The impact of structural optical coherence tomography changes on visual function in retinal vein occlusion

Abstract

Purpose We aimed to determine the correlation between optical coherence tomography (OCT)‐ and demographic features and baseline best corrected visual acuity (BCVA) in treatment‐naïve patients with retinal vein occlusion (RVO). Methods This was a cross‐sectional posthoc analysis of OCT images that included RVO patients from two prospective, open‐label, multicentre studies. The morphological grading was done manually, in the standardized setting of a reading centre. Main outcome measure was the estimated difference in Early Treatment Diabetic Retinopathy Study letters associated with each individual biomarker. Results Included were 381/301 treatment‐naïve patients with BRVO/CRVO. For BRVO, statistically significant correlations with BCVA were seen for a 100 µm increase in central subfield thickness (CST; −3.1 letters), intraretinal cysts at centre point (CP; +4.1), subretinal fluid (SRF) at CP (+3.0) and hyperreflective foci (HRF) at the central B‐scan (−2.2). In CRVO, a 100 µm increase in CST was associated with a loss of −3.4 letters. In the total cohort, 100 µm increase in CST, SRF at CP and HRF at the central B‐scan correlated with a difference of −3.2,+3.2 and −2.0 letters. A 10‐year increase in age and female gender yielded a −2.0 and −2.5 letter decrease in the total cohort. Adjusted multiple R2 for the respective group was 18.3%/26.3%/23.5%. Conclusions Of all parameters studied, only CST and age were consistently associated with worse BCVA in treatment‐naïve RVO patients. Morphology on OCT explained only a modest part of functional loss in this patient cohort.

Prognostic Factor Study of Macular Edema Recurrence in Retinal Vein Occlusion after Conbercept Treatment: A Post Hoc Analysis of the FALCON Study

“…In particular, previous studies identified the correction of disruption in the OLM with poor visual prognosis after RVO treatment [29][30][31][32]. However, in a recent study that collected and analyzed the data of 381/301 BRVO/CRVO naive patients from the BRIGHTER and CRYSTAL studies, only 5 Computational and Mathematical Methods in Medicine CRT and age were associated with visual prognosis instead of OLM disruption or DRIL [15]. In our study, we noted a significant correlation between baseline OLM disruption at the fovea and ME recurrence, suggesting that baseline OLM integrity could serve as a predictor for recurrence of ME.…”

“…Furthermore, central retinal thickness (CRT) is a measure derived from OCT scans and is an essential outcome in clinical trials to assess drug efficacy and vision outcomes [13]. Previous studies have identified the corrections between CRT and visual outcomes after administration of anti-VEGF therapy in patients with ME due to RVO [14,15].…”

Significance of Hyperreflective Foci as an Optical Coherence Tomography Biomarker in Retinal Diseases: Characterization and Clinical Implications

“…In retinal vein occlusion, HRF were topographically scattered along the OPL and the external limiting membrane [103,105]. Similar to other retinal diseases, a poor visual outcome after anti-VEGF treatment accompanied the identification of HRF at baseline [104,106]. Furthermore, the use of intravitreal DEX implants might be privileged in eyes with numerous HRF and long-standing macular edema secondary to RVO in consideration with the inflammatory component [107].…”

Disorganization of Retinal Inner Layers and the Importance of Setting Boundaries

“…Our findings have been published in an abstract for the European Society of Retina Specialists (EURETINA). 6 Although the qualitative approach to DRIL assessment in the present study is a practical solution, the use of quantitative measurements, such as DRIL length or area, might yield additional information in terms of the structural evolution of the feature. With ischemia being a main driver of sequelae in RVO, functional and structural reversibility is of great importance.…”