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Luke Nicholson, Clara Vazquez-Alfageme, Namritha Valerie Patrao, Ioanna Triantafyllopoulou, Philip Hykin, Sobha Sivaprasad; Retinal non-perfusion in the posterior pole determines risk of neovascularisation in central retina vein occlusion. Invest. Ophthalmol. Vis. Sci. 201657(12):.
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© 2017 Association for Research in Vision and Ophthalmology.
Ultra-widefield (UWF) imaging has allowed visualisation into the periphery which was not possible with previous standard imaging. This has introduced controversies in the definition of ischaemic central retinal vein occlusion (CRVO) and the related risk of neovascular complications. We performed a retrospective analysis of UWF angiography (UWF-A) to evaluate the pattern and area of retinal non-perfusion in CRVO that is most predictive of neovascularization.
114 consecutive patients with CRVO and imaged with UWF-A that attended Moorfields Eye Hospital. London, United Kingdom, between January 2014 and December 2014 were assessed. 42 treatment naïve non-diabetic CRVO eyes with gradable UWF-A and a minimum of 12 months follow up were identified and the development of new vessels was recorded. The location and area of retinal non-perfusion (measured in disc areas, DA) were determined using the concentric rings method. This validated method incorporates a macular ring with a radius of 2.5 disc diameters (DD) and five additional concentric rings (rings 1-5), each with a 2.5DD increment in radius. Posterior pole is represented by the macular ring and ring 1, mid-periphery using rings 2 and 3 and pre-equatorial retina by rings 4 and 5. The images were graded by two retinal physicians and average measurements were used.
9 (21.4%) eyes had no areas of retinal non-perfusion. 7 (16.7%) eyes had more than 10DA of non-perfusion isolated in the pre-equatorial location and no areas of non-perfusion posteriorly. 14.3% (1/7) of these eyes developed new vessels. As for eyes with more than 10DA of non-perfusion in the mid-peripheral retina and no areas of non-perfusion posteriorly, n = 7 (16.7%), 0 developed new vessels. From 14 (33.3%) eyes with more than 10DA of non-perfusion in the posterior pole, 78.6% developed new vessels. The association between posterior pole non-perfusion of more than 10DA and development of new vessels was significant (p<0.001).
Posterior pole non-perfusion in central retinal vein occlusion is better associated with new vessel development compared to isolated peripheral non-perfusion.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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