June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
Assessing Disorganization of Retinal Inner Layers in Long Term Follow Up of SCORE2 Trial
Author Affiliations & Notes
  • Jonathan B Le
    Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, United States
  • Barbara A Blodi
    Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, United States
  • Amitha Domalpally
    Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, United States
  • Rick Voland
    Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, United States
  • Paul VanVeldhuisen
    The Emmes Company LLC, Rockville, Maryland, United States
  • Neal Oden
    The Emmes Company LLC, Rockville, Maryland, United States
  • Michael S Ip
    Doheny Eye Institute, University of California Los Angeles, Los Angeles, California, United States
  • Ingrid U Scott
    Department of Ophthalmology, Penn State College of Medicine, Hershey, Pennsylvania, United States
  • Footnotes
    Commercial Relationships   Jonathan Le None; Barbara Blodi None; Amitha Domalpally None; Rick Voland None; Paul VanVeldhuisen None; Neal Oden None; Michael Ip Alimera, Allergan, Amgen, Apellis, Clearside, Novartis, OCCURX, Regeneron, Code C (Consultant/Contractor), Biogen, Genentech, Iveric Bio, Cell Lineage Therapeutics, Regenxbio, Code F (Financial Support); Ingrid Scott None
  • Footnotes
    Support  NIH U10EY023521
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 1761. doi:
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    • Get Citation

      Jonathan B Le, Barbara A Blodi, Amitha Domalpally, Rick Voland, Paul VanVeldhuisen, Neal Oden, Michael S Ip, Ingrid U Scott; Assessing Disorganization of Retinal Inner Layers in Long Term Follow Up of SCORE2 Trial. Invest. Ophthalmol. Vis. Sci. 2023;64(8):1761.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To determine the association of disorganization of the retinal inner layers (DRIL) with central subfield thickness (CST) and visual acuity letter score (VALS) among participants of the Study of COmparative Treatments for REtinal Vein Occlusion 2 (SCORE2) trial over 5 years.

Methods : Participants with central (CRVO) or hemiretinal vein occlusion (HRVO) were treated with anti-VEGF per protocol for 12 months, then treated per investigator discretion and examined at 4 annual visits. DRIL and CST was assessed on spectral domain optical coherence tomography (SD-OCT) at months 1 (M01), 6 (M06), 12 (M12) and annual visits through month 60 (M60). DRIL was graded within and outside of the 1mm central subfield.

Results : 355/362 (98%) of SCORE2 participants had SD-OCT images at M01; of those, 34% had no DRIL, 33% had DRIL without cysts and 30% had DRIL with cysts. The distribution of DRIL at M01 in the 109/355 (31%) of participants who completed the 5-year follow-up, was 40%, 29% and 30%, respectively. Among participants with no DRIL at M01, DRIL was present in 52% at M12 and 82% by M60. All eyes with DRIL (with or without cysts) at M01 had DRIL at M60 and had significantly higher CST and lower VALS at all visits (p<0.001) compared to eyes without DRIL at M01. Although participants with DRIL at M01 had DRIL at M60, DRIL improved in about 20% of these participants at M06 while they were still on SCORE2 anti-VEGF protocol. At M60, mean CST in eyes with no DRIL, DRIL without cysts and DRIL with cysts was 240um, 219um and 329um; VALS was 74, 67 and 57, respectively (p<0.0001).

Conclusions : Presence of DRIL at M01 was associated with higher CST and worse VALS throughout 5-year follow-up. Most participants with no DRIL at M01 developed DRIL during follow-up while those with DRIL at M01 had persistence or recurrence of DRIL by M60. This suggests real world management of CRVO or HRVO with anti-VEGF does not protect against development of DRIL.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

 

Month 1 OCT showed entire loss of inner retinal layers of the right half of the 1 mm foveal center compared to the left where some inner retinal layers remained visible on OCT. Month 60 showed further loss of these inner retinal layers. On the right, loss of the layers extended much further outside the foveal center. Similarly on the left, only one interface remains visible within the foveal center and there is increased loss of the retinal layers.

Month 1 OCT showed entire loss of inner retinal layers of the right half of the 1 mm foveal center compared to the left where some inner retinal layers remained visible on OCT. Month 60 showed further loss of these inner retinal layers. On the right, loss of the layers extended much further outside the foveal center. Similarly on the left, only one interface remains visible within the foveal center and there is increased loss of the retinal layers.

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