Abstract
To analyze the characteristics and the course of macular edema secondary to central retinal vein occlusion (CRVO) using optical coherence tomography (OCT) and to determine correlations between clinical, tomographic and angiographic data, in particular including retinal ischemia. In this retrospective study, 53 consecutive patients with CRVO were included. At each follow-up visit, patients underwent complete ophthalmological examination, including best-corrected visual acuity (BCVA) and OCT. Fluorescein angiography was performed at baseline and on demand during follow-up. 243 OCTs were analyzed. Mean age was 61 years and mean follow-up 13 months. The first structural change, observed very early after the onset of the occlusion, was a diffuse increase at the level of the outer nuclear layer without change at the level of the inner retina. This early change seemed characteristic of retinal vein occlusion. Cystoid spaces were subsequently observed in all retinal layers and were combined with serous retinal detachment in 51 %. During the first 6 months, central retinal thickness was higher in ischemic CRVO (mean, 691 μm) than in non-ischemic CRVO (mean, 440 μm, p < 0.01). In eyes with foveal thickness (central retinal thickness without subretinal fluid) of 700 μm or greater, peripheral ischemia was present in 69 % of eyes, final BCVA was 20/200 or less in 75 % and never reached 20/40 during follow-up. The integrity of the junction of the photoreceptors’ inner and outer segments was correlated with a better prognosis (p < 0.05). Foveal thickness was inversely correlated to BCVA at each visit and could have a prognostic value. OCT examination in CRVO revealed useful data for the diagnosis of CRVO and its prognosis. The largest macular edemas seemed to be the hallmark of ischemic CRVO.
Similar content being viewed by others
References
Shahidi M, Ogura Y, Blair NP, Rusin MM, Zeimer R (1991) Retinal thickness analysis for quantitative assessment of diabetic macular edema. Arch Ophthalmol 109:1115–1119
Nussenblatt RB, Kaufman SC, Palestine AG, Davis MD, Ferris FL III (1987) Macular thickening and visual acuity. Measurement in patients with cystoid macular edema. Ophthalmology 94:1134–1139
Suzuma K, Kita M, Yamana T et al (1998) Quantitative assessment of macular edema with retinal vein occlusion. Am J Ophthalmol 126:409–416
Catier A, Tadayoni R, Paques M et al (2005) Characterization of macular edema from various etiologies by optical coherence tomography. Am J Ophthalmol 140:200–206
Spaide RF, Lee JK, Klancnik JK Jr, Gross NE (2003) Optical coherence tomography of branch retinal vein occlusion. Retina 23:343–347
Shroff D, Mehta DK, Arora R, Narula R, Chauhan D (2008) Natural history of macular status in recent-onset branch retinal vein occlusion: an optical coherence tomography study. Int Ophthalmol 28:261–268
Yamaike N, Tsujikawa A, Ota M et al (2008) Three-dimensional imaging of cystoid macular edema in retinal vein occlusion. Ophthalmology 115:355–362
Ota M, Tsujikawa A, Murakami T et al (2009) Association between integrity of foveal photoreceptor layer and visual acuity in branch retinal vein occlusion. Br J Ophthalmol 91:1644–1649
Ota M, Tsujikawa A, Kita M et al (2008) Integrity of foveal photoreceptor layer in central retinal vein occlusion. Retina 28:1502–1508
Lima VC, Yeung L, Castro LC, Landa G, Rosen RB (2011) Correlation between spectral domain optical coherence tomography findings and visual outcomes in central retinal vein occlusion. Clin Ophthalmol 5:299–305
Jittpoonkuson T, Garcia P, Rosen RB (2010) Correlation between fluorescein angiography and spectral domain optical coherence tomography in the diagnosis of cystoid macular edema. Br J Ophthalmol 94:1197–1200
Brar M, Yuson R, Kozak I et al (2010) Correlation between morphologic features on spectral-domain optical coherence tomography and angiographic leakage patterns in macular edema. Retina 30:383–389
The Central Vein Occlusion Study Group M Report (1995) Evaluation of grid pattern photocoagulation for macular edema in central vein occlusion. Ophthalmology 102:1425–1433
Chung EJ, Roh MI, Kwon OW, Koh HJ (2008) Effects of macular ischemia on the outcome of intravitreal bevacizumab therapy for diabetic macular edema. Retina 28:957–963
Lujan BJ (2011) Revealing Henle’s Fiber Layer using spectral-domain OCT. Invest Ophthalmol Vis Sci 52:1486–1492
Paques M, Tadayoni R, Sercombe R et al (2003) Structural and hemodynamic analysis of the mouse retinal microcirculation. Invest Ophthalmol Vis Sci 44:4960–4967
Noma H, Funatsu H, Mimura T, Harino S, Hori S (2010) Aqueous humor levels of vasoactive molecules correlate with vitreous levels and macular edema in central retinal vein occlusion. Eur J Ophthalmol 20:402–409
Otani T, Kishi S, Maruyama Y (1999) Patterns of diabetic macular edema with optical coherence tomography. Am J Ophthalmol 127:688–693
Zhang HR, Wang X, Lu XR, Yang YF, Liu F (2005) Measurement of macular edema in retinal vein occlusion using optical coherence tomography and its visual prognosis. Zhonghua Yan Ke Za Zhi 41:910–916
Helb HM, Issa PC, Fleckenstein M et al (2010) Clinical evaluation of simultaneous confocal scanning laser ophthalmoscopy imaging combined with high-resolution, spectral-domain optical coherence tomography. Acta Ophthalmol 88:842–849
Shin HJ, Chung H, Kim HC (2011) Association between integrity of foveal photoreceptor layer and visual outcome in retinal vein occlusion. Acta Ophthalmol 89:e35–e40
Glacet-Bernard A, Coscas G, Chabanel A, Zourdani A, Lelong F, Samama MM (1996) Prognostic factors for retinal vein occlusion: prospective study of 175 cases. Ophthalmology 103:551–560
Ach T, Hoeh AE, Schaal KB, Scheuerle AF, Dithmar S (2010) Predictive factors for changes in macular edema in intravitreal bevacizumab therapy of retinal vein occlusion. Graefes Arch Clin Exp Ophthalmol 248:155–159
Scott IU, Vanveldhuisen PC, Oden NL, Ip MS, Blodi BA, Hartnett ME, Cohen G, Standard Care Versus Corticosteroid for Retinal Vein Occlusion Study Investigator Group (2011) Baseline predictors of visual acuity and retinal thickness outcomes in patients with retinal vein occlusion: Standard Care Versus COrticosteroid for REtinal Vein Occlusion Study report 10. Ophthalmology 118:345–352
Conflict of Interest
No financial support. No financial interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Martinet, V., Guigui, B., Glacet-Bernard, A. et al. Macular edema in central retinal vein occlusion: correlation between optical coherence tomography, angiography and visual acuity. Int Ophthalmol 32, 369–377 (2012). https://doi.org/10.1007/s10792-012-9578-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10792-012-9578-5