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A. Domalpally, Q. Peng, R. P. Danis, B. A. Blodi, I. U. Scott, M. S. Ip, SCORE Study Research Group; Association of Outer Retinal Layer Morphology With Visual Acuity in Patients With Macular Edema Secondary to Retinal Vein Occlusion - A SCORE Study Ancillary Study. Invest. Ophthalmol. Vis. Sci. 2010;51(13):276.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the relationship between outer retinal morphology assessed by optical coherence tomography (OCT) and visual acuity (VA) in patients with macular edema secondary to retinal vein occlusion.
High resolution cross hair scans captured with time domain OCT (Stratus) (512 A-scans per B-scan) available from the SCORE Study image database of a single site were evaluated for outer retinal morphology features at baseline and months 4, 8, and 12. The integrity of the inner segment outer segment junction (IS-OS) was assessed on a 3 step scale: absent, questionable, and present. Photoreceptor length was measured from the outer plexiform layer to the retinal pigment epithelium using software calipers. Best corrected ETDRS VA was available for all participants.
OCT scans of 36 eyes were evaluated for outer retinal morphology. There was no difference in VA in eyes with absent (n= 26) or abnormal (n= 10) IS-OS at baseline (51.8 vs. 55.7 p = 0.46). Baseline center point thickness (CPT) was significantly different between these groups with a mean of 657 µ in eyes with absent IS-OS and 469 µ in eyes with abnormal IS-OS (p = 0.02). At month 12, the IS-OS was absent in 13, abnormal in 12 and normal in 11 eyes. Mean VA was 37.2, 52.3 and 72.6, respectively (p<0.001). CPT was also significantly different among eyes with varying IS-OS integrity (p=0.04). Among eyes that improved in IS-OS status (n=17) from baseline to month 12, the mean change in VA was +6.4 letters with 7 (41%) eyes gaining ≥ 15 letters. Among eyes that showed no change in IS-OS status (n=18) between baseline and month 12, the mean change in VA was - 5.9 letters with only 3 (16%) eyes gaining ≥ 15 letters. The results were similar when analyzed separately for central and branch retinal vein occlusion subgroups.
The integrity of the IS-OS can be interpreted from high resolution cross hair scans from time domain OCT. Status of IS-OS correlates with VA at follow up, and change in IS-OS status correlates with change in VA, in eyes with retinal vein occlusion enrolled in the SCORE Study.
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