[Influence of serous macular detachment on the efficacy of ranibizumab treatment in retinal vein occlusions].

ଝ Influencia del desprendimiento seroso macular en la eficacia del tratamiento con ranibizumab en las oclusiones venosas retinianas Dear Sir: Venous occlusions are a frequent cause of retinal vascular disease , only exceeded by diabetic retinopathy. 1 Macular edema constitutes the main cause of visual acuity loss (VA) and accordingly the therapeutic approach aims at reducing said edema by means of photocoagulation, intravitreal corticoids or surgery. The visual prognosis of this disease has improved due to treatment with intravitreal injections of ranibizumab (Lucentis; Genetech, South San Francisco, CA). 2 Optic coherence tomography (OCT) allows ophthalmologists to know that macular serous detachment (MSD) is a frequent tomo-graphic sign in multiple retinal disorders. 3 We have developed a prospective pilot study to determine the influence of MSD in the efficacy of ranibizumab intravitreal injection treatment for retinal venous occlusions. Overall, the study included 49 eyes with retinal branch venous occlusion (RBVO) and 14 eyes with central retinal vein occlusion (CRVO). Measurements were taken of VA (logMAR), retinograph, angiograph and OCT. In the OCT images we analyzed the central retinal thickness values, mean thickness and retinal volume. In addition, we assessed the presence of MSD and its height (Fig. 1). Treatment was initiated with a ranibizumab injection and monthly follow-ups comprising VA measurements and OCT, repeating the treatment due to macular edema or MSD persistence or recurrence (pro re nata). After a mean follow-up of 15.4 months, the following results were determined: • RBVO Group: baseline VA of patients with MSD (n = 22) and without MSD (n = 27) exhibited significant differences (p = 0.033). After the treatment we observed in both groups a significant VA improvement (p < 0.001). The differences in ଝ Please cite this article as: Dolz-Marco R, et al. Influencia del desprendimiento seroso macular en la eficacia del tratamiento con ranibizumab en las oclusiones venosas retinianas. final VA values in patients with MSD and without MSD were statistically significant (p = 0.001). • CRVO Group: baseline VA of patients with MSD (n = 7) and without MSD (n = 7) did not exhibit significant differences (p = 0.123). After the treatment we did not observe significant improvements in both groups (p = 0.108 and p = 0.457) respectively. The differences in the final VA of patients with MSD and without MSD were not statistically significant (p = 0.006). In addition, the correlation analysis between the VA and MSD …