Supplementary Material for: Cotton Wool Spots after Anti-Vascular Endothelial Growth Factor Therapy for Macular Edema Associated with Central Retinal Vein Occlusion

Purpose: To report a case series, whereby we encountered a transient increase in retinal cotton wool spots (CWS) following anti-vascular endothelial growth factor (anti-VEGF) therapy for the treatment of macular edema secondary to central retinal vein occlusion (CRVO). Methods: Eighteen eyes were treated with intravitreal aflibercept (IVA), and 5 were treated with intravitreal ranibizumab (IVR). Fundus photographs obtained 1 month after initial IVA or IVR injections were retrospectively evaluated for the presence of CWS. Results: Twenty-one (91.3%) patients had the following systemic diseases: hypertension, diabetes mellitus without retinopathy, dyslipidemia, or chronic renal failure requiring dialysis. One month after treatment, reduced macular edema was observed in 21 (91.3%) eyes. Initial injections facilitated complete resolution in 14 eyes, and CWS gradually became fainter with additional injections. Conclusion: Some eyes with CRVO-related macular edema can show a transient increase in CWS after initial anti-VEGF therapy; however, macular edema, retinal hemorrhage, and visual acuity were improved in almost every case.研究目的：本研究旨在报道一则病例系列，我们在针对视网膜中央静脉阻塞（CRVO）继发黄斑水肿实施抗血管内皮生长因子（anti-VEGF）治疗的患者中，观察到治疗后视网膜棉绒斑（CWS）一过性增多的现象。 研究方法：共18眼接受玻璃体内注射阿柏西普（IVA）治疗，另5眼接受玻璃体内注射雷珠单抗（IVR）治疗。对初始注射IVA或IVR后1个月时获取的眼底照相进行回顾性评估，以检测视网膜棉绒斑（CWS）的存在情况。 研究结果：21例（91.3%）患者合并以下全身性疾病：高血压、无视网膜病变的糖尿病、血脂异常，或需透析的慢性肾衰竭。治疗后1个月，21眼（91.3%）观察到黄斑水肿减轻。初始注射后14眼的黄斑水肿完全消退，且随着后续追加注射，视网膜棉绒斑逐渐变淡。 研究结论：部分合并CRVO继发黄斑水肿的患眼，在初始anti-VEGF治疗后可出现视网膜棉绒斑一过性增多的情况；但几乎所有病例的黄斑水肿、视网膜出血及视力均得到改善。