EPIRETINAL MACROPHAGE-LIKE CELL ALTERATIONS FOLLOWING ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR THERAPY IN BRANCH RETINAL VEIN OCCLUSION WITH MACULAR EDEMA: A Retrospective Longitudinal Study.

PURPOSE: To investigate the impact of anti-vascular endothelial growth factor therapy on epiretinal macrophage-like cells (eMLC) in branch retinal vein occlusion with macular edema  (BRVO-ME) patients.

METHODS

This retrospective study included 58 BRVO-ME patients treated with anti-vascular endothelial growth factor agents, divided into 2 groups: 28 eyes (1-2 Injection group) and 30 eyes (3 Injection group). The 3-injection group comprised 20 early responders and 10 limited early responders (LERs). Longitudinal changes in macular eMLC count and density were assessed through en face optical coherence tomography during the early response phase (baseline to 3 months postinitial injection). Linear regression and Spearman correlation analyzed eMLC density's relationship with optical coherence tomography angiography parameters and systemic inflammatory indices.

RESULTS

The 3-injection group exhibited greater reductions in macular edema and eMLC density than the 1 to 2 injection group. Macular eMLC density significantly decreased in early responders, whereas LERs showed no significant alteration. Posttreatment central macular thickness change positively correlated with eMLC density change (r = 0.57). Baseline systemic inflammatory indices (neutrophil/lymphocyte ratio, r = -0.46; neutrophil/platelet ratio, r = -0.36; systemic immune-inflammation index, r = -0.33; systemic inflammatory response index, r = -0.31) negatively correlated with posttreatment eMLC density change.

CONCLUSION

Anti-vascular endothelial growth factor therapy reduces macular eMLC in BRVO-ME patients, especially in early responders receiving three injections. Macular eMLCs are closely associated with inflammation and may serve as a valuable treatment response biomarker.