Purchase this article with an account.
Jay J. Meyer, Veronica Kon-Jara, Maurice B. Landers, Seema Garg, Odette M. Houghton, Travis A. Meredith, Jan N. Ulrich, Sai H. Chavala; Clinical Correlation Of Wide-angle Fluorescein Angiography And Retinal Oxymetry Findings In The Treatment Response Of Retinal Vein Occlusions. Invest. Ophthalmol. Vis. Sci. 2012;53(14):2078.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To study the association of angiographic non-perfusion and retinal oxygenation status with the treatment response in retinal vein occlusions.
Prospective case series. Patients with a diagnosis of central retinal vein occlusion (CRVO) or branch retinal vein occlusion (BRVO) were recruited. Evaluations were performed every 4 weeks +/- 7 days for 3 months. All subjects underwent a complete ophthalmologic evaluation, retinal oximetry (RO) and spectral domain optical coherence tomography (SD-OCT) at every visit. Ultra wide-field fluorescein angiography (UWFA) was performed at baseline and after 3 months of follow-up. Based on clinical findings, patients received laser and/or anti-VEGF treatments. The RO images were graded by hemoglobin oxygen saturation using the Oxymap software. The UWFA images were graded with the ischemic index (II) using Adobe Photoshop CS3.
Twenty eyes of 20 patients were studied. Three patients were excluded due to poor quality of the images. Seventeen patients were included with a mean age of 72.5 years (range 55-86). Mean follow-up of the vein occlusions was 23.4 months. Ten eyes had residual cystoid macular edema (CME) after failed treatments. UWFA showed peripheral areas of non-perfusion with an ischemic index (II) that ranged from 16-33%. RO images demonstrated a low hemoglobin oxygen saturation in 100% of cases. CRVO patients showed a lower saturation than BRVO cases and these indices improved after receiving treatment. Persistence of CME was associated with a higher ischemic index and lower oxygen saturation levels, and some of these cases seemed to benefit from laser treatment in addition to intravitreal injections of anti-VEGF.
Hemoglobin oxygen saturation may fluctuate after treatment but its correlation with CME is weak. Areas of non-perfusion shown in UWFA were correlated with persistence of CME. Patients with higher II might need a combination of laser+intravitreal injections of anti-VEGF to improve the clinical outcome in cases of retinal vein occlusions.
This PDF is available to Subscribers Only