April 2010
Volume 51, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2010
Ischemic Index for the Quantification of Retinal Non-Perfusion in Branch Retinal Vein Occlusion
Author Affiliations & Notes
  • P. Prasad
    Ophthalmology, Jules Stein Eye Institute, Los Angeles, California
  • I. Tsui
    Ophthalmology, Jules Stein Eye Institute, Los Angeles, California
  • G. Heilweil
    Ophthalmology, Jules Stein Eye Institute, Los Angeles, California
  • J.-P. Hubschman
    Ophthalmology, Jules Stein Eye Institute, Los Angeles, California
  • S. D. Schwartz
    Ophthalmology, Jules Stein Eye Institute, Los Angeles, California
  • Footnotes
    Commercial Relationships  P. Prasad, None; I. Tsui, None; G. Heilweil, None; J.-P. Hubschman, None; S.D. Schwartz, Optos, plc, C.
  • Footnotes
    Support  Price Foundation Retina Research Fund
Investigative Ophthalmology & Visual Science April 2010, Vol.51, 285. doi:
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      P. Prasad, I. Tsui, G. Heilweil, J.-P. Hubschman, S. D. Schwartz; Ischemic Index for the Quantification of Retinal Non-Perfusion in Branch Retinal Vein Occlusion. Invest. Ophthalmol. Vis. Sci. 2010;51(13):285.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: : To quantify retinal non-perfusion as an index for ischemia in patients with branch retinal vein occlusion (BRVO). To correlate ischemic index values with the presence of neovascularization and macular edema in BRVO.

Methods: : An imaging database of ultra wide-field angiograms performed at a single academic institution was searched for patients with a diagnosis of BRVO. Images from 25 patients with BRVO not previously treated with focal macular laser, scatter photocoagulation or intravitreal pharmacotherapy were graded for the presence of non-perfusion, neovascularization and macular edema. Image analysis software was used to quantitatively measure areas of non-perfusion and to calculate a retinal ischemic index defined as total area of non-perfusion divided by total area of retina visualized. Statistical analysis was performed to determine the sensitivity and specificity of various degrees of non-perfusion for the presence of neovascularization and macular edema. A chart review (average follow-up time 16 months) was performed for all patients for the development of macular edema or neovascularization.

Results: : Ultra wide-field angiograms from 25 eyes of 25 patients were analyzed with a diagnosis of BRVO. Non-perfusion was visualized and quantified in all patients and an ischemic index was generated for each patient. Neovascularization and macular edema were seen in 28% and 80% of patients, respectively. Ischemic index values ranged from 0.1% to 30%. An ischemic index of 7% was 100% sensitive and 83% specific for the presence of neovascularization and 50% sensitive and 100% specific for macular edema. Increasing ischemic index for all patients was significantly associated with neovascularization (p < 0.01). Increasing inschemic index for patients with major BRVO was significantly associated with macular edema (p =0.028)

Conclusions: : Retinal ischemia following branch retinal vein occlusion can be quantified utilizing ultra wide-field fluorescein angiography. A retinal ischemic index may help risk stratify patients with BRVO for the development of neovascularization and macular edema.

Keywords: vascular occlusion/vascular occlusive disease • imaging/image analysis: clinical • ischemia 
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