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S. Yamamoto, M. Kitahashi, E. Ohoka, M. Kubota-Taniai, Y. Mitamura; Correlation Between Foveal Outer Nuclear Layer Thickness and Visual Acuity in Eyes With Submacular Hemorrhage Treated With Intravitreal Bevacizumab and Pneumatic Displacement. Invest. Ophthalmol. Vis. Sci. 2010;51(13):3613.
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To determine if a significant correlation exists between the thickness of the outer nuclear layer (ONL) in the foveal area and the visual acuity in patients with submacular hemorrhage (SMH) treated with intravitreal bevacizumab (IVB) combined with pneumatic displacement (PD).
A retrospective study was performed on 14 patients with thick and large SMH secondary to polypoidal choroidal vasculopathy. Fourier domain optical coherence tomography was used to determine the ONL thickness at the central fovea and the integrity of the photoreceptor inner and outer segment junction (IS/OS) line after the resolution of a SMH by IVB+PD. The average follow-up time was 11.2 months (6 to 28 months), and all were followed for ≥6 months. The patients were divided into two groups: Group A included 7 eyes with best-corrected visual acuity (BCVA) <0.6, and Group B included 7 eyes with BCVA ≥0.6. The normal fellow eyes without age-related macular degeneration of 10 of the patients were placed in Group C as controls. We examined whether a significant correlation existed between the ONL thickness and BCVA, and also between an intact IS/OS line and the BCVA.
The average ONL thicknesses at the central fovea in Groups A, B, and C were 65.14±16.49 µm, 95.71±8.79 µm, and 123.00±12.03 µm, respectively. The average ONL thickness at the central fovea in Group A was significantly thinner than that in group B (P =0.012), and that in Group B was significantly thinner than that in Group C (P<0.01). The ONL thickness was significantly correlated with the BCVA (r=0.81; P<0.001). A discontinuity of the IS/OS line was observed in 6 eyes (85.7%) in Group A, in 1 eye (15.3%) in Group B, and in no eye in Group C. The difference in the numbers between Groups A and B was significant (P<0.01).
The significant correlation between the ONL thickness and the BCVA after IVB+PD is probably due to a recovery of the photoreceptors. This is supported by the significant correlation between an intact IS/OS line of the photoreceptors and the BCVA.
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