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Evaluation of Capillary and Other Vessel Contribution to Macular Perfusion Density Measured with Optical Coherence Tomography Angiography
Published on: February 18, 2022
Optical coherence tomographic comparison of naive macular edema due to ischemic and nonischemic retinal vein
1Department of Ophthalmology, Faculty of Medicine, University of Inonu, 44280, Malatya, Turkey. drnihatpolat@gmail.com.
Purpose:
To examine the macular microstructure in macular edema (ME) due to retinal vein occlusion (RVO) in terms of ischemic or nonischemic type to determine whether and how ischemia affects macular microstructure.
Methods:
This retrospective, nonrandomized study included 75 newly diagnosed RVO cases (group 1: 55 nonischemic RVO cases and group 2: 20 ischemic RVO cases) with evidence of center-involving ME without any treatment. Quantitative measures on spectral-domain optical coherence tomography images were performed. Central subfield thickness (CST) was collected in the central 1 mm from the thickness map. The following items were evaluated in a 3-mm-wide area (perifoveal ETDRS circle) centered on the fovea: disorganization of the retinal inner layers (DRIL), disrupted external limiting membrane (ELM) and ellipsoid zone disruption (EZD). The microstructural changes were measured manually.
Results:
Baseline characteristics, such as age, sex, study eye, and RVO risk factors, were similar between the groups (P > 0.05). CST was 554.15 ± 191.45 µm for group 1 and 769.90 ± 290.00 µm for group 2 (P: 0.001). The extent of DRIL was 1864.09 ± 941.70 µm and 2447.25 ± 492.59 µm for groups 1 and 2, respectively (P: 0.010). The disrupted ELM length was 1700 (0-3000) µm for group 1 and 2725 (300-3000) µm for group 2 (P: 0.027). The EZD length was 1453.09 ± 870.38 µm for group 1 and 1846.00 ± 926.54 µm for group 2 (P: 0.093).
Conclusions:
Ischemic RVOs cause greater macular edema and greater disruption in the macular microstructure compared to nonischemic RVOs, especially in terms of DRIL and ELM.
Insights
Ischemic retinal vein occlusion (RVO) causes more severe macular edema and microstructural damage than nonischemic RVO. This includes greater disorganization of retinal inner layers (DRIL) and external limiting membrane (ELM) disruption.
Area of Science:
- Ophthalmology
- Retinal Imaging
- Macular Edema Research
Background:
- Retinal vein occlusion (RVO) is a common cause of vision loss.
- Macular edema (ME) is a primary complication of RVO, affecting central vision.
- Understanding the microstructural impact of ischemic versus nonischemic RVO is crucial for treatment strategies.
Purpose of the Study:
- To compare macular microstructure in ischemic and nonischemic RVO with center-involving ME.
- To determine the specific effects of ischemia on retinal layers.
- To provide quantitative data on microstructural changes in RVO.
Main Methods:
- Retrospective analysis of 75 treatment-naive RVO patients (55 nonischemic, 20 ischemic).
- Spectral-domain optical coherence tomography (SD-OCT) used for quantitative analysis.
- Measurements included central subfield thickness (CST), disorganization of retinal inner layers (DRIL), disrupted external limiting membrane (ELM), and ellipsoid zone disruption (EZD).
Main Results:
- Ischemic RVO showed significantly higher CST (769.90 µm vs. 554.15 µm) and DRIL (2447.25 µm vs. 1864.09 µm) compared to nonischemic RVO.
- Disrupted ELM length was also significantly greater in ischemic RVO (2725 µm vs. 1700 µm).
- Ellipsoid zone disruption (EZD) showed a trend towards greater severity in ischemic RVO but did not reach statistical significance (P=0.093).
Conclusions:
- Ischemic RVO leads to more pronounced macular edema and significant disruption of macular microstructure, particularly DRIL and ELM.
- These findings highlight the detrimental effect of ischemia on retinal integrity in RVO.
- Quantifying these microstructural changes can aid in understanding RVO severity and prognosis.
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