Delayed absorption of macular edema accompanying serous retinal detachment after grid laser treatment in patients with branch retinal vein occlusion.
OBJECTIVE
To study the detailed process of macular edema (ME) absorption after grid laser photocoagulation in patients with branch retinal vein occlusion (BRVO). The influence of pretreatment serous retinal detachment (SRD) at the fovea on patient outcome was also evaluated.


METHODS
Retrospective, interventional, comparative case series.


METHODS
Thirty-seven BRVO patients presenting with severe ME.


METHODS
Patients were treated with grid laser photocoagulation with 6 months of follow-up examinations. Baseline and post-treatment examinations included measurements of visual acuity (VA), fluorescein angiography, and detailed imaging of ME by optical coherence tomography (OCT). Macular thickness was defined as the distance from the inner retinal surface to the outer border of the sensory retina (foveal retinal thickness) and also to the inner border of the retinal pigment epithelium including the SRD (total foveal elevation).


METHODS
Post-treatment macular thickness with OCT, VA converted to the logarithm of the minimum angle of resolution, and absorption of SRD, and correlations of macular thickness and VA both before and after treatment.


RESULTS
Total foveal elevation and VA were significantly improved at 1, 3, and 6 months after treatment. There was also a significant correlation between reduction of total foveal elevation and increase in VA. Fourteen eyes (37.8%) displayed SRD, as evidenced by OCT at the baseline. In eyes without SRD, foveal retinal thickness and VA had significantly improved in a time-dependent manner. However, although SRD itself was almost absorbed 6 months after treatment, the improvement of both VA and total foveal elevation in eyes with pretreatment SRD was not significant compared with baseline conditions. Both post-treatment total foveal elevation and VA of eyes with SRD tended to be worse than eyes without SRD.


CONCLUSIONS
The presence of subfoveal SRD retards the absorption of ME and recovery of VA after grid laser photocoagulation in patients with BRVO.
Ohashi
Hirokazu
H
Department of Ophthalmology and Visual Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Oh
Hideyasu
H
Nishiwaki
Hirokazu
H
Nonaka
Atsushi
A
Takagi
Hitoshi
H
D000042:Absorption; D000368:Aged; D003941:Diagnostic Techniques, Ophthalmological; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D017075:Laser Coagulation; D008269:Macular Edema / Q000503:physiopathology* / Q000601:surgery; D008297:Male; D012163:Retinal Detachment / Q000503:physiopathology* / Q000601:surgery; D012170:Retinal Vein Occlusion / Q000503:physiopathology* / Q000601:surgery; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence / Q000379:methods; D014792:Visual Acuity / Q000502:physiology