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Suk Ho Byeon, Jae Sang Ko; Optical Coherence Tomography Predicts Visual Outcome after Acute Retinal Ischemia due to Central Retinal Vein Occlusion. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3618.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the clinical features of central retinal vein occlusion (CRVO) and evaluate acute ischemic retinal damage using optical coherence tomography (OCT).
All patients underwent fluorescence angiography (FA) and OCT at initial presentation. A hyperreflective line located in the inner synaptic portion of the retinal outer plexiform layer (“prominent middle-limiting membrane [MLM] sign”) in OCT was used as an acute ischemic sign. Acute ischemia was determined by the concurrence of two independent experienced researchers. Cases with prominent definitive MLM sign were grouped and compared with the group of eyes with no MLM sign and equivocal MLM sign (non-MLM group), for clinical features including initial and final visual acuity, central fovea thickness (CFT), CRVO type, and neovascular glaucoma development.
In 50 eyes, the mean age was 57.9±16.7 years and 14 eyes (28%) had prominent MLM sign, 21 eyes (42%) had no MLM sign, and 15 eyes (30%) had equivocal findings. Mean follow-up duration was 10.0±8.3 months. Eyes with prominent MLM sign presented worse initial and final BCVA in comparison with combined non-MLM group (logarithm of the minimum angle of resolution, LogMAR, 1.10±0.72 versus 0.47±0.49 in the MLM group, P=0.007; and LogMAR 1.19±0.91 versus 0.43 ± 0.49 in the non-MLM group, P=0.012). The MLM group eyes presented more ischemic-type CRVO (57.1% versus 4.8%, P=0.001), and developed more neovascular glaucoma (two eyes versus none), than the combined non-MLM group. Eyes with equivocal MLM had larger CFTs when compared with either the no-MLM or the prominent MLM group. (775.3±291.3 versus 426.4±239.1 and 409.9 ± 179.3 µm, respectively; P=0.001 for both comparisons with the equivocal MLM group)
CRVO cases with acute ischemic sign on OCT show poor initial and final visual outcomes that are unrelated to extent of macular edema.
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