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Retina. 2014 Sep;34(9):1736-42. doi: 10.1097/IAE.0000000000000148.

Area of peripheral retinal nonperfusion and treatment response in branch and central retinal vein occlusion.

Author information

1
*Medical Center Ophthalmology, San Antonio, Texas; †Department of Ophthalmology, Tan Tock Seng Hospital, Singapore, Singapore; ‡Fundus Image Reading Center, National Healthcare Group Eye Institute, Singapore, Singapore; and §Doheny Eye Institute, University of Southern California, Los Angeles, California.

Abstract

PURPOSE:

To evaluate the extent of peripheral retinal nonperfusion in retinal vein occlusion and to determine its effect on the severity of macular edema and response to treatment.

METHODS:

This prospective clinic-based cohort study included 32 consecutive patients with retinal vein occlusion and refractory macular edema evaluated using spectral domain optical coherence tomography and wide-field fluorescein angiography. Areas of ischemia were calculated as a percentage of the total visible retina (ischemic index), which was evaluated when macular edema was present (foveal central subfield >300 μm) and when edema had resolved (foveal central subfield ≤ 300 μm). Ischemic index was the main outcome measure.

RESULTS:

The mean ischemic index at study enrollment was 14.8% and was larger when macular edema was present compared with when edema had resolved (14.8 vs. 10.3%, P < 0.001). Compared with those with less nonperfusion, patients with ischemic index >10% had thicker mean foveal central subfield on optical coherence tomography (520.8 vs. 424.5 μm, P = 0.029) and worse visual acuity (56.3 vs. 59 letters) with the presence of macular edema and experienced greater decrease in optical coherence tomography (296.1 vs. 165.3 μm, P = 0.019) and gain in visual acuity (12.4 vs. 0.9 letters, P = 0.036) in response to treatment.

CONCLUSION:

The area of peripheral retinal nonperfusion is variable in patients with retinal vein occlusion and affects its clinical course and response to treatment.

Comment in

PMID:
24732695
DOI:
10.1097/IAE.0000000000000148
[Indexed for MEDLINE]

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