Abstract
Purpose :
To evaluate the impact of complete vitreomacular separation on presenting characteristics, treatment patterns, and clinical outcomes of central retinal vein occlusions (CRVO).
Methods :
We performed a retrospective longitudinal cohort study of patients seen at our institution for treatment-naïve CRVO between 2009-2017 and who had at least 12 months of follow-up. Presenting OCTs were individually reviewed for vitreomacular status at the presenting visit. Presenting clinical characteristics, treatment patterns, and outcomes were tabulated and analyzed between eyes with complete vitreomacular separation and those without.
Results :
Of the 141 treatment-naïve eyes with CRVOs identified, 54 (38.3%) had complete vitreomacular separation on OCT at presentation, while 87 (61.7%) did not. Eyes with vitreomacular separation had baseline central subfield thickness (CST) of 490.0±296.1μm, while those with attached posterior hyaloid (including partially attached) had baseline CST of 548.7 ± 286.0μm (p=0.15). CST on final visit was significantly lower for eyes that presented with vitreomacular separation (280.5 ±139.9μm vs 345.0 ±172 μm, p=0.02). 12-month injection burden was lower for eyes that presented with complete vitreomacular separation (3.3 ± 3.6 injections vs 4.8 ± 4.1 injections, p=0.02). Presence of cystoid macular edema (CME) at presentation and final visit did not differ between groups. On presentation, 38/54 (70.4%) eyes with vitreomacular separation had CME, while 61/87 (70.4%) of those without had CME (p=0.97). At final visit, 15/54 eyes (27.8%) of eyes with vitreomacular separation had CME while 27/87 (31%) did not (p=0.68).
Conclusions :
Assessment of the vitreomacular relationship on OCT at presentation in eyes with CRVO may serve as a prognostic imaging biomarker. Eyes with complete vitreomacular separation have a significantly lower injection burden and CST at final visit compared to eyes without.
This is a 2021 ARVO Annual Meeting abstract.