Ranibizumab on optic disc perfusion in central retinal vein occlusion

Area of Science:

• Ophthalmology
• Vascular Biology
• Medical Imaging

Background:

• Central retinal vein occlusion (CRVO) with macular edema (ME) significantly impacts visual function.
• Microvascular changes in the optic disc and macula are key pathological features of CRVO-ME.
• Hemorheological abnormalities are frequently observed in CRVO patients.

Purpose of the Study:

• To assess the therapeutic impact of ranibizumab on optic disc and macular microvascular perfusion in CRVO with ME.
• To investigate the relationship between microvascular density and visual acuity in CRVO patients.
• To evaluate hemorheological parameters in CRVO patients compared to healthy controls.

Main Methods:

• Optical coherence tomography angiography (OCTA) was used to quantify vessel density (VD) in the optic disc and macular capillary plexuses.
• Central macular thickness (CMT) and best-corrected visual acuity (BCVA) were measured.
• Monthly intravitreal ranibizumab injections were administered for three months, with pre- and post-treatment assessments.

Main Results:

• Ranibizumab treatment significantly increased optic disc VD (whole-disc, intra-disc, peripapillary) and decreased CMT.
• Macular superficial and deep capillary plexus VD showed non-significant reductions post-treatment.
• Baseline BCVA correlated with optic disc VD, with intra-disc VD showing the strongest association; BCVA improvement correlated positively with optic disc VD post-treatment.

Conclusions:

• Optic disc perfusion, particularly intra-disc VD, is a stronger predictor of visual acuity than macular perfusion in CRVO.
• Ranibizumab effectively improves optic disc perfusion but may have limited or detrimental effects on macular perfusion.
• Elevated hemorheological parameters were observed in CRVO patients, and reduced C/D ratio may be a susceptibility factor.