Investigative Ophthalmology & Visual Science Cover Image for Volume 65, Issue 7
June 2024
Volume 65, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2024
RETICAD: Quantitative Analysis of Treatment Response in Eyes with Retinal Vein Occlusion
Oren Tomkins-Netzer; Colyn Munn; Lyna Kamintsky; Yonatan Serlin; Ryan S. Huang; Marko Popovic; Rajeev Hemant Muni; Corey A Smith; Alan Cruess; Alon Friedman; Jaime Levy
Author Affiliations & Notes
  • Oren Tomkins-Netzer
    Department of Ophthalmology, Carmel Medical Center, Haifa, Haifa, Israel
  • Colyn Munn
    Emagix, Halifax, Nova Scotia, Canada
    Department of Medical Neuroscience, Dalhousie University Faculty of Medicine, Halifax, Nova Scotia, Canada
  • Lyna Kamintsky
    Emagix, Halifax, Nova Scotia, Canada
    Department of Medical Neuroscience, Dalhousie University Faculty of Medicine, Halifax, Nova Scotia, Canada
  • Yonatan Serlin
    Department of Medical Neuroscience, Dalhousie University Faculty of Medicine, Halifax, Nova Scotia, Canada
  • Ryan S. Huang
    University of Toronto Temerty Faculty of Medicine, Toronto, Ontario, Canada
  • Marko Popovic
    Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
  • Rajeev Hemant Muni
    Department of Ophthalmology, St Michael's Hospital, Toronto, Ontario, Canada
    Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
  • Corey A Smith
    Department of Ophthalmology and Visual Sciences, Dalhousie University Faculty of Medicine, Halifax, Nova Scotia, Canada
  • Alan Cruess
    Department of Ophthalmology and Visual Sciences, Dalhousie University Faculty of Medicine, Halifax, Nova Scotia, Canada
  • Alon Friedman
    Emagix, Halifax, Nova Scotia, Canada
    Department of Medical Neuroscience, Dalhousie University Faculty of Medicine, Halifax, Nova Scotia, Canada
  • Jaime Levy
    Department of Ophthalmology, Hadassah University Medical Center, Jerusalem, Israel
  • Footnotes
    Commercial Relationships   Oren Tomkins-Netzer Novartis, Allergan, Code C (Consultant/Contractor); Colyn Munn Emagix, Code E (Employment), Emagix, Code P (Patent); Lyna Kamintsky Emagix, Code E (Employment), Emagix, Code P (Patent); Yonatan Serlin None; Ryan S. Huang None; Marko Popovic PSI Foundation, Fighting Blindness Canada, Code F (Financial Support); Rajeev Muni Alcon, Apellis, AbbVie, Bayer, Bausch Health, Roche, Code C (Consultant/Contractor), Alcon, AbbVie, Bayer, Novartis, Roche, Code F (Financial Support); Corey Smith None; Alan Cruess Novartis, Bayer, Code C (Consultant/Contractor); Alon Friedman Emagix, Code P (Patent), Emagix, Code S (non-remunerative); Jaime Levy None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2024, Vol.65, 6286. doi:
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      Oren Tomkins-Netzer, Colyn Munn, Lyna Kamintsky, Yonatan Serlin, Ryan S. Huang, Marko Popovic, Rajeev Hemant Muni, Corey A Smith, Alan Cruess, Alon Friedman, Jaime Levy; RETICAD: Quantitative Analysis of Treatment Response in Eyes with Retinal Vein Occlusion. Invest. Ophthalmol. Vis. Sci. 2024;65(7):6286.

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Abstract

Purpose : To quantify the effects of treatment, either anti-VEGF or in combination with laser on blood-retina barrier (BRB) leakage, retinal perfusion, and blood flow in eyes with retinal vein occlusion (RVO).

Methods : A total of 168 patients with RVO were recruited from three centers (Hadassah Medical Center, Jerusalem, Israel; St. Michael’s Hospital, Toronto, Canada; and the Queen Elizabeth II Hospital, Halifax, Canada). All patients underwent baseline fluorescein angiography (FA). A sub-group of patients underwent treatment with either: (1) anti-VEGF agents [bevacizumab (CRVO=15, BRVO=2) or ranibizumab (CRVO=13, BRVO=11)]; or (2) anti-VEGF (bevacizumab) and panretinal photocoagulation (PRP) [CRVO=7]. Treated patients underwent follow-up FA imaging post-treatment. RETICAD, an FA analysis software, was used to quantify BRB leakage, retinal perfusion, and blood flow in 9 ETDRS subfields and 4 peripheral regions (Fig. 1). Regions with improved function post-treatment were defined as those with reduced BRB leakage, increased blood flow, or increased perfusion. Measures were compared using non-parametric statistical analysis.

Results : When compared with healthy controls (n=7), eyes with RVO showed significantly higher rates of BRB leakage (in 10/13 regions, p<.05), lower rates of perfusion (in 3/13 regions, p<.05), and a lower rate of blood flow (in 1/13 regions, p<.05). Among treated patients, combined therapy (anti-VEGF and PRP) reduced BRB leakage in all 13 regions, while anti-VEGF alone reduced leakage in 10/13 regions. Combined therapy increased perfusion in 12/13 regions, compared with 10/13 regions of the anti-VEGF group. Increased blood flow was observed in 11/13 regions in both groups.

Conclusions : RETICAD analysis enables an objective characterization of the functional effects of treatment. Results from our cohort of RVO eyes show that combined anti-VEGF and PRP therapy may improve vascular function better than anti-VEGF alone.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.

 

Fig. 1: Quantification of BRB leakage, perfusion, and blood flow in healthy and RVO eyes.
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Fig. 1: Quantification of BRB leakage, perfusion, and blood flow in healthy and RVO eyes.

Fig. 1: Quantification of BRB leakage, perfusion, and blood flow in healthy and RVO eyes.

Fig. 1: Quantification of BRB leakage, perfusion, and blood flow in healthy and RVO eyes.
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Fig. 2: Assessing the effects of treatment with RETICAD’s measures BRB leakage, perfusion, and blood flow.
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Fig. 2: Assessing the effects of treatment with RETICAD’s measures BRB leakage, perfusion, and blood flow.

Fig. 2: Assessing the effects of treatment with RETICAD’s measures BRB leakage, perfusion, and blood flow.

Fig. 2: Assessing the effects of treatment with RETICAD’s measures BRB leakage, perfusion, and blood flow.
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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
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Copyright © 2025 Association for Research in Vision and Ophthalmology.
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