title: Correlation between optic nerve head circulation and visual function before and after anti-VEGF therapy for central retinal vein occlusion: prospective, interventional case series.
abstract: BACKGROUND
  To determine the correlation between the optic nerve head (ONH) circulation determined by laser speckle flowgraphy and the best-corrected visual acuity or retinal sensitivity before and after intravitreal bevacizumab or ranibizumab for central retinal vein occlusion.
  
  
  METHODS
  Thirty-one eyes of 31 patients were treated with intravitreal bevacizumab or ranibizumab for macular edema due to a central retinal vein occlusion. The blood flow in the large vessels on the ONH, the best-corrected visual acuity, and retinal sensitivity were measured at the baseline, and at 1, 3, and 6 months after treatment. The arteriovenous passage time on fluorescein angiography was determined. The venous tortuosity index was calculated on color fundus photograph by dividing the length of the tortuous retinal vein by the chord length of the same segment. The blood flow was represented by the mean blur rate (MBR) determined by laser speckle flowgraphy. To exclude the influence of systemic circulation and blood flow in the ONH tissue, the corrected MBR was calculated as MBR of ONH vessel area - MBR of ONH tissue area in the affected eye divided by the vascular MBR - tissue MBR in the unaffected eye. Pearson's correlation tests were used to determine the significance of correlations between the MBR and the best-corrected visual acuity, retinal sensitivity, arteriovenous passage time, or venous tortuosity index.
  
  
  RESULTS
  At the baseline, the corrected MBR was significantly correlated with the arteriovenous passage time and venous tortuosity index (r = -0.807, P < 0.001; r = -0.716, P < 0.001; respectively). The corrected MBR was significantly correlated with the best-corrected visual acuity and retinal sensitivity at the baseline, and at 1, 3, and 6 months (all P < 0.050). The corrected MBR at the baseline was significantly correlated with the best-corrected visual acuity at 6 months (r = -0.651, P < 0.001) and retinal sensitivity at 6 months (r = 0.485, P = 0.005).
  
  
  CONCLUSIONS
  The pre-treatment blood flow velocity of ONH can be used as a predictive factor for the best-corrected visual acuity and retinal sensitivity after anti-VEGF therapy for central retinal vein occlusion.
  
  
  BACKGROUND
  
  
  
  BACKGROUND
  UMIN000009072. Date of registration: 10/15/2012.
authors.affiliation: Department of Ophthalmology, Saneikai Tsukazaki Hospital, Himeji, Japan.|Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Nagasato
authors.affiliation: Department of Ophthalmology, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto, Tokushima, 770-8503, Japan. ymitaymitaymita@yahoo.co.jp.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Mitamura
authors.affiliation: Department of Ophthalmology, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto, Tokushima, 770-8503, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Semba
authors.affiliation: Department of Ophthalmology, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto, Tokushima, 770-8503, Japan.
authors.forename: Kei
authors.initials: K
authors.lastname: Akaiwa
authors.affiliation: Department of Ophthalmology, Saneikai Tsukazaki Hospital, Himeji, Japan.|Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Nagasawa
authors.affiliation: Department of Ophthalmology, Saneikai Tsukazaki Hospital, Himeji, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Yoshizumi
authors.affiliation: Department of Ophthalmology, Saneikai Tsukazaki Hospital, Himeji, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Tabuchi
authors.affiliation: Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Kiuchi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000068258:Bevacizumab / Q000627:therapeutic use; D001775:Blood Circulation / Q000502:physiology*; D001783:Blood Flow Velocity; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D058449:Intravitreal Injections; D017078:Laser-Doppler Flowmetry; D008297:Male; D008875:Middle Aged; D009898:Optic Disk / Q000098:blood supply*; D011446:Prospective Studies; D000069579:Ranibizumab / Q000627:therapeutic use; D012170:Retinal Vein Occlusion / Q000188:drug therapy* / Q000503:physiopathology; D041623:Tomography, Optical Coherence; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity / Q000502:physiology*; D058609:Visual Field Tests
chemical_list: D020533:Angiogenesis Inhibitors; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab; D000069579:Ranibizumab
keywords: Anti-vascular endothelial growth factor agent; Central retinal vein occlusion; Fundus-related microperimetry; Laser speckle flowgraphy; Retinal blood flow