Abstract
Purpose :
To investigate differences between eyes with ischemic and non-ischemic retinal vein occlusion (RVO) and evaluate the change of peripheral non-perfusion area (PNP) during intravitreal dexamethasone treatment.
Methods :
Forty eyes of 40 consecutive patients with macular edema (ME) due to either branch- or central retinal vein occlusion (25 BRVO; 15 CRVO) were included for analysis. At baseline all patients were treated with an intravitreal dexamethasone implant (Ozurdex®) and re-treated if indicated earliest after 4 months. Ischemic RVO was defined as evidence of >10 disc diameter of PNP at baseline as seen on 200° wide-field fluorescein angiography. Eyes included for follow-up analysis were quantified manually for the total area of PNP by calculating the percentage of the total visible retina (ischemic index).
Results :
Eighteen eyes showed evidence of PNP and were graded as ischemic RVO. At baseline and at final follow-up best-corrected visual acuity (BCVA) and central retinal thickness (CRT) did not differ between ischemic/non-ischemic RVO patients (61±14/65±15 letters and 536±172/531±131µm at baseline; 69±15/70±18 letters and 298±107/305±61 µm month 6). No difference regarding the time of dexamethasone re-treatment was identified between patients with ischemic/non-ischemic RVO (11/11 received re-treatment at month 4, 3/5 at month 5, 3/4 at month 6). In the ischemic RVO eyes, the mean area of PNP (ischemic index) was calculated to be 14.7% at baseline. One month after initial dexamethasone treatment the mean area of PNP was 13.7% and after three months 16.9% (p=0.8; p=0.4). After re-treatment total PNP area was 16.7% (month 6; p=0.8 in comparison to baseline). In eyes graded as non-ischemic the mean PNP area was 0.3% at baseline, 0.6% after one month, 0.6% after three months and 0.6% after six months, respectively (p>0.05). A significant negative correlation between the total area of PNP and VA was identified (p=0.03).
Conclusions :
Using wide-field fluorescein angiography the ischemic index was shown to remain stable under intravitreal Ozurdex® treatment. Functional and anatomical outcomes did not differ between patients with ischemic and non-ischemic RVO.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.