Hemorrhage Within Foveal Cystoid Spaces in the Eyes With Retinal Vein Occlusion

Abstract

Purpose: : To study the clinical characteristics of hemorrhage within the foveal cystoid spaces in the eyes with retinal vein occlusion, and to determine the association of hemorrhage with visual prognosis.

Methods: : We retrospectively reviewed the medical records of 61 eyes of 61 consecutive patients with macular edema accompanied with foveal cystoid spaces secondary to branch retinal vein occlusion (49 eyes) and hemi-central retinal vein occlusion (12 eyes); these patients were examined at Kyoto University Hospital from November 1, 2007 to April 30, 2009. All eyes were examined using spectral-domain optical coherence tomography (SD-OCT) and were followed up for at least 6 months.

Results: : At the initial visit, all eyes showed retinal thickening with large foveal cystoid spaces. SD-OCT images revealed cystoid spaces with minimal reflectivity. The longitudinal OCT sections, however, revealed retinal hemorrhage within the foveal cystoid spaces that showed niveau formation in 34 (55.7%) eyes. Of these 34 eyes with a niveau, 25 (73.5%) had serous retinal detachment beneath the fovea. At the initial visit, there were no significant differences in visual acuity between eyes with and without hemorrhage in the foveal cystoid spaces (P = 0.732). However, at the final visit, the visual acuity (logMAR) of the eyes with a niveau (0.43 ± 0.31) was significantly worse than that of the eyes without a niveau (0.26 ± 0.34) (P = 0.0496). Among the 34 eyes with a niveau, the final visual acuity of the eyes with foveal detachment (0.50 ± 0.27) was significantly worse than that of the eyes without foveal detachment (0.23 ± 0.35) (P = 0.0220).

Conclusions: : Hemorrhage within foveal cystoid spaces is a common feature in eyes with retinal vein occlusion; such cases may have poor visual prognosis, especially when accompanied with foveal retinal detachment.

Keywords: edema • macula/fovea • retina