Observation on the blood flow changes around the optic disc before and after the combined treatment of anti-vascular endothelial growth factor and Dexamethasone intravitreal implant for central retinal vein occlusion
10.3760/cma.j.cn511434-20250116-00023
- VernacularTitle:抗血管内皮生长因子药物联合地塞米松植入剂治疗对视网膜中央静脉阻塞患眼视盘周围血流的影响
- Author:
Min XU
1
;
Guohai HUANG
;
Yanyun SHI
Author Information
1. 山西医科大学第一临床医学院, 太原 030001
- Publication Type:Journal Article
- Keywords:
Central retinal vein occlusion;
Anti-vascular endothelial growth factor drugs;
Dexamethasone intravitreal implant;
Optical coherence tomography angiograp
- From:
Chinese Journal of Ocular Fundus Diseases
2025;41(8):595-598
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To observe changes in peripapillary blood flow before and after combined treatment with anti-vascular endothelial growth factor (VEGF) drugs and Dexamethasone intravitreal implant (DEX) in patients with central retinal vein occlusion (CRVO).Methods:A prospective clinical study. Thirty-three eyes of 33 patients with newly diagnosed non-ischemic CRVO and macular edema (ME) were enrolled from Shanxi Eye Hospital between April 2023 and April 2024. All patients underwent best-corrected visual acuity (BCVA) and swept-source optical coherence tomography angiography (SS-OCTA) examinations. The treatment regimen consisted of three intravitreal injections of ranibizumab and one DEX implant. SS-OCTA was used to scan a 3 mm×3 mm area centered on the optic disc to measure peripapillary retinal nerve fiber layer (RNFL) thickness and blood flow density in the superficial vascular complex (SVC), deep vascular complex (DVC), and radial peripapillary capillaries (RPC). Changes in SVC, DVC, and RPC blood flow density and RNFL thickness were evaluated at 3 and 6 months post-treatment. Shapiro-Wilk test was used to assess normality, and Spearman's rank correlation coefficient was applied for correlation analysis.Results:Compared with before treatment, the blood flow density changes of SVC and RPC showed a downward trend at 3 and 6 months after treatment. Among them, the difference was statistically significant at 6 months after treatment ( Z=?2.592, ?2.070, P=0.012, 0.042), while there was no statistically significant difference at 3 months after treatment ( P>0.05). The blood flow density of DVC showed an upward trend at 3 and 6 months after treatment, but the differences were not statistically significant ( P>0.05). The results of the correlation analysis showed that the thickness of RNFL was negatively correlated with the blood flow density of DVC ( r=?0.768, P<0.001). It was positively correlated with the blood flow densities of SVC and RPC ( r=0.288, 0.398; P=0.040, 0.004). Conclusion:Anti-VEGF drugs combined with DEX treatment can significantly improve the perioptic disc blood flow distribution in eyes with CRVO, manifested as a decrease in blood flow density of SVC and RPC, while a compensatory increase in blood flow of DVC. The thickness variation of RNFL is closely related to the blood flow density of different vascular layers.
