Abstract
Purpose :
To identify patterns of nonperfusion (NP) in retinal vein occlusion (RVO) among participants of the Study of COmparative Treatments for REtinal Vein Occlusion 2 (SCORE2) trial over 5 years and to determine prevalence of the NP patterns longitudinally.
Methods :
SCORE2 participants with central or hemicentral RVO (CRVO, HRVO) were treated with anti-VEGF per protocol for 12 months, then treated per investigator discretion and examined at 4 annual visits. UWF FA was an ancillary imaging study using the Optos 200Tx system (Optos, Dunfermline, Scotland). NP was graded using the NETWORC grid, which contains the macular ETDRS grid and 3 concentric zones outside of the macula (zone 3 being the furthest from macula).
Graders identified 4 distinct patterns of NP on UWF FA: Temporal, Panretinal, Multifocal, and Wedge. Temporal NP was defined as NP involving the temporal periphery; Panretinal NP as contiguous NP involving 2 or more zones of the NETWORC grid; Multifocal NP as noncontiguous areas of NP anywhere in the ETDRS grid and all 3 zones and Wedge NP as wedge-shaped NP extending from the temporal periphery into the ETDRS grid. All UWF FA were evaluated for presence of NP and the predominant type of NP pattern at baseline, month 6, month 12, and annual visits through month 60.
Results :
94/362 participants underwent UWF FA at baseline. After excluding 16 eyes (17%) due to image quality, 48 eyes (51%) had NP. Of these 48 eyes, the predominant NP pattern at baseline was 40% Temporal, 38% Panretinal, 19% Multifocal, and 4% Wedge. Percentages of the predominant NP pattern across all visits were Temporal 40%, Panretinal 34%, Multifocal 18%, and Wedge 8%. We noted a change in the predominant NP pattern in only 3 eyes (6%) over the course of the trial; 2 eyes changed from Temporal to Panretinal and 1 eye went from Panretinal to Wedge. The intergrader agreement on NP pattern grading was moderate with 64% exact agreement.
Conclusions :
The most frequent NP pattern on UWF FA in SCORE2 eyes was Temporal in Zones 1, 2 and 3. The predominant NP patterns at baseline remained very stable with 94% of eyes demonstrating the same NP pattern and area at all subsequent timepoints. In none of the NP patterns did re-perfusion occur. Future analyses will examine the correlations between NP pattern and visual acuity as well as other clinical variables.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.