Abstract
Purpose :
To describe the clinical significance of microcystoid macular changes in patients with retinal vein occlusion with and without glaucomatous optic neuropathy.
Methods :
A retrospective, observational chart review of patients diagnosed with RVO between January 1, 2008 and August, 31 2017 was performed. Best-corrected visual acuity (BCVA), intraocular pressure, fundus photography and optical coherence tomography (OCT) were recorded at each visit. Microcystoid macular changes were assessed quantitatively by two independent and masked observers. The diagnosis of glaucomatous optic neuropathy was made by a glaucoma specialist. Eyes were divided into 2 groups, those with history of retinal vein occlusion and glaucoma (RVOG) and those with retinal vein occlusion without glaucoma (RVO).
Results :
There were 40 eyes (38 patients) in the RVOG group and 38 eyes (35 patients) in the RVO group. At baseline the mean BCVA was worse in the RVOG group than in the RVO group (0.81 ± 0.63 logMAR versus 0.46 ± 0.36 logMAR, respectively, CI: 0.14-0.61; p=0.002). Microcystoid macular changes in the inner nuclear layer were found in 32 out of 40 eyes with RVOG (80 %) and in 26 out of 38 eyes with RVO (68.42%), the mean number of microcysts was 29.02 ± 35.56 and 15.39 ± 14.5, respectively (CI: 1.26-25.99; p=0.03). The mean follow-up was similar in both groups (4.24 ± 2.77 and 4.36 ± 2.45 years, respectively, CI: -68.13-55.10; p=0.83). At the end of the follow-up period, the mean BCVA was worse in RVOG eyes than in RVO eyes (0.56 ± 0.55 logMar versus 0.31 ± 0.38 logMar, respectively; CI: 0.05-0.47; p=0.003). The mean total number of antivascular endothelial growth factor (anti-VEGF) injections was 10.53 ± 9.4 in the RVOG group versus 5.32 ± 5.3 in the RVO group (CI:1.95-8.89; p= 0.003). The mean number of microcysts increased from baseline in RVOG group (90,79 ± 14.35; p=0.00003) and decreased in RVO group (4.95 ± 11.26; p= 0.008). Mean average reduction in CRT was greater in RVO group (-103.18 ± 126.78 μm; p=0.001) than in the RVOG group (-55.58 ± 182.90 μm; p=0.047).
Conclusions :
Eyes with RVOG were associated with a greater number of macular microcystic changes, greater number anti-VEGF injections, and worse BCVA. Further studies will be needed to understand the clinical significance of microcystoid macular changes in patients suffering from retinal vein occlusion and glaucoma optic neuropathy.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.