Abstract
Purpose :
To evaluate the predictive value of location of macular edema, central subfield thickness (CST) and loss of interdigitation zone (IZ) by SD-OCT on visual acuity (VA) in treatment-naïve central retinal vein occlusion (CRVO) eyes treated with anti-VEGF intraocular injections.
Methods :
A retrospective chart review was performed of treatment-naïve patients with a newly diagnosed CRVO and no other significant ocular disease that would limit visual acuity. Medical records were reviewed to obtain baseline demographic information as well as baseline and follow-up visual acuity and anatomic data. A baseline OCT image was collected and segmentation was performed manually at the foveal center. We determined whether presence of intraretinal fluid, subretinal fluid and maintenance of the IZ at the foveal center was associated with visual acuity. We also determined whether automated CST, inner retinal thickness (ILM to IPL) and outer retinal thickness (ONL to IZ) were associated with baseline VA and improvement in VA.
Results :
There were 18 eyes in 18 patients who presented at a median time of 29 days (range 0-1150 days) after developing CRVO symptoms. The mean baseline VA was 0.93 ± 0.67 (Snellen 20/169). Loss of the IZ on the OCT images was associated with worse initial VA (p<0.0001) but higher likelihood of visual improvement (p=0.03). In four of the five patients with IZ loss, segmentation of the IZ returned on future OCT images. Conversely, presence of intraretinal fluid was associated with worse initial VA (p=0.04) but was not associated with a statistically significant improvement in VA (p=0.14). Presence of subretinal fluid was associated with neither initial VA (p=0.60) nor improvement in VA (p=0.36). CST was strongly correlated with initial VA (R=0.66) but was not associated with improvement in VA (p=0.16). Foveal inner retinal thickness and outer retinal thickness were not associated with initial VA (p=0.13 and p=0.12, respectively) or improvement in VA (p=0.89 and p=0.08, respectively).
Conclusions :
Baseline loss of the IZ on OCT imaging of CRVO eyes is associated with worse initial VA but is predictive of future VA improvement. Initial CST and intraretinal fluid were associated with baseline VA only. No other parameters had predictive value for VA outcomes.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.