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Aghdam, Kaveh Abri; Reznicek, Lukas; Sanjari, Mostafa Soltan; Klingenstein, Annemarie; Kernt, Marcus; Seidensticker, Florian (2017): Anti-VEGF treatment and peripheral retinal nonperfusion in patients with central retinal vein occlusion. In: Clinical Ophthalmology, Vol. 11: pp. 331-336
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Purpose: To evaluate the association between the size of peripheral retinal nonperfusion and the number of intravitreal ranibizumab injections in patients with treatment-naive central retinal vein occlusion (CRVO). Methods: Fifty-four patients with treatment-naive CRVO and macular edema were included. Each patient underwent a full ophthalmologic examination including optical coherence tomography imaging and ultrawide-field fluorescein angiography. Monthly intravitreal ranibizumab injections were applied according to the recommendations of the German Ophthalmologic Society. Two ophthalmologists quantified the areas of peripheral retinal nonperfusion (group 1= less than five disc areas, group 2= more than five disc areas). Correlation analyses between the size of nonperfusion with best-corrected visual acuity, central subfield thickness, and the number of intravitreal injections were performed. Results: Best-corrected visual acuity improved significantly after intravitreal injections (P<0.001, both groups). Final central subfield thickness after treatment did not significantly differ between both groups (P= 0.92, P= 0.96, respectively). Mean number of injections in group 1 and group 2 was 4.12 +/- 2.73 and 9.32 +/- 3.84, respectively (P<0.001). There was a significant positive correlation between areas of nonperfusion and the number of injections in each group. (R= 0.97, P<0.001;R= 0.94, P<0.001, respectively). Conclusion: Peripheral retinal nonperfusion in patients with CRVO correlates significantly with the number of needed intravitreal ranibizumab injections. Ultrawide-field fluorescein angiography is a useful tool for detection of peripheral retinal ischemia, which may have direct implications in the diagnosis, follow-up, and treatment of these patients.