Evaluation The Efficacy Of Intravitreal Ranibizumab In The Treatment Of Retinal Vein Occlusion With Macular Edema By OCTA

Purpose:To observe the feature of The foveal avascular zone(FAZ),outer retinal blood flow area,retinal thickness and blood flow density in optic disc of branch retinal vein occlusion(BRVO)patients by optical coherence tomography angiography(OCTA).Evaluate the efficacy of intravitreal Ranibizumab was evaluated,and the factors related to the vision was investgated.Methods:Thirty-two patients with unilateral BRVO were included and followed up for 3 months.The following parameters were recorded with OCTA:the best corrected visual acuity(BCVA),the FAZ,the outer retina flow area(outer retina flow area,ORFA),the radial peripapillary capillary(RPC)of the optic disc area(4.5X4.5mm)blood vessel density,the retinal nerve fiber layer(RNFL)thickness and other related indicators at baseline,1 month and 3 months after treatment.Reasults:Compared between the healthy eye and the fellow eye,the FAZ area of BRVO eye was significantly smaller than that of the healthy eye.The foveal avascular zone circularity index(FAZ-CI)became lower,the average thickness of RNFL was decreased and the average thickness of RNFL/VD was increased than that of the healthy eyes.There were no significant differences in FAZ perimeter,outer retinal blood flow area and RPC VD.Compared the baseline with 1 month after treatment of the BRVO eye,the FAZ-CI was increased,the average thickness of RNFL was reduced and the average thickness of RNFL/VD was decreased.There were no significant differences in the FAZ area,FAZ perimeter,outer retinal blood flow area and RPC VD.Compared 1 month with 3 months after treatment of the BRVO eye,the FAZ area became larger,the FAZ perimeter became longer,the FAZ-CI was increased,the average thickness of RNFL was reduced and the average thickness of RNFL/VD became lower.There were no significant differences in the outer retinal blood flow area and RPC VD.Compared the baseline with 3 months after treatment of the BRVO eye,the FAZ area became larger,the FAZ perimeter became longer,the FAZ-CI was increased,the average thickness of RNFL was reduced,the average thickness of RNFL/VD became lower,the BCVA was improved.There were no significant differences in the outer retinal blood flow area and RPC VD.Correlation analysis showed that the BCVA was correlated with FAZ area and FAZ-CI at baseline,and the BCVA was correlated with age,RNFL average thickness/VD,and RPC VD at 3 months after treatment.There were no significant correlation between the other indicators and visual acuity.Linear regression analysis showed that the baseline BCVA was independently correlated with FAZ area and FAZ-CI.Unary linear regression showed that the BCVA was correlated with age,RPC VD,and RNFL average thickness/VD at 3 months after treatment.The results of multiple linear regression analysis showed that only the RPC VD of 3 months after treatment was positively correlated with the BCVA.Conclusions:BRVO patients had significantly improved their visual acuity after 3 months of Ranibizumab treatment.In RVO patients,the FAZ area of the affected eye is enlarged and the FAZ-CI is reduced,indicating that the capillary network in the macular area has been affected.With the process of treatment,the FAZ area was expanded,and FAZ-CI was gradually increased after treatment.The effect of anti-VEGF treatment on the microvessels of the macular area still needs long-term observation.The average thickness of RNFL in BRVO’s affected eye was significantly increased,and the average thickness of RNFL was gradually decreased after treatment,indicating that the treatment was effective in reducing the edema of the tissues around the optic disc.The higher the RPC VD,the better the vision after treatment.The ratio of RNFL thickness to RPC VD was positively correlated with visual acuity after treatment.