Purchase this article with an account.
Youning Zhang, Amir H. Kashani; Posterior Vitreous Status Among Subjects with Retinal Vein Occlusion. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):3737.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To evaluate the attachment of posterior vitreous in patients with branch retinal vein occlusion (BRVO) and central retinal vein occlusion (CRVO) and to compare it with that of eyes without RVO.
A retrospective cross-sectional study that included chart review of 38 patients (76 eyes) whose age was >18 years and who had a diagnosis of RVO. Exclusion criteria included poor view to the posterior pole due to media opacity. The study was performed with approval of the IRB. Optical coherence tomography (OCT) images were manually reviewed using macular and retinal nerve fiber layer scans to assess the posterior vitreous. Posterior vitreous status was classified as attached, partially detached or completely detached based on the location of the hypereflective line that denotes the posterior vitreous face on OCT scans. Vitreous status was evaluated at the time of RVO diagnosis. In cases where the OCT was indeterminate, clinical examination and/or ultrasound were used to help assess the status of the posterior vitreous. In all cases, fundus photographs, fluorescein angiograms and ultrasound evaluations (if available) were reviewed for each patient.
Seventy-six eyes of 38 patients met the inclusion and exclusion criteria. Of the 76 eyes, 18 (24%) had BRVO, 24 (32%) had CRVO, and 34 (45%) had no RVO (contralateral eyes). The majority of eyes had either complete vitreous attachment or complete detachment (61% of BRVO eyes, 83% of CRVO eyes, and 74% of eyes without RVO). The remaining patients in each group (39% of BRVO, 17% of CRVO and 26% of eyes without RVO) had partial vitreous detachment. Comparison of OCT scans with fundus images showed that subjects with partial vitreous detachment were more likely to have the remaining areas of attached posterior vitreous overlying (or adjacent to) the area of most severe RVO clinical findings. In addition, the percentage of patients with fluorescein angiographic findings of RVO and concurrent overlying vitreous attachment on OCT was significantly higher in BRVO group than the other RVO subgroups (86% vs. 0% each, Pearson’s chi-squared test, p=0.0001).
There is a high prevalence of attached vitreous overlying areas of RVO clinical findings in BRVO patients. This finding may play a pathophysiologic role in the development or progression of RVO and requires further investigation.
This PDF is available to Subscribers Only