Name

656 - Occlusions veineuses rétiniennes compliquées d'ischémie maculaire: intérêt des anti-VEGF dans le traitement de l'oedème maculaire associé

The objective of this study is to evaluate the functional and anatomic response of ischemic macular oedema on venous occlusion, after treatment with intravitreal injections (IVT) of anti-VEGF 

Retrospective observational study conducted at the Metz-Thionville CHR, from a collection of patient files treated between 2012 and 2017. All patients suffering from ischemic macular oedema on central retinal venous occlusion (CRVO) or branch occlusion (BRVO), documented by OCT (optical coherence tomography) and retinal angiography, then treated with IVT of Ranibizumab or Aflibercept, with a minimum follow-up of 6 months, were included. The best corrected visual acuity (BCVA) and central retinal thickness (CRT) before and after resorption of macular oedema were collected. The appearance of the OCT outer retina (ellipsoid line) was noted, and correlated with the functional response to treatment

Twenty eyes were included, with a mean follow-up of 16.4 +/- 16.5 months. On average, 3.45 +/- 1 IVT were necessary for the resorption of macular oedema. Across the entire study population, the mean BCVA after resorption of macular oedema was significantly improved from 1.24 +/- 0.6 logMar to 0.677 +/- 0.49 logMar (p = 0.002), as did the CRT which significantly decreased from 754 +/- 278.6 microns to 241.7 +/- 59.8 microns (p <0.001). Eight patients had a severe alteration of the ellipsoid line in OCT, and did not show any significant improvement in BCVA after resorption of macular oedema (p = 0.17), despite a significant decrease in CRT (p = 0.001).

Although anatomical improvement with significant resorption of ischemic macular oedema has been observed throughout the entire study population, functional recovery seems conditioned by the integrity of the OCT external retina

In our cohort, treatment of ischemic macular oedema with anti-VEGF IVTs showed favourable functional outcomes when the underlying external retina was preserved. The treatment of this type of macular oedema seems to be lawful to begin with it as soon as it is diagnosed, and to continue in case of proven functional recovery