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Michael Myung-Sup Han, Felipe Conti, Fabiana Queiroga de Paula Araujo Silva, Rishi P Singh, Amy Shrader Babiuch; Disorganized Retinal Inner Layers in Predicting Visual Acuity in Patients with Retinal Vein Occlusion. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4289.
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© ARVO (1962-2015); The Authors (2016-present)
Disorganization of the inner retinal layers (DRIL) has been demonstrated as a significant biomarker of visual acuity (VA) in retinovascular diseases. This study was conducted to establish the prevalence of DRIL in patients with retinal vein occlusion.
This retrospective chart review included patients presenting with retinal vein occlusion (branch, central, or hemispheric) between December 2010 to January 2016, aged 18 or older, and with spectral-domain optical coherence tomography (SD-OCT) at the time of diagnosis. Exclusion criteria included the presence of active confounding retinal or ocular disease, history of pars plana vitrectomy, or any prior intravitreal injection treatment. Images were acquired with Cirrus™ HD-OCT (Carl Zeiss Meditech, Dublin, CA). Three horizontal raster scans centered at the fovea and divided into three concentric 500um zones were used to assess the status of DRIL. DRIL was defined as the loss of distinction of either the interface between the ganglion cell layer-inner plexiform layer complex and inner nuclear layer, and/or the interface between inner nuclear layer and outer plexiform layer in any zone. Scans were assessed using the default Review Software (version 184.108.40.20685). When needed, interfaces were enhanced utilizing reverse grayscale and increased contrast tools. Scans of sufficient quality were reviewed by two masked, independent reviewers. A third masked reviewer was used for adjudication. T-tests were performed to compare between groups of patients with and without DRIL.
Of the 197 patient OCTs reviewed, 175 scans had sufficient image quality for interpretation. 62% of eyes had detectable DRIL in the central line scan, 75% eyes in the line scan above center, and 73% eyes in the scan below center. Of the eyes with a positive central line scan, 23% eyes had DRIL in the innermost 1mm zone and 50% eyes had DRIL in the zone extending 500 um from the innermost zone on either side. There was a direct correlation between eyes with DRIL in the central line scan and worse ETDRS letter scores. Eyes with any DRIL in the central line scan had a mean ETDRS letter score significantly lower than eyes without any DRIL in the central line scan (52.0 vs. 60.3; p=0.0029).
DRIL is a common finding in patients with RVO, and the presence of DRIL at the central horizontal level of the fovea correlates with poorer baseline visual acuity.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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