June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Longitudinal Analysis of Cone Structure in Patients with Central Retinal Vein Occlusion (CRVO) and Cystoid Macular Edema (CME)
Author Affiliations & Notes
  • Nicholas Rinella
    Department of Ophthalmology, University of California San Francisco, San Francisco, California, United States
  • Jia Qin
    Department of Ophthalmology, University of California San Francisco, San Francisco, California, United States
  • Austin Roorda
    School of Optometry and Vision Science Graduate Group, University of California Berkeley, Berkeley, California, United States
  • Mina M Chung
    Flaum Eye Institute, Center for Visual Science, University of Rochester, Rochester, New York, United States
  • Hongxin Song
    Flaum Eye Institute, Center for Visual Science, University of Rochester, Rochester, New York, United States
  • Joseph Carroll
    Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
  • Lynn W. Sun
    Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
  • Jessica Ijams Wolfing Morgan
    Scheie Eye Institute, Department of Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Robert F Cooper
    Scheie Eye Institute, Department of Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Toco Yuen Ping Chui
    Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, United States
    Icahn School of Medicine at Mount Sinai, New York, New York, United States
  • Richard B Rosen
    Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, United States
  • Barbara A Blodi
    Department of Opthalmology and Visual Sciences, University of Wisconsin Madison, Madison, Wisconsin, United States
  • Ingrid U Scott
    Hershey Eye Center, Pennsylvania State University, Hershey, Pennsylvania, United States
  • Travis C Porco
    Department of Ophthalmology, University of California San Francisco, San Francisco, California, United States
    Proctor Foundation, University of California, San Francisco, San Francisco, California, United States
  • Jacque L. Duncan
    Department of Ophthalmology, University of California San Francisco, San Francisco, California, United States
  • Footnotes
    Commercial Relationships   Nicholas Rinella, None; Jia Qin, None; Austin Roorda, Canon, Inc (F), University of Houston (P), University of Rochester (P); Mina Chung, Canon, Inc (F), Glaxo Smith Kline (C); Hongxin Song, None; Joseph Carroll, AGTC (F), Optovue, Inc (F); Lynn Sun, None; Jessica Morgan, Canon, Inc (F), US Patent 8226236 (P); Robert Cooper, None; Toco Chui, None; Richard Rosen, Advanced Cellular Technologies (C), Allergan (C), Carl Zeiss Meditech (C), Clarity (C), Genentech (C), NanoRetina (C), OD-OS (C), Opticology (C), Optovue (C), Regeneron (C); Barbara Blodi, None; Ingrid Scott, None; Travis Porco, None; Jacque Duncan, None
  • Footnotes
    Support  SCORE2 grant: NIH grant EY002162, FDA grant: R01-41001, Research to Prevent Blindness, Foundation Fighting Blindness, That Man May See, Claire Giannini Foundation, L.L. Hillblom Foundation, National Eye Institute grants: U10EY023529, U10EY023533, and U10EY023521
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 306. doi:
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      Nicholas Rinella, Jia Qin, Austin Roorda, Mina M Chung, Hongxin Song, Joseph Carroll, Lynn W. Sun, Jessica Ijams Wolfing Morgan, Robert F Cooper, Toco Yuen Ping Chui, Richard B Rosen, Barbara A Blodi, Ingrid U Scott, Travis C Porco, Jacque L. Duncan; Longitudinal Analysis of Cone Structure in Patients with Central Retinal Vein Occlusion (CRVO) and Cystoid Macular Edema (CME). Invest. Ophthalmol. Vis. Sci. 2017;58(8):306.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To study cone photoreceptors over 12 months in patients with CRVO and CME in the Study of COmparative Treatments for REtinal Vein Occlusion 2 (SCORE2) using adaptive optics scanning laser ophthalmoscopy (AOSLO) imaging.

Methods : Subjects enrolled in SCORE2 were evaluated at 1 of 5 sites. After baseline imaging, subjects received monthly intravitreal anti-VEGF injections for 6 months, and were then randomized to either continued monthly or treat-and-extend (TAE) treatment arms. AOSLO images were obtained twice at baseline within 1 month after the first injection, and at 6 and 12 months. At least 10 regions of interest (ROIs) were selected by a single investigator from the baseline images where at least 50 cones could be counted reliably. The same ROIs were analyzed by 1 independent grader from each study site who evaluated cone spacing using a density recovery profile program after detailed instruction. An independent investigator reviewed all cone selections from all graders and judged them as acceptable or unacceptable. Statistical analysis was performed using a mixed linear regression analysis of inter-grader and inter-visit variability.

Results : Of 8 subjects evaluated at baseline, 3 had at least 10 ROIs in both baseline AOSLO montages; 2 were imaged successfully at 6 and 12 months, while no quantifiable images were obtained in the third patient at 6 or 12 months due to poor patient cooperation. Both subjects with follow-up images were randomized into the TAE group and received 11 and 10 injections, respectively; subjects had 11 and 14 ROIs, respectively, with visible cones at all 4 study visits. Of 500 ROIs analyzed by 5 graders, cone markings were deemed acceptable at 378 and unacceptable at 122. Analyzing only the acceptable measures, graders differed significantly in cone spacing measures (interclass correlation coefficient = 0.27, 95% confidence interval = 0.20 – 0.34). Controlling for grader, there was no evidence of change in cone spacing over time.

Conclusions : Cone spacing measures in eyes with CRVO-associated CME were associated with significant inter-grader variability, but controlling for grader, we found no evidence of change in cone spacing over time. The study demonstrates challenges associated with cone spacing measures in eyes with CRVO-associated CME performed by independent graders in a multicenter trial.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

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