Outcomes of transcorneal electrical stimulation therapy in the early stages of retinitis pigmentosa.

BACKGROUND: To investigate the effect of transcorneal electrical stimulation (TES) therapy in patients with retinitis pigmentosa (RP). METHODS: We performed TES therapy in 21 patients with RP in 12 sessions with 1-week intervals. The following parameters obtained before and after the TES therapy were compared statistically; the best corrected visual acuity (BCVA, logMAR), Ishihara color vision level, multifocal electroretinography (mf-ERG) response, automated visual field (VF) outcome, and the 25-item low vision quality-of-life (LVQOL) questionnaire points. RESULTS: The mean age of patients (6 females; 15 males) was 31.67 ± 9.80 years (20-50 years). While increases in BCVA level, color vision level, mf-ERG response in p1 amplitude of ring 1, and LVQOL questionnaire points were statistically significant, changes in VF test and other mf-ERG responses were not. Twenty of the patients (95.24%) stated that they were satisfied with the TES therapy. No considerable side effect was observed in any patient due to the therapy. DISCUSSION: The TES therapy may be an effective and safe treatment modality in slowing the RP progression, especially in the early stages of the disease. Longer-term follow-ups in larger patient populations are warranted.

Guideline for the treatment of no light perception eyes induced by mechanical ocular trauma.

Severe mechanical ocular trauma with no light perception (NLP) predicts a poor prognosis of visual acuity and enucleation of the eyeball. Since the innovative treatment concept of exploratory vitreoretinal surgery has developed and treatment technology has advanced, the outcomes of severe ocular trauma treatment in NLP patients have greatly improved. However, there remains a lack of unified standards for the determination, surgical indication, and timing of vitrectomy in NLP eye treatment. To address these problems, we aimed to create evidence-based medical guidelines for the diagnosis, treatment, and prognosis of mechanical ocular trauma with NLP. Sixteen relevant recommendations for mechanical ocular trauma with NLP were obtained, and a consensus was reached. Each recommendation was explained in detail to guide the treatment of mechanical ocular trauma associated with NLP.

Intravitreal erythropoietin injection in late-stage optic neuropathy: a safety study on human.

AIM: To evaluate the whether intravitreal erythropoietin (EPO) administration has any beneficial or adverse effect in patients with late-stage optic neuropathy (ON) or not. METHODS: The study examined 16 eyes of 16 patients who had late-stage ON and ≥1/20 best-corrected visual acuity (BCVA) in their affected eye. There were nonarteritic ischemic ON in 10 (62.5%) eyes, traumatic ON in 4 (25.0%) eyes and methanol-induced ON in 2 (12.5%) eyes. Using pars plana approach, 2000 IU/0.2 ml EPO was administered intravitreally with a 30-gauge needle. Injections were administered three times with 6-week intervals. We compared the differences in the BCVA, intraocular pressure (IOP), retinal nerve fiber layer (RNFL) thickness, pattern visual evoked potentials (p-VEP) and pattern electroretinography (p-ERG) parameters performed at initial examination and final visits. RESULTS: The mean age of the patients was 52.38 ± 12.00 years; 2 (12.50%) of them were female, and 14 (87.50%) of them were male. The mean BCVA levels of 16 patients with optic atrophy were 1.12 ± 0.25 logMAR at the initial examination and 1.08 ± 0.26 logMAR at the final visit (p = 0.102). There was no statistically significant difference between the initial and final RNFL thicknesses, IOP values, p-ERG or p-VEP responses. CONCLUSIONS: Intravitreal EPO injections have no beneficial or detrimental effect on the late stage of ON. Further studies are necessary to compare our results in patients with ON in earlier stages.

CHOROIDAL THICKNESS IN PATIENTS WITH STARGARDT DISEASE.

PURPOSE: To investigate the relationship between choroidal thicknesses (CT), central foveal thicknesses, multifocal electroretinography (mf-ERG) responses, and best-corrected visual acuity levels in patients with Stargardt disease (STGD). METHODS: A total of 30 eyes of 30 patients with STGD, and 30 age- and sex-matched healthy controls were included in the study. All participants underwent detailed ophthalmic examination including best-corrected visual acuity and spectral domain optical coherence tomography measurements, and also patients with STGD were performed mf-ERG. RESULTS: The mean subfoveal CT values were 271.95 ± 85.57 µm in patients with STGD and 355.73 ± 87.41 µm in the control group (P < 0.001). The mean central foveal thickness values were 223.56 ± 61.38 µm in patients with STGD and 272.46 ± 27.52 µm in the control group (P < 0.001). The mean central and paracentral mf-ERG responses (45.71 ± 26.60 and 16.47 ± 10.75 Nv/deg respectively) in patients with STGD were significantly lower from the normal ranges (66.6-130.8 Nv/deg and 30.9-77.7 Nv/deg, respectively; P < 0.001 for both). There was a statistically significant correlation between subfoveal CT and best-corrected visual acuity levels (P = 0.012, r = -0.452), and between parafoveal CT and inner retinal thickness and paracentral mf-ERG responses (P = 0.043, r = +0.372 and P = 0.049, r = +0.363, respectively). Paracentral mf-ERG responses were also correlated with outer retinal thickness values (P = 0.005, r = +0.503). CONCLUSION: Patients with STGD have a thinner CT, which may be responsible for some of the clinical findings. The pathophysiological significance of these findings needs further study.

Association of retinal vein occlusion, homocysteine, and the thrombophilic mutations in a Turkish population: A case-control study.

PURPOSE: To compare homocysteine and thrombophilic mutations for the methylenetetrahydrofolate reductase (MTHFR) C677T, factor V Leiden, and prothrombin G20210A between retinal vein occlusion (RVO) and healthy controls in a Turkish population. MATERIALS AND METHODS: Forty-nine subjects with RVO were compared for homocysteine status and the MTHFR C677T, prothrombin G20210A, and factor V Leiden mutations with those of 68 healthy controls. Then, the groups were subdivided into two subgroups according to age (less than 50 years old, equal to or more than 50 years old) and were further compared. RESULTS: Mean plasma level of homocysteine was similar, but the frequency of hyperhomocysteinemia was significantly higher in the RVO group when compared with the control group (22.5% and 8.8%, respectively, p = 0.037). The frequency of all thrombophilic mutations was similar between the groups (p > 0.05). The frequency of all thrombophilic mutations and homocysteine levels was also similar between age subgroups (p > 0.05). Only hyperhomocysteinemia was significantly different between subgroups (p = 0.037); the frequency of hyperhomocysteinemia was significantly different in RVO patients less than 50 years old (22.7%) from that in healthy controls less than 50 years old (11.1%). Two RVO patients (4.1%) with bilateral involvement had MTHFR C677T mutation. CONCLUSIONS: Screening for thrombophilic mutations such as MTHFR C677T, factor V Leiden, and prothrombin G20210A in RVO patients at all ages seems to be unnecessary and not cost-effective. However, thrombophilic disorders should be screened selectively, focusing on young individuals, especially with bilateral involvement, without additional cardiovascular risk factors, or a family history of thrombosis.

Ophthalmic pathologies in female subjects with bilateralcongenital sensorineural hearing loss.

BACKGROUND/AIM: The high prevalence of ophthalmologic pathologies in hearing-disabled subjects necessitates early screening of other sensory deficits, especially visual function. The aim of this study is to determine the frequency and clinical characteristics of ophthalmic pathologies in patients with congenital bilateral sensorineural hearing loss (SNHL). MATERIALS AND METHODS: This descriptive study is a prospective analysis of 78 young female SNHL subjects who were examined at a tertiary care university hospital with a detailed ophthalmic examination, including electroretinography (ERG) and visual field tests as needed. RESULTS: The mean age was 19.00 ± 1.69 years (range: 15 to 24 years). A total of 39 cases (50%) had at least one ocular pathology. Refractive errors were the leading problem, found in 35 patients (44.9%). Anterior segment examination revealed heterochromia iridis or Waardenburg syndrome in 2 cases (2.56%). Dilated fundus examination revealed retinal pathologies in 15 cases (19.23%), including retinitis pigmentosa or Usher's syndrome in 8 cases (10.25%). Most of the Usher's syndrome cases (87.5%) had consanguinity. CONCLUSION: Screening for congenital SNHL in the early years of life and routine yearly follow-ups are essential for maximizing the rehabilitation of this disabled group. The high rate of visually debilitating syndromic ocular pathologies associated with high frequency of consanguinity doubles the importance.

Effects of commonly used intravitreal anti-vascular endothelial growth factor drugs on mesenchymal stem cells derived from the limbus and ciliary body.

BACKGROUND: To investigate the effects of commonly used intravitreal anti-vascular endothelial growth factor (anti-VEGF) antibodies on proliferation index and viability of mesenchymal stem cells derived from ciliary body and limbus (CB-MSC and LMSC). METHODS: CB-MSCs and LMSCs were isolated from newborn rats' eyes, and they were expanded in medium by the explant method. Intravitreally used anti-VEGF drugs, aflibercept, bevacizumab and ranibizumab were tested into the 16-well plates, respectively, at four different concentrations. After keeping them for 48 h, the proliferation indexes and viabilities of CB-MSCs and LMSCs were compared separately by Real-Time Cell Analyzer and Methylthiazoltetrazoli (MTT) test. RESULTS: Anti-VEGFs used at 5-times and 10-times of the standard clinical dosage caused statistically significant negative effects on proliferation indexes of CB-MSCs and LMSCs at the 24th hour compared to control group. Only the anti-VEGF group that had 10-times dosage of those used clinically had a statistically significant negative effect on the viabilties of CB-MSCs and LMSCs. CONCLUSION: Administrations of high doses or repeated standard doses of intravitreal anti-VEGF agents may affect the proliferation indexes and viabilities of CB-MSCs and LMSCs adversely. These novel findings deserve further in vivo investigations.

The effects of commonly used intravitreal steroids on proliferation index of ciliary body-derived mesenchymal stem cells: an in vitro study.

AIM: To investigate the effects of commonly used intravitreal steroids on survival and proliferation (namely, proliferation index) of ciliary body-derived mesenchymal stem cells (CB-MSC). METHODS: CB-MSCs were isolated from newborn rats' eye, and they were expanded in the medium. Commonly used intravitreal steroids such as dexamethasone (Dex) and triamcinolone acetonide (TA) were added into the medium at commonly used concentration in clinical practice (0.1 mg/mL) and at lower concentration (0.01 mg/mL). Proliferation indexes of CB-MSCs were analyzed with the xCELLigence system at nine consecutive times (at 3rd, 6th, 21th, 30th, 45th, 60th, 75th, 90th and 100th h). RESULTS: Both TA and Dex at both 0.01 mg/mL and 0.1 mg/mL concentrations had negative effect on proliferation indexes of CB-MSC. Although negative effect of TA on proliferation index of CB-MSC at both concentrations was not statistically significant, statistically significant negative effect of Dex at 0.01 mg/mL concentration started 60th h (p = 0.017) and 0.1 mg/mL concentration started 30th h (p = 0.014). DISCUSSION: Even therapeutic doses of intravitreal corticosteroid agents might have negative effects on limited numbers of stem cells. Especially, Dex caused statistically significant toxic effects on CB-MSCs even at lower concentrations of those used clinically. These novel findings deserve further in vivo investigations.

The effects of amphotericin B on angiogenesis in chick chorioallantoic membrane.

OBJECTIVE: Amphotericin B (AmB) is widely used as a mainstay in the treatment of sight-threatening fungal endophthalmitis. From the time that itraconazole was discovered to have a previously unknown anti-angiogenic activity, we have suspected that AmB may have possible effects on ocular angiogenesis. The purpose of this study was to evaluate the in vivo anti-angiogenic effect of AmB in the chick chorioallantoic membrane (CAM) model. MATERIALS AND METHODS: Atak-S type fertilized eggs obtained from the Poultry Institution were used. The eggs were kept under 37 °C at 85-90% relative humidity throughout the experiment. Amphotericin B was prepared in two different concentrations (AmB 125 µg/1 mL and 0.125 µg/1 mL). The CAMs treated with sterile distilled water was specified as controls. About 0.1 mL of each containing 12.5 and 0.0125 µg of AmB, respectively, were dropped to CAM surface. Thirteen eggs were used for each group. The results were evaluated at the 48th hour of the administration of the drugs and recorded by digital camera. RESULTS: A reduction of angiogenesis in CAM area which treated with 125 µg/1 mL of AmB was appreciable macroscopically. The affected areas showed impaired radial arrangement of small vessels with the presence of avascular zone at periphery. The dose of 0.125 µg/1 mL AmB did not show any visible anti-angiogenic effect. Numerous blood vessels with a radially arranged pattern developed toward the periphery after 48 h of treatment. In the CAMs that treated with distilled water, physiological angiogenesis was observed in allantoic vessels. Vessel formation seems to be similar in CAMs treated with 0.125 µg/1 mL AmB with the presence of visibly non-malformed alive embryos. CONCLUSIONS: The present study gives the impression that AmB has the capacity to serve as an anti-angiogenic treatment. As it is a preliminary CAM study only, further studies on both animals and humans are required.

Progressive Hemifacial Atrophy With Contralateral Uveitis: A Case Report.

INTRODUCTION: Progressive hemifacial atrophy, known as Parry-Romberg syndrome (PRS), was first described by Parry in 1825. There is a progressive atrophy of facial tissues including skin, bones and muscles. Ophthalmic disorders are common and include keratitis, uveitis, cataract, ipsilateral enophthalmos, optic neuritis, retinal vasculitis and scleral melting. CASE PRESENTATION: We describe a patient with progressive hemifacial atrophy at right facial side who developed granulomatous uveitis and periferic retinal vasculitis in his left eye. We started topical and systemic steroid therapy. Uveitic reaction had regressed almost entirely after a 3-month steroid treatment. CONCLUSIONS: The individuals should have multidisciplinary approach for the variety of disorders to maintain the appropriate treatment for a better appearance of the patients.

Therapeutic Potential of Erythropoietin in Retinal and Optic Nerve Diseases.

Recent studies have shown that, in addition to its well-known erythropoietic effects, erythropoietin has anti-inflammatory, neuroprotective, and neurotrophic effects in different tissues including the retina and optic nerve. In this review, we made a comprehensive search to define the therapeutic potential of erythropoietin in retinal and optic nerve diseases that lead to blindness.

Acute retinal necrosis following intravitreal dexamethasone (Ozurdex®) implant.

A 52-year-old woman undergoing azathioprine treatment for rheumatoid arthritis developed acute retinal necrosis a month after intravitreal dexamethasone (Ozurdex ®) implantation for posterior uveitis in the left eye. Varicella zoster virus (VZV) DNA was detected in the anterior chamber and vitreous samples on polymerase chain reaction (PCR) analysis. Retinal detachment occurred despite systemic and intravitreal antiviral therapy. Favorable structural and functional outcomes were achieved after retinal surgery with silicone oil. To the authors' knowledge, this is the first reported case of acute retinal necrosis following placement of an Ozurdex® implant. Physicians practicing Ozurdex® implantations should be aware of this unusual but devastating complication. Extra caution and frequent follow-up are required in all immunocompromised patients receiving Ozurdex® implantation.

Acute retinal necrosis following intravitreal dexamethasone (Ozurdex®) implant / Necrose aguda de retina após implante de dexametasona intravítrea (Ozurdex®)

A 52-year-old woman undergoing azathioprine treatment for rheumatoid arthritis developed acute retinal necrosis a month after intravitreal dexamethasone (Ozurdex ®) implantation for posterior uveitis in the left eye. Varicella zoster virus (VZV) DNA was detected in the anterior chamber and vitreous samples on polymerase chain reaction (PCR) analysis. Retinal detachment occurred despite systemic and intravitreal antiviral therapy. Favorable structural and functional outcomes were achieved after retinal surgery with silicone oil. To the authors’ knowledge, this is the first reported case of acute retinal necrosis following placement of an Ozurdex® implant. Physicians practicing Ozurdex® implantations should be aware of this unusual but devastating complication. Extra caution and frequent follow-up are required in all immunocompromised patients receiving Ozurdex® implantation.

Uma mulher de idade de 52 anos em tratamento azatioprina para a artrite reumatóide desenvolveu necrose aguda de retina um mês após implantação Ozurdex® para uveíte posterior do olho esquerdo. DNA de varicela zoster (VZV) foi detectado em amostras de câmara anterior e vítreo por análise de PCR. Apesar da terapia antiviral sistêmica e intravítrea, o paciente apresentou descolamento de retina. Desfecho favorável estrutural e funcional foi obtida após a cirurgia retiniana com óleo de silicone. Pelo conhecimento dos autores, este é o primeiro caso relatado de necrose aguda de retina após a colocação de um implante Ozurdex®. Os médicos que implantam Ozurdex® devem estar cientes desta complicação incomum, mas devastadora. É necessário cuidado extra e acompanhamento frequente dos pacientes que recebam o implante Ozurdex® e apresentem qualquer condição imunocomprometedora.

Effect of allogeneic limbal mesenchymal stem cell therapy in corneal healing: role of administration route.

AIMS: To investigate whether allogeneic limbal mesenchymal stem cell (LMSC) therapy affects corneal healing after a severe chemical burn and whether the route of administration of LMSCs differs in its therapeutic effect in this respect. METHODS: A total of 60 Sprague-Dawley rats with clinically proven alkali injury were divided into four equal groups (n = 15) as follows: group 1: 2 × 10(5) cells/drop LMSCs, topically applied 6 times a day for 2 days; group 2: 2.4 × 10(6) cells in 0.5 ml LMSCs, subconjunctivally applied; group 3: 2.4 × 10(6) cells in 1 ml LMSCs, intraperitoneally applied, and group 4: no LMSC treatment. The groups were compared according to grades of corneal opacity (CO), corneal neovascularization (CNV) and corneal fluorescein staining (CFS). The migration of LMSCs into the cornea and the inflammatory characteristics of the groups were evaluated with BrdU (5-bromo-2'-deoxyuridine bromodeoxyuridine) immunostaining and histopathologically in a 4-week follow-up. RESULTS: There were statistically significant differences between the LMSC-treated and control groups in each week regarding mean CO scores and in the 3rd week regarding the mean CNV and CFS scores (p < 0.05). The statistical significance was due to the differences between the topical and the control group and between the subconjunctival and the control group. BrdU+ LMSCs were seen in the corneal epithelium of the all LMSC-administered rats, and fewer inflammatory changes were observed in these rats. CONCLUSION: Allogeneic LMSC treatment, especially topical and subconjunctival administration, seems to be helpful in affecting corneal healing after a severe corneal burn.

The effect of combined treatment of bevacizumab and triamcinolone for diabetic macular edema refractory to previous intravitreal mono-injections.

The purpose of this study is to evaluate the efficiency of combined treatment of bevacizumab and triamcinolone in refractory diffuse DME (DDME). Twenty-five pseudophakic eyes with DDME refractory to previous successive intravitreal bevacizumab (IVB, 1.25 and 2.5 mg/0.1 ml) and triamcinolone (IVT, 4 mg and 10 mg/0.1 ml) injections were included. The average number of injections was two (1-4). The mean best corrected visual acuity (BCVA) was 0.8 (0.3-1.5) logMAR before enrollment, 0.6 (0.0-1.5) logMAR at 6 months and 0.6 (0-1.8) logMAR at 12 months (p = 0.0001, p = 0.003). The median central macular thickness (CMT) of all the eyes was 575 (502-1049) µm at baseline, 370 (179-983) µm at 6 months, and 410 (198-929) µm at 12 months (p = 0.0001; p = 0.0001). At 6 months, the VA of 13 (52 %) patients was stabilized (± 0.2 logMAR of initial BCVA) and 12 (48 %) patients showed visual improvement (>0.2 logMAR). At 12 months, 10 (40 %) patients had stabilized vision, 13 (52 %) showed visual improvement and 2 (8 %) showed visual loss. At 6 months, 18 (72 %) patients showed anatomic stabilization (a decrease of 10 % to 50 % in initial CMT) and 7 (28 %) anatomical success (a decrease in CMT more than 50 % or ≤250 µm at final visit). At 12 months, 13 (52 %) patients showed anatomic stabilization, 10 (40 %) anatomic success, and 2 (8 %) anatomical failure (decrease in CMT less than 10 %). The combined application of IVB and triamcinolone may improve vision and decrease CMT in severe DDME cases refractory to previous monotherapies.

Post-Traumatic Endophthalmitis: A Mini-Review.

Post-traumatic endophthalmitis comprises 25-30% of all endophthalmitis cases. Post-traumatic endophthalmitis is an important clinical condition that may have serious anatomical and functional consequences. The type of pathogenic microorganism, nature of the injury, the presence of a foreign body, and the geographical region in which the trauma occurred are all important factors influencing both treatment and prognosis. Unlike postoperative endophthalmitis, there is not a confirmed treatment protocol recommended by the Endophthalmitis-Vitrectomy Study Group in traumatic cases. In this study, we examine the incidence, risk factors, diagnosis, microbiological features, and treatment principles of post-traumatic endophthalmitis in order to guide clinicians who often encounter eye trauma related to this potential complication.

Efficacy of topical mesenchymal stem cell therapy in the treatment of experimental dry eye syndrome model.

Purpose. The current study was set out to address the therapeutic efficacy of topically applied mesenchymal stem cells (MSCs) on dry eye syndrome (DES) induced by benzalkonium chloride (BAC) in rats. Methods. Rats were divided into two groups just after establishment of DES. Eye drops containing either bromodeoxyuridine labeled MSCs (n = 9) or phosphate buffer solution (n = 7) were topically applied once daily for one week. Schirmer test, break-up time score, ocular surface evaluation tests, and corneal inflammatory index scoring tests were applied to all rats at baseline and after treatment. All rats were sacrificed after one week for histological and electron microscopic analysis. Results. Mean aqueous tear volume and tear film stability were significantly increased in rats treated with MSCs (P < 0.05). Infiltration of bromodeoxyuridine labeled MSCs into the meibomian glands and conjunctival epithelium was observed in MSCs treated rats. Increased number of secretory granules and number of goblet cells were observed in MSCs treated rats. Conclusion. Topical application of MSCs could be a safe and effective method for the treatment of DES and could potentially be used for further clinical research studies.

Late hyperbaric oxygen treatment of cilioretinal artery occlusion with nonischemic central retinal vein occlusion secondary to high altitude.

AIM: To report a case of cilioretinal artery occlusion (CRAO) with central retinal vein occlusion (CRVO) after a journey to high altitude region and the use of late period hyperbaric oxygen (HBO) therapy successfully. CASE REPORT: A previously healthy 48-year-old lowlander woman was admitted to our department for sudden blurred vision in her right eye started at 2 weeks prior to examination. The patient had a history of 1-month exposure to high altitude that finished a day before the onset of her complaints. The best corrected visual acuity (BCVA) was 10/20 in the right eye (RE) and 10/10 in the left eye. Fundus examination of the RE revealed whitening of the retina along the distribution of cilioretinal artery, sparing fovea, flame-shaped hemorrhages, and roth spots with minimally dilated and tortuous retinal veins. Visual field analysis revealed centrocecal scotoma. The patient was treated by a daily session of 2 h of HBO at 2.5 atmosphere absolute for 11 days. BCVA rised to a level of 20/20 for the RE and the scotomas were disappeared immediately after using of the HBO treatment. CONCLUSION: CRVO related CRAO should be regarded as a rare complication of exposure to high altitude and HBO seems to be the treatment of choice of high altitude related co-occurence of CRVO and CRAO in the late period.

The comparison of intravitreal triamcinolone and bevacizumab in patients with macular edema secondary to branch retinal vein occlusion.

PURPOSE: This study was conducted to compare the efficacy and safety of intravitreal triamcinolone acetonide (IVTA) and intravitreal bevacizumab (IVB) in the treatment of macular edema related to branch retinal vein occlusion (BRVO), using the new optical coherence tomography parameters. MATERIAL AND METHODS: The medical records of 62 patients (IVTA n=26; IVB n=36) with macular edema secondary to BRVO and at least 12 months follow-up between 2007 and 2011 were evaluated by within-group and inter-group comparisons. RESULTS: Both groups were similar in terms of demographic characteristics (P>0.05). Best corrected visual acuity (BCVA) improvement and central subfoveal thickness (CST) reduction were significantly higher in the IVTA group at only the third month (P<0.05). In nonischemic BRVO, while BCVA improvement was significantly higher in the IVTA group at the third and sixth months (P<0.05), no significant difference was found in CST reduction at all visits (P>0.05). In ischemic BRVO, no significant difference was found in BCVA improvement at all visits, but CST reduction was significantly higher in the IVTA group at the first and third months. Logarithmic optical coherence tomography change (LogOCTc) and relative change in retinal thickness (RCRT) showed the same levels of significance in the comparisons. Relative change in retinal thickening (RCRTing) was more valuable compared to the other parameters in the subgroup analyses. CONCLUSION: There was no difference between groups at the 12th month. IVTA was more efficient than IVB in regard to BCVA improvement in nonischemic BRVO in the early follow-up. IVTA made significant retinal thinning compared to IVB in ischemic BRVO in the early period. RCRTing and LogOCTc are important parameters used to monitor the response to treatment in BRVO. Because of the similar levels of significance, RCRT and LogOCTc can be used interchangeably.