Evaluation of treatment and monitoring results in retinal vein occlusions

In retinal vein occlusion(RVO), it comes across as one of the most dramatic paintings in ophthalmology. It is divided into two categories; non-ischemic and ischemic type. The natural course of the non-ischemic type is relatively benign; however, it is believed that permanent cystoid macular changes remain in some patients. In our study, we aims to compare the predictive factors related to visual activity results for patients with RVO, OCT biomarkers and intravitreal injection results in patients diagnosed with BRVO and CRVO. Patients diagnosed with macular edema secondary to RVO at PAU Hospital Ophthalmology Clinic were included in the study. Demographic and disease-related data (age, gender, systemic diseases, time elapsed since symptom/disease onset) information was taken from the patient's file records. The best corrected visual acuity, intraocular pressure, anterior and posterior segment examination findings, FFA and OCT examination results were taken into consideration during the initial visit of all patients registered in the system. The visual acuity(VA) was evaluated by LogMAR scoring. The records of 19 patients in the CRVO group and 44 patients in the RBRVO group were accessed and evaluated retrospectively. The average age of the patients was 61.33±10.81 years. There was a similar age range in patients diagnosed with CRVO and BVRO (p>0.050). In the 12-month follow-up, after the initial mandatory 3-dose intravitreal bevacizumab injection, it was observed that the intravitreal anti-VEGF injection was 2.73±0.80 in the CRVO group and 2.28±0.991 in the BVRO group. At the 12th month follow-up, after the initial mandatory 3-dose intravitreal bevacizumab injection, it was observed that intravitreal dexamethasone injection was performed at 1.5±0.55 times in the CRVO group and 1.69±0.48 times in the BRVO group. Similar initial VA results were observed in the CRVO and BRVO groups. VA(LogMAR) values in the BRVO group were significantly lower than the CRVO group at the 4th month control (p=0.015) and 12th month control (p=0.007). When the CRVO and BVRO subgroups were evaluated in PFMT measurement, we saw that there were similar results at the baseline, 4th month and 12th month controls. While CFT measurements were statistically significantly higher in the CRVO group than in the BVRO group at baseline (p=0.040), they were within a similar range in the 4th and 12th month controls. When central foveal thickness (CFT) and parafoveal macular thickness (PFMT) were evaluated in RVO patients, a statistically significant thinning was observed at the 12th month follow-up compared to the initial measurements (p<0.050). It was observed that the disruption of EZ and ELM was higher in CRVO patients compared to BRVO patients and this difference was statistically significant among the subgroups (p<0.050). The presence of hyperreflective dots was not statistically significant with an average of 1.58±2.57 in CRVO and 2.27±3.21 in BRVO (p>0.050). There was no statistically significant difference between the CRVO and BRVO subgroups regarding the presence of intraretinal cysts at baseline, the time of onset, the layer in which the intraretinal cyst was located, and the presence of intraretinal cysts at 12 months (p>0.050). In conclusion, In RVO patients, intravitreal bevacizumab loading followed by anti-VEGF and/or dexamethasone implant injections resulted in an increase in visual acuity and a decrease in macular edema at 1-year follow-up. Significant correlations were found between OCT biomarkers and CMT at both baseline and 12-month follow-ups. It can be concluded that the current findings may be guiding in terms of patient-specific treatment planning and providing better visual acuity.