Noritatsu Yamaike

Association between integrity of foveal photoreceptor layer and visual acuity in branch retinal vein occlusion

Aim: To study the correlation between integrity of the photoreceptor layer after resolution of macular oedema (MO) associated with branch retinal vein occlusion (BRVO) and final visual acuity (VA), and to determine prognostic factors for visual outcome. Methods: We retrospectively studied 46 eyes from 46 patients with resolved MO secondary to BRVO, the foveal thickness of which was less than 250 µm at final observation. We assessed the status of the third high reflectance band (HRB) in the fovea using optical coherence tomography (OCT) at final observation, and studied OCT images taken at the initial visit in the hope of identifying a factor that would be prognostic of visual outcome. Results: No differences were found in initial VA or in foveal thickness between eyes with or without complete third HRB at final observation. However, final VA in eyes without a complete HRB was significantly poorer (p<0.002). Additionally, initial status of the third HRB in the parafoveal area of unaffected retina was associated with final VA; lack of visualisation of the third HRB at 500 µm (p = 0.0104) or 1000 µm (p = 0.0167) from the fovea on initial OCT images was associated with poor visual recovery after resolution of the MO. Conclusion: Integrity of the photoreceptor layer in the fovea is associated with VA in resolved MO, and status of the third HRB before treatment might be predictive of visual outcome.

Integrity of foveal photoreceptor layer in central retinal vein occlusion.

Purpose: To study the correlation between final visual acuity and integrity of the foveal photoreceptor layer after resolution of macular edema (ME) associated with central retinal vein occlusion (CRVO). Methods: We studied retrospectively 27 eyes of 27 patients with resolved ME associated with central retinal vein occlusion. On optical coherence tomography, integrity of the foveal photoreceptor layer was studied using the junctions between inner and outer segments of the photoreceptor (IS/OS) line as a hallmark. Results: At the final visit, foveal thickness was decreased to a physiologic level in all eyes. On optical coherence tomography, 14 eyes showed the IS/OS line in the fovea, whereas 13 eyes showed no IS/OS line. In concordance with resolution of the ME, visual acuity had improved significantly by the final visit. However, final visual acuity in eyes without an IS/OS line was significantly poorer than that in eyes with an IS/OS line (P < 0.0001). In addition, integrity of the foveal photoreceptor layer after resolution of the ME had a significant correlation with the initial retinal perfusion status (P = 0.0156) and with initial visual acuity (P = 0.0050). Conclusions: After resolution of the ME associated with central retinal vein occlusion, visual acuity is closely associated with integrity of the foveal photoreceptor layer.

Role of posterior vitreous detachment induced by intravitreal tissue plasminogen activator in macular edema with central retinal vein occlusion.

Purpose: To evaluate the effects of posterior vitreous detachment (PVD) in macular edema associated with central retinal vein occlusion (CRVO) treated with intravitreal tissue plasminogen activator (tPA). Methods: The authors conducted a retrospective study of 36 eyes of 36 patients with macular edema by CRVO treated with intravitreal tPA. In 16 of 21 eyes without pretreatment PVD, PVD developed after the treatment. Multiple linear regression analysis was used to evaluate the correlation between logarithm of the minimum angle of resolution (logMAR) visual acuity (VA) changes and several variables. Results: The VA and macular thickness significantly improved after treatment. The pretreatment logMAR VA (R = 0.646; P < 0.0001), PVD development after tPA (R = −0.303; P = 0.025), and age (R = 0.255; P = 0.050) correlated with the logMAR VA at final visit. The greater improvement in logMAR VA was correlated only with PVD development (R = 0.467; P = 0.0041). Macular thickness in the eyes with PVD development was significantly less than without PVD development at the 6-month visit and the end of follow-up. Conclusion: The findings suggest that PVD development after intravitreal tPA may partly contribute to the resolution of macular edema and a better VA outcome.

Retinal sensitivity after intravitreal injection of bevacizumab for the treatment of macular edema secondary to retinal vein occlusion.

Purpose: To evaluate the change in macular function after intravitreal injection of bevacizumab for the treatment of macular edema associated with retinal vein occlusion. Methods: For this interventional case series, 20 eyes of 20 patients with macular edema associated with retinal vein occlusion were treated with an intravitreal injection of bevacizumab. Microperimetry in the macular area was performed with a Micro Perimeter 1 before and at 1, 3, and 6 months after treatment. Results: Improvement in macular function was detected immediately after treatment and lasted for at least 6 months. As measured by the Micro Perimeter 1, mean retinal sensitivities within the central 10° field (4.9 ± 2.7 dB at baseline) improved to 7.2 ± 3.1 dB at 1 month, to 7.6 ± 3.4 dB at 3 months, and to 7.7 ± 3.9 dB at 6 months (P < 0.001). Of the 20 eyes, a recurrence of macular edema was observed in 14 (70%), but with the use of optical coherence tomography, integrity of the outer aspect of the foveal photoreceptors was detected at 3 months to 6 months in 15 (75%) eyes. Conclusion: In eyes with macular edema associated with retinal vein occlusion, improvement in macular function was detected immediately after intravitreal injection of bevacizumab and lasted for at least 6 months.

Evaluation of potential visual acuity in eyes with macular oedema secondary to retinal vein occlusion.

Purpose:  To evaluate the potential visual acuity (VA) of eyes with macular oedema (MO) associated with retinal vein occlusion (RVO).