Analysis Of The Predictors Of Recurrent Macular Edema Secondary To Retinal Vein Occlusion

Purpose: To determine the predictive factors for recurrent macular edema due to retinal vein occlusion(RVO)during intravitreal conbercept(IVC)monotherapy.Method: Clinical records were retrospectively reviewed for patients who were diagnosed with macular edema due to RVO and treated with IVC basing on a 1+PRN(Pro Re Nata)protocol for 6 months at Department of Ophthalmology,the First Affiliated Hospital of Dalian Medical University,from May 2016 to July 2019.Primary outcomes include best-corrected visual acuity(BCVA)and the following lesions in the1-mm-wide area centered on the fovea in spectral domain optical coherence tomography(SD-OCT)were evaluated: central foveal thickness(CFT),largest retinal thickness(MRT),external limiting membrane(ELM),ellipsoid zone(EZ)and Disorganization of the retinal inner layers(DRIL)disruption,the area of intraretinal cysts and subretinal fluids(SRF),hyperreflective foci(HF)before,1week and 1,3,6 months after the initial treatment.According to the recurrence of macular edema in the follow-up period of 6months,the patients were divided into recurrence group and non recurrence group.The differences of baseline data and early OCT results between the two groups were compared.Logistic regression analysis was used to explore the risk factors related to the recurrence of macular edema.Results: The study included 35 eyes of 35 cases,11 eyes(31.4%)of which had no recurrence while 24 yes(68.6%)had recurrent macular edema.Both the CFT and theBCVA were significantly improved after treatment compared to baseline(p<0.05).Although CFT decreased with treatment,BCVA in the recurrence group was worse than that in the non-recurrence group at 6 months of follow-up(P<0.05).There was a statistically significant difference in baseline CFT,DRIL,the area of intraretinal cysts between two groups(P<0.05),however,there was no statistically significant difference in SRF,MRT,ELM,EZ and the number of HF(P>0.05).Logistic regression analysis showed that the risk of recurrent macular edema increased in patients with more severe initial DRIL after adjusting the baseline CFT,the area of the intraretinal cysts and the laser treatment after injection(OR= 1.007,95% CI: 1.001-1.012,P = 0.026).Receiver operating characteristic(ROC)curve analysis showed that baseline DRIL= 527 μ m(AUC: 0.795,sensitivity: 70.8%;specificity: 81.8%)was the critical value of macular edema recurrence.Conclusions: Macular edema secondary to recurrent retinal vein occlusion affects visual prognosis,especially for patients with more than 527 μ m DRIL within 1 mm of fovea,the recurrence of macular edema should be closely monitored within 6 months after IVC.ELM,EZ,SRF,and HF are not good biomarkers for predicting RVO-ME recurrence...