Correlation between spectral domain optical coherence tomography findings and visual outcomes in central retinal vein occlusion

Verônica Castro Lima¹, Ling Yeung^1,2, Leonardo C Castro³, Gennady Landa¹, Richard B Rosen^1,4
1Retina Service, Department of Ophthalmology, The New York Eye and Ear Infirmary, New York, NY, USA; ²Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung, Taiwan; ³New England Eye Center, Tufts Medical Center, Boston, MA, USA; ⁴The New York Medical College, Valhalla, NY, USA

Purpose: To investigate the relationship between spectral domain optical coherence tomography (SD-OCT) findings and visual outcomes following resolution of macular edema in central retinal vein occlusion (CRVO).
Methods: Patients with recent onset CRVO who had undergone SD-OCT and fluorescein angiography (FA) exams on the day of initial presentation were included. All patients had resolution of macular edema in SD-OCT images at the end of follow-up, and they were separated into two groups according to final visual acuity: group 1 (≤ 20/200) and group 2 (> 20/200). SD-OCT scans and FA studies were analyzed in a masked fashion. Macular perfusion status by FA was categorized according to presence or absence of macular ischemia.
Results: A total of 22 eyes from 22 patients [mean age 53.0 ± 15.0 (standard deviation)] were included. Mean follow up period was 14.6 ± 8.1 (standard deviation) months. Group 1 (10 eyes) had significantly higher rates of residual intraretinal fluid, loss of foveal inner segment/outer segment (IS/OS) junction line and loss of inner retinal layers in late stage SD-OCT images (P = 0.027) when compared with group 2 (12 eyes). Loss of foveal IS/OS junction line (odds ratio [OR] = 13.826; P = 0.098) and loss of inner retinal layers (OR = 38.908; P = 0.013) in late stage SD-OCT images were correlated with poorer final visual outcomes. Macular ischemia by FA correlated with thinner central subfield thickness (r = —0.54, P = 0.021) and loss of inner retinal layers (r = 0.47, P = 0.031) in early stage SD-OCT images; and presence of residual intraretinal fluid (r = 0.61, P = 0.003) and loss of inner retinal layers (r = 0.71, P < 0.001) in late stage SD-OCT images.
Conclusion: Loss of foveal IS/OS junction line and inner retinal layers on SD-OCT significantly correlated with poorer visual outcomes in CRVO patients.
Keywords: macular edema, inner retinal layers, macular ischemia