Abstract
Purpose :
To investigate the relationship between structural change of distinct retinal layers and visual prognosis in patients with macular edema (ME) secondary to branchial retinal vein occlusion (BRVO) following anti-vascular endothelial growth factor (VEGF) treatment.
Methods :
We retrospectively reviewed 51 eyes of 51 patients who were treated with intravitreous injection of anti-VEGF agent (1+PRN regimen) for ME due to BRVO and were followed up for more than 12 months. Subjects who underwent any intraocular surgery during follow-up period or who had any other retinal disease were excluded. We extracted following parameters from optical coherence tomography (OCT) images 1 month after initial anti-VEGF treatment: (1) the integrity of ellipsoid zone (EZ), (2) the presence/absence of disorganization of the retinal inner layers (DRIL), and (3) slab value produced from an en face slab OCT image. In brief, the built-in algorithms of Cirrus HD-OCT ® creates a pseudo-color image of 20 µm-thick slab at the innermost retinal layer using 3D-OCT data. Then, the ratio of red pixel area at papillomacular bundle zone on a slab en face OCT image was calculated by Image J software® and was defined as a slab value. The correlation between these OCT-based parameters and best corrected visual acuity (BCVA) (converted to logMAR scale) at 12 months was analyzed. Data were provided as mean±standard deviation otherwise specified.
Results :
The age was 70.7±10.2 years old, and the BCVA before treatment was 0.333±0.248. At 1 month, 11 eyes had the disrupted or irregular EZ and 1 eye had DRIL. After the 3.4±1.5 injections of anti-VEGF agent, the BCVA significantly improved to 0.125±0.203 (p<0.0001) at 12 months. BCVA at 12 months significantly and negatively correlated with slab value (rho=-0.318, p=0.0231). However, there was no significant correlation between BCVA at 12 months and EZ status or the presence/absence of DRIL. The cut-off value of slab value to predict favorable BCVA at 12 months (more than 16/20) was 25.26, and the sensitivity and specificity were 76.9% and 64.0%, respectively (AUC: 0.725, p=0.0019).
Conclusions :
In the treatment of ME secondary to BRVO with intravitreal injection of anti-VEGF agent, the status of the innermost retinal layer at papillomacular bundle zone 1 month after treatment might be a predictor of visual prognosis.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.