The Short-Term Efficacy of Intravitreal Ranibizumab for Macular Edema in Central Retinal Vein Occlusion

Hye Young Shin; Dong Hyun Jee

doi:10.3341/jkos.2011.52.9.1048

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Shin and Jee: The Short-Term Efficacy of Intravitreal Ranibizumab for Macular Edema in Central Retinal Vein Occlusion

Original Article

J Korean Ophthalmol Soc 2011;52(9):1048-1054.

Published online: 7 September 2011

DOI: https://doi.org/10.3341/jkos.2011.52.9.1048

The Short-Term Efficacy of Intravitreal Ranibizumab for Macular Edema in Central Retinal Vein Occlusion

Hye Young Shin, MD, Dong Hyun Jee, MD

Department of Ophthalmology and Visual Science, The Catholic University of Korea College of Medicine, Suwon, Korea

Address reprint requests to Dong Hyun Jee, MD Department of Ophthalmology, St. Vincent Hospital #93-6 Ji-dong, Paldal-gu, Suwon 442-723, Korea Tel: 82-31-249-7343, Fax: 82-31-251-6625, E-mail: dhjee73@nate.com

Received 12 July 2011 Revised 31 March 2011 Accepted 5 June 2011

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the short-term efficacy of intravitreal ranibizumab injection in eyes with macular edema secondary to central retinal vein occlusion (CRVO).

Methods

The records of 17 patients (17 eyes, 11 ischemic, six ischemic) who received an intravitreal ranibizumab injection for macular edema secondary to CRVO were retrospectively analyzed. The ophthalmic examination included best corrected visual acuity (BCVA) and central macular thickness (CMT) at baseline and follow-up visits.

Results

After intravitreal ranibizumab injection, the mean BCVA improved from log MAR 1.25 ± 0.47 at baseline to log MAR 0.78 ± 0.49 at 4 weeks and to log MAR 0.81 ± 0.52 at 12 weeks (p < 0.05). Additionally, the mean CMT decreased from 679.4 ± 230.5 μ m at baseline to 224.4 ± 129.9 μ m at 4 weeks and to 271.6 ± 174.1 μ m at 12 weeks (p < 0.001). In subgroup analysis, the decreases in CMT at 4 weeks and 12 weeks were similar in ischemic CRVO and non-ischemic CRVO, but no significant changes in visual acuity were found at 12 weeks in the ischemic CRVO group (p = 0.138). Ten eyes (58.8%) did not require reinjections for macular edema for up to 12 weeks.

Conclusions

Intravitreal ranibizumab injection appeared to be an effective option for the treatment of macular edema secondary to central retinal vein occlusion.

Keywords: Central retinal vein occlusion, Macular edema, Ranibizumab

References

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Figure 1.

Changes of the visual acuity (log MAR) in 11 patients with non-ischemic and 6 patients with ischemic central retinal vein occlusion after intravitreal ranibizumab injection. Mean visual acuity in all patients prior to injection was log MAR 1.25 ± 0.47, Visual acuity increased to log MAR 0.78 ± 0.49, and log MAR 0.81 ± 0.52, 1 and 3 months after ranibizumab injection. CRVO = central retinal vein occlusion.

Figure 2.

Changes of the central macular thickness (μ m) measured by optical coherence tomography in 11 patients with non-ischemic and 6 patients with ischemic central retinal vein occlusion after intravitreal ranibizumab injection. Mean central macular thickness in all patients prior to injection was 679.4 ± 230.5 μ m. Central macular thickness decreased to 224.4 ± 129.9 μ m, and 271.6 ± 174.1 μ m, 4 and 12 weeks after ranibizumab injection. CRVO = central retinal vein occlusion.

Table 1.

Demographics of patients

Demographic data	
Number of eyes	17
Sex (M:F)	11:6
Non-ischemic:ischemic	11:6
Mean patient age (mean ± SD^*, yr)	60.24 ± 13.22
Baseline BCVA^† (mean ± SD, log MAR^‡)	1.25 ± 0.47
Baseline CMT^§ (mean ± SD, μ m)	679.4 ± 230.5

^* SD = standard deviation

^† BCVA = best corrected visual acuity; log MAR = logarithm of the minimum angle of resolution

^§ CMT = central macular thickness.

Table 2.

Changes in visual acuity after ranibizumab injection (mean ± SD^*)

		Baseline	4 weeks	12 weeks
BCVA^† (log MAR^‡)	Total CRVO^§	1.25 ± 0.47	0.78 ± 0.49	0.81 ± 0.52
			(p < 0.001)	(p = 0.001)
	Non-ischemic CRVO	1.11 ± 0.46	0.62 ± 0.43	0.61 ± 0.47
			(p = 0.008)	(p = 0.003)
	Ischemic CRVO	1.51 ± 0.42	1.07 ± 0.45	1.17 ± 0.48
			(p = 0.029)	(p = 0.138)

^* SD = standard deviation

^† BCVA = best corrected visual acuity

^‡ log MAR = logarithm of the minimum angle of resolution

^§ CRVO = central retinal vein occlusion.

Table 3.

Changes in central macular thickness after ranibizumab injection (mean ± SD^*)

		Baseline	4 weeks	12 weeks
CMT^† (μ m)	Total CRVO^‡	679.4 ± 230.5	224.4 ± 129.9	271.6 ± 174.1
			(p < 0.001)	(p < 0.001)
	Non-ischemic CRVO	685.6 ± 242.5	237.2 ± 145.5	249.5 ± 132.7
			(p = 0.003)	(p = 0.004)
	Ischemic CRVO	668.0 ± 228.4	201.0 ± 103.2	312.2 ± 142.3
			(p = 0.028)	(p = 0.030)

^* SD = standard deviation

^† CMT = central macular thickness

^‡ CRVO = central retinal vein occlusion.

Table 4.

Improvement of final visual acuity

	Total CRVO^*	Non-ischemic CRVO	Ischemic CRVO
Improved^†	11 (64.7%)	8 (72.7%)	3 (50.0%)
Borderline	4 (23.5%)	3 (27.3%)	1 (16.7%)
Worsed	2 (11.8%)	0 (0%)	2 (33.3%)

^* CRVO = central retinal vein occlusion.

^† Improved at least two lines with Snellen chart.

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