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Frederiksen KH, Pedersen FN, Vergmann AS, Yang D, Laugesen CS, Vestergaard JP, Sørensen TL, Cheung CY, Kawasaki R, Peto T, Grauslund J. Predictive value of retinal oximetry, optical coherence tomography angiography and microperimetry in patients with treatment-naïve branch retinal vein occlusion. Int J Retina Vitreous 2023; 9:38. [PMID: 37381014 DOI: 10.1186/s40942-023-00468-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 04/06/2023] [Indexed: 06/30/2023] Open
Abstract
Vascular endothelial growth factor inhibitors have substantially improved the visual outcomes in patients with macular edema (ME) caused by branch retinal vein occlusion (BRVO), but treatment outcomes are highly variable and early prediction of expected clinical outcome would be important for individualized treatment.As non-invasive metabolic, structural and functional retinal markers might act as early predictors of clinical outcomes, we performed a 12-month, prospective study aimed to evaluate if baseline retinal oximetry, optical coherence tomography angiography (OCT-A) or microperimetry were able to predict need of treatment, structural or functional outcome in patients with ME caused by treatment-näive BRVO.We evaluated 41 eyes of 41 patients with a mean age of 69.6 years and 56% females. We found a strong tendency towards a higher retinal arteriolar oxygen saturation in patients without a need of additional aflibercept treatment after the loading phase (99.8% vs. 92.3%, adjusted odds ratio 0.80 (95% confidence interval 0.64-1.00), adjusted p = 0.058), but otherwise, retinal oximetry, OCT-A or microperimetry were not able to predict need of treatment, structural nor functional outcomes. (Trial registration: clinicaltrials.gov, S-20,170,084. Registered 24 August 2014, https://clinicaltrials.gov/ct2/show/NCT03651011 ).
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Affiliation(s)
- Katrine Hartmund Frederiksen
- Department of Ophthalmology, Odense University Hospital, Odense, Denmark.
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
| | - Frederik Nørregaard Pedersen
- Department of Ophthalmology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | | | - Dawei Yang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
| | | | | | - Torben Lykke Sørensen
- Department of Ophthalmology, Zealand University Hospital, Roskilde, Denmark
- Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark
| | - Carol Y Cheung
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
| | - Ryo Kawasaki
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Vision Informatics, Osaka University School of Medicine, Osaka, Japan
| | - Tunde Peto
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University, Belfast, Northern Ireland, UK
| | - Jakob Grauslund
- Department of Ophthalmology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
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Yin S, Cui Y, Jiao W, Zhao B. Potential Prognostic Indicators for Patients With Retinal Vein Occlusion. Front Med (Lausanne) 2022; 9:839082. [PMID: 35692537 PMCID: PMC9174432 DOI: 10.3389/fmed.2022.839082] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 02/16/2022] [Indexed: 11/13/2022] Open
Abstract
The second most prevalent cause of retinal vascular disease is retinal vein occlusion (RVO). RVO raises intravascular pressure in the capillary and veins, triggering vessel barrier collapse and subsequent leaking of blood or plasma components into the tissue (edema). Macular edema (ME) is a major complication of RVO that results in significant visual impairment. Laser therapy, intravitreal steroid injections, and vascular endothelial growth factor (VEGF) inhibitors are the major therapeutic techniques. Different therapies reduce ME of RVO and improve visual activity. However, some people have no impact on the resolution of ME, while others have a poor visual prognosis despite full ME cure. There are many investigators who studied the relationship between indicators of various instruments with visual activity. However, a summary of those findings is currently lacking. Therefore, we will focus on the predictive factors of different studies associated with positive visual activity outcomes, which would be very useful and important to help address both treatment expectations and methods for patients with RVO.
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Affiliation(s)
- Shan Yin
- The First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yanyan Cui
- Department of Ophthalmology, Liaocheng People’s Hospital, Liaocheng, China
| | - Wanzhen Jiao
- Department of Ophthalmology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Bojun Zhao
- Department of Ophthalmology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
- *Correspondence: Bojun Zhao,
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Sugimoto M, Wakamatsu Y, Miyata R, Kato K, Matsubara H, Kondo M. Effectiveness of microperimetry in evaluating anti-vascular endothelial growth factor therapy for diabetic macular edema patients with relatively good vision: A retrospective observational study. Medicine (Baltimore) 2021; 100:e28404. [PMID: 34941181 PMCID: PMC8702257 DOI: 10.1097/md.0000000000028404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 12/02/2021] [Indexed: 11/25/2022] Open
Abstract
No studies have evaluated the retinal sensitivity (RS) for diabetic macular edema (DME) patients with good vision. Therefore, this study aimed to determine the effectiveness of microperimetry in evaluating the effectiveness of anti-vascular endothelial growth factor (anti-VEGF) treatment for DME patients with relatively good vision.Twenty-seven eyes of 27 patients (mean age, 61.3 ± 11.2 years) with DME and decimal best-corrected visual acuity (BCVA) ≥0.6 were studied. All patients received 3 consecutive monthly injections of intravitreal anti-VEGF agents. The BCVA, central subfield macular thickness (CMT), and RS were evaluated by microperimetry (MAIA) within the 10 degree of the foveal center. To determine significant differences between the values, we used paired t tests.Patients were evaluated at baseline and 4 weeks after the third injection. The BCVA improved significantly from 0.18 ± 0.06 logarithm of the minimum angle of resolution (logMAR) units to 0.13 ± 0.13 logMAR units (P = .002; paired t test). The CMT decreased significantly from 464.3 ± 91.8 μm to 393.4 ± 129.0 μm (P = .005), and the RS also improved significantly from 21.8 ± 3.1 dB to 24.1 ± 2.8 dB at 4 weeks after treatment (P = .006). Among the patients with a decimal BCVA of 0.7 or better at baseline, there was no significant improvement in the BCVA (P = .28). However, the CMT decreased significantly from 479.5 ± 79.1 μm to 394.0 ± 99.8 μm at 4 weeks after treatment (P = .007). The RS also improved significantly from 22.0 ± 2.4 dB to 24.0 ± 3.1 dB at 4 weeks after treatment (P = .004).Measuring RS by microperimetry is a good option for evaluating the effectiveness of anti-VEGF treatment for DME patients with a relatively good BCVA.
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Fujino R, Asaoka R, Aoki S, Sugiura A, Kusakabe M, Asano-Shimizu K, Nomura Y, Aoki A, Hashimoto Y, Azuma K, Inoue T, Obata R. The usefulness of the retinal sensitivity measurement with a microperimetry for predicting the visual prognosis of branch retinal vein occlusion with macular edema. Graefes Arch Clin Exp Ophthalmol 2020; 258:1949-1958. [PMID: 32458100 PMCID: PMC7438381 DOI: 10.1007/s00417-020-04759-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 05/08/2020] [Accepted: 05/19/2020] [Indexed: 12/02/2022] Open
Abstract
Purpose To evaluate the usefulness of the retinal sensitivity in branch retinal vein occlusion (BVO) with macular edema (ME) following the anti-vascular endothelial growth factor (anti-VEGF) treatment. Methods Best-corrected visual acuity (BCVA), microperimetry, and optical coherence tomography (OCT) measurements were carried out in 20 patients with BVO with ME, at baseline and 1 month after the anti-VEGF treatment. The relationships among BCVA, mean retinal sensitivity (MS), macular volume (MV), central retinal thickness (CRT), integrity of ellipsoid zone (EZ), mean retinal sensitivity in the most affected quadrant (qMS), and macular volume in the most affected quadrant (qMV) were investigated. In addition, the relationships among the change in BCVA at 1 month (ΔBCVA1m), mean sensitivity in the most affected quadrant at 1 month (ΔqMS1m), MV in the most affected quadrant at 1 month (ΔqMV1m), and CRT at 1 month (ΔCRT1m) were analyzed. The optimal model for BCVA at 3 months after the treatment (BCVA3m) was identified. Results There was not a significant difference in BCVA (paired Wilcoxon test, p = 0.058) between at baseline and after the treatment, but there were significant differences in MS, MV, CRT, qMS, and qMV (p < 0.05). There was a significant relationship between ΔqMS1m and ΔMV1m, ΔCRT1m, and ΔqMV1m, respectively. ΔMS1m or ΔqMS1m and BCVA at baseline and ΔBCVA1m were selected as explanatory variables in the optimal model for BCVA3m. Conclusion Retinal sensitivity was related to retinal structure, whereas this was not the case with BCVA. In addition, retinal sensitivity was useful to predict BCVA after anti-VEGF therapy.
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Affiliation(s)
- Ryosuke Fujino
- Department of Ophthalmology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.,Asahi General Hospital, Chiba, Japan
| | - Ryo Asaoka
- Department of Ophthalmology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
| | - Shuichiro Aoki
- Department of Ophthalmology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Aya Sugiura
- Department of Ophthalmology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Mari Kusakabe
- Department of Ophthalmology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Kimiko Asano-Shimizu
- Department of Ophthalmology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.,Asahi General Hospital, Chiba, Japan
| | - Yoko Nomura
- Department of Ophthalmology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Aya Aoki
- Department of Ophthalmology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Yohei Hashimoto
- Department of Ophthalmology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Keiko Azuma
- Department of Ophthalmology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Tatsuya Inoue
- Department of Ophthalmology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. .,Department of Ophthalmology and Micro-technology, Yokohama City University, Yokohama, Kanagawa, Japan.
| | - Ryo Obata
- Department of Ophthalmology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
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Multimodal OCT Reflectivity Analysis of the Cystoid Spaces in Cystoid Macular Edema. BIOMED RESEARCH INTERNATIONAL 2019; 2019:7835372. [PMID: 31016197 PMCID: PMC6446091 DOI: 10.1155/2019/7835372] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Revised: 07/12/2018] [Accepted: 12/30/2018] [Indexed: 11/24/2022]
Abstract
Purpose To compare and evaluate images of macular cysts with different degrees of reflectivity (from gray to black signal) as observed in B scan spectral domain OCT (SDOCT) and EnFace OCT with decorrelation signal obtained with OCT-angiography (OCTA) in eyes with cystoid macular edema (CME) secondary to diabetic retinopathy (DR) and retinal vein occlusion (RVO). Methods Images from 3033 patients affected by CME secondary to diabetes or RVO examined OCTA (Optovue XR Avanti, Optovue, USA) at the University Eye Clinic of Créteil, Hôpital Intercommunal, France, and at the University Eye Clinic of Cagliari, “San Giovanni di Dio” Hospital, Italy, were retrospectively examined. The deep capillary plexus OCTA images and the corresponding EnFace OCT images, both acquired with the same automatic segmentation, had been overlapped to compose RGB color images as red and green channels, respectively, using ImageJ software (National Institutes of Health, Bethesda, MD). Afterward, linear regions of interest were traced on the color images to obtain the profiles of OCTA and EnFace gray values. Number of pixels, mean gray value and standard deviation of the area traced in OCT-A, and EnFace image were analyzed and statistically correlated. Data were exported to Excel to create the plots. Results 94 patients with DME and 27 patients with RVO showed intraretinal macular cystoid spaces with similar homogeneous, gray-looking content; 73 patients with DME and 113 patients with RVO showed macular cystoid spaces with homogeneous, black-looking content, as observed at SD-OCT, EnFace and OCTA scans. Interestingly, the limits of macular cystoid spaces were clearly detectable with OCTA. The analysis of red and green profiles demonstrated a clearly visible overlap between average OCTA and EnFace signal observed around cystoid spaces that could be attributed to a relationship between the dynamic vascularization and the structural density of the tissue. Conclusions This is the first investigation that characterizes and correlates OCTA and EnFace signals on images of macular cystoid spaces in DR and RVO. The low intensity OCTA signals observed inside cystoid spaces raise a relevant question about their nature, as to whether they are due to the presence of corpusculated material pouring out from bloodocular-barrier or they should be considered OCTA artifacts.
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New Developments in the Classification, Pathogenesis, Risk Factors, Natural History, and Treatment of Branch Retinal Vein Occlusion. J Ophthalmol 2017; 2017:4936924. [PMID: 28386476 PMCID: PMC5366235 DOI: 10.1155/2017/4936924] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Accepted: 02/07/2017] [Indexed: 12/15/2022] Open
Abstract
For years, branch retinal vein occlusion is still a controversial disease in many aspects. An increasing amount of data is available regarding classification, pathogenesis, risk factors, natural history, and therapy of branch retinal vein occlusion. Some of the conclusions may even change our impression of branch retinal vein occlusion. It will be beneficial for our doctors to get a deeper understanding of this disease and improve the treatment skills. The aims of this review is to collect the information above and report new ideas especially from the past a few years.
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