Association of disorganization of retinal inner layers with optical coherence tomography angiography features in branch retinal vein occlusion

Abstract

To examine the associations between the disorganization of the retinal inner layers (DRIL) and optical coherence tomography angiography characteristics and visual acuity (VA) outcomes in eyes with macular edema secondary to branch retinal vein occlusion (BRVO). In this single-center cross-sectional cohort study, the data of 43 patients with macular edema secondary to BRVO that received pro re nata anti-vascular endothelial growth factor therapy were analyzed. B-scan and en face angiographic images were obtained by swept-source-based wide-field optical coherence tomography angiography performed at a single visit 1 month after the anti-vascular endothelial growth factor therapy session and evaluated. Correlations between the vascular indices in macula-centered 3\u2009×\u20093 and 12\u2009×\u200912 mm2 areas and B-scan parameters, such as DRIL length and VA, were examined. The mean DRIL length (Rs\u2009=\u20090.588, p\u2009<\u20090.001) and the proportion of scans with DRIL out of five scans (Rs\u2009=\u20090.507, p\u2009=\u20090.001) were significantly correlated with the final best-corrected VA in patients with BRVO. DRIL length was associated with vascular density (VD) and vascular length in the macula (Rs\u2009=\u2009\u2009−\u20090.425, p\u2009=\u20090.006 and Rs\u2009=\u2009\u2009−\u20090.382, p\u2009=\u20090.013, respectively), but not with VD and vascular length in the larger areas (12\u2009×\u200912 mm2). Multilinear regression analysis revealed that the extent of macular edema (p\u2009=\u20090.0016) and VD in the 3\u2009×\u20093 mm2 area (p\u2009=\u20090.004) was significantly associated with the DRIL development. DRIL severity was correlated with VA and associated with the peri-macular perfusion status in eyes with BRVO. Macular edema and macular perfusion affected DRIL severity. These findings would help understand the pathogenesis of DRIL in eyes with BRVO.