Abstract
Purpose :
To investigate the combined relationship between ischemia, retinal fluid and layer thickness measurements with visual acuity outcomes for RVO patients and derive insights into disease pathology.
Methods :
Swept-source OCT data obtained from Triton (Topcon Healthcare, Tokyo, Japan) were used to assess retinal layer thicknesses and quantify both intraretinal fluid (IRF) and subretinal fluid (SRF) using a deep learning-based, macular fluid segmentation algorithm for forty-nine treatment-naive eyes that were diagnosed with visual impairment due to central or branch RVO. Patients received 3 loading doses of 2 mg intravitreal aflibercept injections (IAI) and then were put on a treat-and extend regimen. Image analysis was performed at baseline, 3-month, and 6-month follow-up. Baseline OCT morphological features and fluid measurements were correlated using the Pearson correlation coefficient (PCC) to changes in BCVA to determine which features most impacted change in BCVA at 6 months. Areas of non-perfusion in OCTA images at baseline were also correlated with change in BCVA at 6 months.
Results :
A combined model incorporating thickness in the outer-plexiform layer (OPL), retinal nerve fiber layer (RNFL) and presence of IRF had the strongest overall correlation for CRVO (PCC=0.865, p<0.05). For BRVO, the addition of IRF to the OPL-Inner Nasal model had a strong correlation (PCC=0.803, p<0.05). Baseline ischemic index in the deep capillary complex (DCP) demonstrated notable correlation with 6-month change in BCVA for CRVO (PCC=0.9101, p<0.001 and BRVO (PCC=0.9200, p<0.001) BCVA.
Conclusions :
A combined model of IRF volume, OPL and RNFL layer thicknesses, alongside ischemic indices provide the best correlation to BCVA changes. Combined fluid and layer segmentation of OCT images provides clinically useful biomarkers for RVO patients. These results give insight into the pathology of RVOs, describing the relationship between DCP ischemia & OPL/RNFL thickness in BCVA outcomes.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.