Anti-Vascular Endothelial Growth Factor Treatment for Macular Edema in Eyes with Branch Retinal Vein Occlusion with vs Without Glaucoma - Does Glaucoma Affect Visual Outcome in Eyes with BRVO-ME After antiVEGF Injections?

Purpose: To compare the therapeutic effects of anti-vascular endothelial growth factor (anti-VEGF) agents in eyes with macular edema associated with branch retinal vein occlusion (BRVO-ME) with glaucoma to those without glaucoma.Patients and Methods: This retrospective study was conducted using the medical records of Mie University Hospital from 2013 to 2017. Patients were recruited if they had received anti-VEGF agents for BRVO-ME treatment and included 30 patients (30 eyes) without glaucoma (G[-] group) and 27 patients (27 eyes) with glaucoma (G[+] group). The central retinal thickness (CRT) and bestcorrected visual acuity (BCVA) at 3 months after a single injection of anti-VEGF agents were compared between the two groups.Results: Before treatment, the mean +/- standard deviation of the CRT was 514.2 +/- 117.3 gm for the G[-] group, which was not significantly different from that for the G[+] group (533.4 +/- 171.4 gm). The CRT in the G[-] and G[+] groups significantly reduced to 321.1 +/- 114.6 gm and 347.8 +/- 134.7 gm, respectively, at 1 month after the injection and to 360.4 +/- 159.5 gm and 352.4 +/- 151.9 gm, respectively, at 3 months after the injection (P<0.01 for each group). The difference in the degree of CRT reduction between the two groups was not significant. Before treatment, the BCVA was 0.42 +/- 0.32 logMAR units in the G[-] group and 0.57 +/- 0.33 logMAR units in the G[+] group, showing no significant difference. The BCVA in the G[-] and G[+] groups improved significantly to 0.27 +/- 0.26 logMAR units and 0.34 +/- 0.42 logMAR units, respectively, at 1 month, and to 0.18 +/- 0.20 logMAR units and 0.39 +/- 0.34 logMAR units, respectively, at 3 months (P<0.01). The BCVA in the G[-] group was significantly better than that in the G[+] group at 3 months (P=0.02).Conclusion: The therapeutic response of anti-VEGF agents for BRVO-ME is affected by the presence of glaucoma.