Macular Microvascular Changes and Their Correlation With Peripheral Nonperfusion in Branch Retinal Vein Occlusion

Ryu, Gahyung; Park, Dong-Geun; Lim, Jinam; Hemert, Jano van; Sagong, Min

doi:10.1016/j.ajo.2020.12.026

Cited by 17 publications

(19 citation statements)

References 34 publications

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“…Clinically, ocular levels of VEGF-A and PlGF are elevated in RVO ( Aiello et al, 1994 ; Noma et al, 2015 ). An analysis of aqueous samples taken from controls and patients with BRVO showed marked elevations of both VEGF-A and PlGF ( Noma et al, 2014 ), and importantly a significant positive correlation for both VEGF-A and PlGF with increasing levels of ischemia ( Ryu et al, 2021 ). These positive correlations are also observed in patients who have CRVO ( Noma et al, 2015 ).…”

Section: Role Of Vegfr1 In Retinal Vascular Diseasementioning

confidence: 99%

VEGFR1 signaling in retinal angiogenesis and microinflammation

Uemura

Fruttiger

D’Amore

et al. 2021

Progress in Retinal and Eye Research

188

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Five vascular endothelial growth factor receptor (VEGFR) ligands (VEGF-A, -B, –C, -D, and placental growth factor [PlGF]) constitute the VEGF family. VEGF-A binds VEGF receptors 1 and 2 (VEGFR1/2), whereas VEGF-B and PlGF only bind VEGFR1. Although much research has been conducted on VEGFR2 to elucidate its key role in retinal diseases, recent efforts have shown the importance and involvement of VEGFR1 and its family of ligands in angiogenesis, vascular permeability, and microinflammatory cascades within the retina. Expression of VEGFR1 depends on the microenvironment, is differentially regulated under hypoxic and inflammatory conditions, and it has been detected in retinal and choroidal endothelial cells, pericytes, retinal and choroidal mononuclear phagocytes (including microglia), Müller cells, photoreceptor cells, and the retinal pigment epithelium. Whilst the VEGF-A decoy function of VEGFR1 is well established, consequences of its direct signaling are less clear. VEGFR1 activation can affect vascular permeability and induce macrophage and microglia production of proinflammatory and proangiogenic mediators. However the ability of the VEGFR1 ligands (VEGF-A, PlGF, and VEGF-B) to compete against each other for receptor binding and to heterodimerize complicates our understanding of the relative contribution of VEGFR1 signaling alone toward the pathologic processes seen in diabetic retinopathy, retinal vascular occlusions, retinopathy of prematurity, and age-related macular degeneration. Clinically, anti-VEGF drugs have proven transformational in these pathologies and their impact on modulation of VEGFR1 signaling is still an opportunity-rich field for further research.

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Section: Role Of Vegfr1 In Retinal Vascular Diseasementioning

confidence: 99%

VEGFR1 signaling in retinal angiogenesis and microinflammation

Uemura

Fruttiger

D’Amore

et al. 2021

Progress in Retinal and Eye Research

188

View full text Add to dashboard Cite

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“…Similarly to the study by Seknazi et al [12], there was no distinction between different forms of RVOs and between treatment-naive eyes and the ones that had already received intravitreal therapies for macular edema; moreover, FA was not performed with UWF technology, and the evaluation of peripheral ischemia was not performed quantitatively by means of an ISI, but with a qualitative grading system. Another recent study by Ryu et al [23] sought to investigate the correlation between macular microvascular alterations on OCT-A and retinal ischemia on UWF FA in eyes with BRVO. They found that OCT-A macular parameters (namely vessel density, skeletal density, and fractal dimension) from both the SCP and DCP significantly correlated with ISI calculated in different concentric retinal regions (peri-macular, near-peripheral, mid-peripheral, far-peripheral) [23].…”

Section: Discussion/conclusionmentioning

confidence: 99%

Section: Discussion/conclusionmentioning

confidence: 99%

“…Another recent study by Ryu et al [23] sought to investigate the correlation between macular microvascular alterations on OCT-A and retinal ischemia on UWF FA in eyes with BRVO. They found that OCT-A macular parameters (namely vessel density, skeletal density, and fractal dimension) from both the SCP and DCP significantly correlated with ISI calculated in different concentric retinal regions (peri-macular, near-peripheral, mid-peripheral, far-peripheral) [23]. While the rigorous inclusion of only eyes with BRVO provided more homogeneity to the study population compared to previous investigations, it must be noted that all included patients were administered repeated intravitreal anti-vascular endothelial growth factor (VEGF) injections prior to undergoing FA and OCT-A imaging.…”

Section: Discussion/conclusionmentioning

confidence: 99%

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Optical Coherence Tomography Angiography in Central Retinal Vein Occlusion: Macular Changes and Their Correlation with Peripheral Nonperfusion at Ultra-Widefield Fluorescein Angiography

et al. 2022

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Introduction: To investigate the correlation between ischemic index (ISI) measured on ultra-widefield (UWF) fluorescein angiography (FA) images and macular parameters obtained by optical coherence tomography angiography (OCT-A) in eyes affected by central retinal vein occlusion (CRVO). Methods: Retrospective study of data from 12 eyes affected by treatment-naïve CRVO. All patients underwent a comprehensive ocular examination including structural OCT, OCT-A, and UWF FA. Variables analyzed included best-corrected visual acuity (BCVA) measured with the ETDRS chart; foveal avascular zone (FAZ) area at full-thickness OCT-A angiogram; perfusion density (PD) in the superficial (SCP) and deep capillary plexus (DCP); ISI; and central macular thickness (CMT). Results: ISI showed a significant positive correlation with FAZ area (r=0.63, p=0.019) and a significant negative correlation with PD in the SCP (r=-0.62, p=0.022), PD in the DCP (r=-0.66, p=0.011), and BCVA (r=-0.75, p=0.002). FAZ area also negatively correlated to PD in the SCP (r=-0.75, p=0.002) and DCP (r=-0.64, p=0.016). BCVA positively correlated to PD in the SCP (r=0.67, p=0.009) and DCP (r=0.68, p=0.008), while a negative correlation was found with FAZ area (r=-0.65, p=0.013) and CMT (r=-0.70, p=0.006). Discussion/Conclusion: OCT-A macular parameters (namely, FAZ area and PD of SCP and DCP) significantly correlated with ISI, a quantitative way to assess peripheral retinal nonperfusion on UWF FA. Macular OCT-A analysis may help in assessing the need for additional UWF FA testing in eyes affected by CRVO.

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“…It is not easy to expand our results to nonischemic BRVO, because this study included only ischemic BRVO. However, considering that nonischemic BRVO has a better clinical course than ischemic BRVO and that the degree of ischemia affects various OCTA parameters 37 – 39 , we can reduce the confounding factors on baseline characteristics and OCTA parameters by excluding nonischemic BRVO. Prospective studies are needed to determine whether early treatment or shortening the follow-up period according to the thickness of DCP-C reduces the ME recurrence rate.…”

Section: Discussionmentioning

confidence: 99%

Association between capillary congestion and macular edema recurrence in chronic branch retinal vein occlusion through quantitative analysis of OCT angiography

Kang

Kim

Park

et al. 2021

Sci Rep

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This study aims to quantitatively investigate the optical coherence tomographic angiography (OCTA) findings of capillary congestion and its association with macular edema (ME) recurrence in chronic branch retinal vein occlusion (BRVO). We retrospectively reviewed the medical records of 115 consecutive patients with major ischemic BRVO who reached stable macula (without ME for two consecutive visits) at baseline (the first visit within the stable period). All patients were classified into a recurrence or non-recurrence groups depending on ME recurrence. Capillary congestion of deep capillary plexuses (DCP-C) and other abnormal capillary lesions were segmented, and their areas, vascular densities, and mean retinal thicknesses (MRT) were calculated. The main outcomes were differences between the two groups and risk factors for recurrence among baseline and OCTA parameters. A total of 76 eyes were included, of which 22 (28.9%) recurred. DCP-C existed in all eyes at baseline. MRT of DCP-C (p = 0.006) was greater in the recurrence group. Greater MRT of DCP-C (OR: 1.044; p = 0.002) and more frequent intravitreal injections (OR: 1.803; p < 0.001) were associated with a higher risk of relapsing ME. DCP-C may contribute to the anatomical stability of chronic BRVO and simultaneously be the source of ME.

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Macular Microvascular Changes and Their Correlation With Peripheral Nonperfusion in Branch Retinal Vein Occlusion

Cited by 17 publications

References 34 publications

VEGFR1 signaling in retinal angiogenesis and microinflammation

VEGFR1 signaling in retinal angiogenesis and microinflammation

Optical Coherence Tomography Angiography in Central Retinal Vein Occlusion: Macular Changes and Their Correlation with Peripheral Nonperfusion at Ultra-Widefield Fluorescein Angiography

Association between capillary congestion and macular edema recurrence in chronic branch retinal vein occlusion through quantitative analysis of OCT angiography

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