ORIGINAL RESEARCH article
Front. Med.
Sec. Ophthalmology
Subretinal Injection of Balanced Salt Solution for Macular Edema Secondary to Retinal Vein Occlusion
Yue Pan 1
Xiang Zhang 1
Zetong Nie 1
Jiaxing Chi 1
Chang Liu 1
Qinning Xie 1
Mengqi An 1
Xiaorong Li 1
Wenbo Li 1
Bojie Hu 2
1. Tianjin Medical University Eye Hospital, Tianjin, China
2. Tianjin Medical University Hospital for Metabolic Diseases, Tianjin, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
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 using retinal angiography and persistent or recurrent edema on optical coherence tomography after at least three standard-dose anti-vascular endothelial growth factor (VEGF) treatments. The operation group received pars plana vitrectomy(PPV) combined with internal limiting membrane (ILM) peeling and subretinal injection of BSS. The injection 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. Statistical comparisons were adjusted for baseline imbalances using analysis of covariance. Results: After adjustment for baseline best corrected visual acuity (BCVA) and prior injection number, the difference in final BCVA between the surgery and injection groups was not statistically significant (p=0.081). However, the surgery group demonstrated a statistically significant reduction in final Central macular thickness after adjustment (adjusted mean: 222.67 μm vs. 270.60 μm, p=0.048). The surgery group also showed a strong trend towards a lower recurrence rate (40.0% vs. 88.9%, p=0.051) and a longer median time to recurrence (10.0 vs. 4.0 months), though the latter was not statistically significant (log-rank p=0.503). No serious adverse events were observed. Conclusions: This preliminary study suggests that PPV combine with ILM peeling and subretinal BSS injection was feasible and associated with significant anatomical improvement in refractory RVO-ME. The procedure has shown potential in controlling edema and reducing recurrence. While visual outcomes were comparable to anti-VEGF after adjustment, the anatomical benefit warrants further investigation in prospective trials.
Summary
Keywords
Anti-vascular endothelial growth factor, Balanced salt solution, Macular Edema, Pars plana vitrectomy, Retinal Vein Occlusion, subretinal injection
Received
09 September 2025
Accepted
10 February 2026
Copyright
© 2026 Pan, Zhang, Nie, Chi, Liu, Xie, An, Li, Li and Hu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Wenbo Li; Bojie Hu
Disclaimer
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.