Abstract
Purpose :
To identify patterns of nonperfusion and its prevalence longitudinally using ultrawide field fluorescein angiography (UWF FA) imaging in retinal vein occlusion (RVO) among participants of the Study of COmparative Treatments for REtinal Vein Occlusion 2 (SCORE2) trial over 5 years.
Methods :
: In SCORE2, participants with central or hemicentral RVO 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 ETDRS grid and 3 concentric zones outside of the macula (zone 3 being the furthest from macula).
raders identified 4 distinct morphological 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 in a longitudinal fashion for presence of NP and the predominant NP pattern at baseline, month 6, month 12, and annual visits through month 60.
Results :
UWF FA was acquired on 94/362 participants 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 :
UWF FA becomes more available, understanding of peripheral non perfusion is of great interest. 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 at all subsequent timepoints. Future SCORE2 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 Imaging in the Eye Conference, held in Seattle, WA, May 4, 2024.