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Egbert Matthe, Olga Furashova; Spectral-domain optical coherence tomography findings in retinal vessel occlusion – A pilot study of detecting ischemia in OCT. Invest. Ophthalmol. Vis. Sci. 2017;58(8):1555.
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© ARVO (1962-2015); The Authors (2016-present)
Retinal vessel occlusions might lead to ischemia of the inner retina, more severe so in artery occlusions. Intracellular edema may develop and decrease transparency of those layers, showing retinal edema. In spectral domain optical coherence tomography (SD-OCT) retinal reflectivity changes as a result of retinal edema. We examined the reflectivity changes of different retinal layers between healthy eyes and eyes with retinal artery occlusion and ischemic or non-ischemic vein occlusions. Aim of the study was to evaluate whether those changes can be used to measure the level of ischemia in the inner retina.
Retrospective evaluation of 60 eyes with retinal artery and 34 eyes with retinal vein occlusion. Fluorescein-Angiography was performed to distinguish between ischemic and non-ischemic vein occlusion. SD-OCT-scans of affected retina where exported as black-on-white-JPEG-pictures to Adobe Photoshop. Areas of vitreous body (VB) , ganglion cell layer (GC), inner plexiform layer (IPL) und outer nuclear layer (ONL) 1000µm away from the fovea were marked and mean gray scale calculated to quantify reflectivity (0: black, high reflectivity; 255: white, low reflectivity). Comparison of those values with healthy partner eyes (Student‘s t-test, double-sided, heteroskedastic; p<0.05 chosen as statistically significant).
Given are grayscale values of different layers in healthy eyes, non-ischemic and ischemic vein occlusion and artery occlusion. Reflectivity of VB does not differ significantly (247; 250; 246; 245; p>0.05). GC and IPL reflectivity increased. Differences where significant between healthy and all forms of occlusion (GC: 160; 128; 102; 97; p<0.05; IPL: 189; 160; 147; 145; p<0.05) and between artery, non-ischemic and ischemic vein occlusion, but not between non-ischemic and ischemic vein occlusions (p=0.63 und p=0.24). ONL reflectivity did not differ (225; 235; 238; 233; p>0.05).
In retinal vessel occlusions, SD-OCT-measured reflectivity changes in inner retinal layers according to the type of occlusion (artery or vein) and therefore presumably to the level of ischemia. There are significant differences between artery and vein occlusions. Vitreous body or outer nuclear layer reflectivity do not change and might be used for scaling purposes. According to this study, OCT can detect different levels of ischemic changes in the retina.
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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