Structural and Microvascular Characteristics of Branch Retinal Vein Occlusion Eyes with and without Retinal Atrophy...

To evaluate the baseline optical coherence tomography (OCT) and OCT angiography (OCTA) characteristics of patients with branch retinal vein occlusion (BRVO) who developed retinal atrophy following the resolution of macular edema (ME). A secondary objective is to assess the relationship between these baseline imaging parameters and final visual acuity (VA).

This retrospective cohort study analyzed 65 eyes of 65 patients diagnosed with BRVO-related ME. All patients received three loading doses of intravitreal anti-vascular endothelial growth factor treatment based on their ME and VA status; intravitreal injections were administered. Patients were divided into two groups; Group 1 included eyes with complete resolution of ME with retinal atrophy, and Group 2 included eyes without retinal atrophy. Group 1 patients were further divided into those with good and poor VA.

The baseline central retinal thickness (CRT) was significantly higher (P = 0.041), and the baseline and final central choroidal thickness (CCT) were significantly lower in the retinal atrophy group (Group 1) compared to the nonatrophy group (Group 2) (P = 0.024 and P < 0.001, respectively). The baseline quadrantal superficial capillary plexus vascular density (SCP VD) (%) was lower in the atrophic group, while the baseline quadrantal deep capillary plexus VD (DCP VD) (%) was significantly higher in retinal atrophy patients with good VA. The presence of ischemia on fluorescein angiography was significantly more frequent in patients with poor VA (P = 0.039). A positive correlation was also found between baseline DCP VD (%) in the perifoveal region and final VA.

Higher baseline CRT, lower baseline CCT, and lower quadrantal SCP VD were found in BRVO patients with retinal atrophy. However, higher DCP VD and less ischemia at baseline are predictive of better visual outcomes even in the presence of retinal atrophy. These findings may highlight the prognostic value of OCT and OCTA parameters in the treatment of BRVO.