PURPOSE: To evaluate the anatomical and functional outcomes in patients with ischemic central retinal vein occlusion (CRVO) treated with intravitreal anti-vascular endothelial growth factor (VEGF) agents. METHODS: This retrospective study included 15 treatment-naive patients with ischemic CRVO and macular edema who were treated with intravitreal ranibizumab or aflibercept. The main outcomes were the evolution of retinal ischemia over time, as well as the change in best corrected visual acuity (BCVA) and in central subfield thickness (CST) at month 24. RESULTS: At month 24, patients with ischemic CRVO gained +7.8 letters compared to baseline, while there was a significant decrease in CST by 243.7 μm. At baseline, ischemia was located mainly at the peripheral retina, while 6.6% of patients presented macular ischemia. At month 24, 20% of patients had macular ischemia, which was found to be negatively correlated with BCVA. The patients with macular ischemia had very poor final visual outcome and were advised to discontinue treatment. CONCLUSIONS: Our study showed that anti-VEGF treatment was effective in patients with ischemic CRVO, since it reduces macular edema and maintains or improves VA in the long term (24-month follow-up). It is worthy of note that in a small proportion of patients (13.3%) peripheral ischemia progressed to macular ischemia over time. In cases where macular ischemia is present, anti-VEGF treatment does not seem to offer any improvement in VA.
PURPOSE: To evaluate the anatomical and functional outcomes in patients with ischemic central retinal vein occlusion (CRVO) treated with intravitreal anti-vascular endothelial growth factor (VEGF) agents. METHODS: This retrospective study included 15 treatment-naive patients with ischemic CRVO and macular edema who were treated with intravitreal ranibizumab or aflibercept. The main outcomes were the evolution of retinal ischemia over time, as well as the change in best corrected visual acuity (BCVA) and in central subfield thickness (CST) at month 24. RESULTS: At month 24, patients with ischemic CRVO gained +7.8 letters compared to baseline, while there was a significant decrease in CST by 243.7 μm. At baseline, ischemia was located mainly at the peripheral retina, while 6.6% of patients presented macular ischemia. At month 24, 20% of patients had macular ischemia, which was found to be negatively correlated with BCVA. The patients with macular ischemia had very poor final visual outcome and were advised to discontinue treatment. CONCLUSIONS: Our study showed that anti-VEGF treatment was effective in patients with ischemic CRVO, since it reduces macular edema and maintains or improves VA in the long term (24-month follow-up). It is worthy of note that in a small proportion of patients (13.3%) peripheral ischemia progressed to macular ischemia over time. In cases where macular ischemia is present, anti-VEGF treatment does not seem to offer any improvement in VA.