio; BCVA, best-corrected visual acuity; ETDRS, Early Treatment Diabetic Retinopathy Study; CRT, central retinal thickness.

Table 6 Factors associated with microaneurysms formation at month 6

Factors	OR (95% CI)	P-value
Age	0.94 (0.85–1.0)	0.248
Gender	0.90 (0.12–6.8)	0.919
Subtype	0.64 (0.1–4.1)	0.640
Duration between symptoms and initial therapy	4.8 (1.1–21)	0.0367*
Baseline BCVA (ETDRS letters)	1.1 (0.97–1.2)	0.142
Baseline CRT	1.0 (0.99–1.0)	0.739
Number of injections	1.1 (0.47–2.8)	0.766

Note:

* P<0.05.

Abbreviations: OR, odds ratio; BCVA, best-corrected visual acuity; ETDRS, Early Treatment Diabetic Retinopathy Study; CRT, central retinal thickness.

Figure 3 Microaneurysms detected by FA at month 6. (A and B) An early-phase FA image from a 62-year-old woman with BRVO. The patient received an initial IVR injection 1 month after disease onset. (A) A baseline FA image. (B) An FA image at month 6. No microaneurysms are seen. (C and D) Early-phase FA images from a 71-year-old woman with BRVO. The patient received an initial IVR injection 4 months after disease onset. (C) A baseline FA image. (D) An FA image obtained at month 6. Leaky microaneurysms (black arrows) are observed.

Abbreviations: FA, fluorescein angiography; BRVO, branch retinal vein occlusion; IVR, intravitreal ranibizumab.