Subretinal injection of balanced salt solution for macular edema secondary to retinal vein occlusion

Abstract Purposes: To investigate the efficacy and safety of subretinal balanced salt solution (BSS) injections for macular edema secondary to retinal vein occlusion (RVO-ME). Methods: We retrospectively analyzed 19 eyes of 19 patients characterized by Retinal vein occlusion (RVO) diagnosed usng retinal angiography and persistent or recurrent edema on OCT after at least three standard-dose Anti-vascular endothelial growth factor (anti-VEGF) treatments. The operation group received vitrectomy combined with internal limiting membrane (ILM) peeling and subretinal injection of BSS. The operation group continued to receive intravitreal injection of anti-VEGF drugs. The results of visual acuity, retinal morphology, and recurrence were analyzed and compared between the two groups after treatment. Results: The best corrected visual acuity (BCVA) of the surgery group improved (0.60 ± 0.45, P = 0.006) and the best visual acuity reached the same level as that of the injection group (0.53 ± 0.49, P = 0.622). The minimum Central macular thickness (CMT) of the two groups after intervention was 266.40 ± 52.08 µm and 221.89 ± 38.62 µm (P = 0.051), respectively, and both groups exhibited reduced CMT and edema (P < 0.001, P = 0.008). The recurrence rate of the surgery group was 40%, which was lower than that of the injection group (88.9%, P = 0.051). The CMT were 473.00 ± 45.44 µm and 586.89 ± 169.18 μm (P = 0.225) at recurrence. Conclusions: Vitrectomy with ILM peeling and subretinal BSS injection may enhance visual acuity, reduce macular edema, and lower the recurrence rate in patients with RVO-ME.