Correlation between macular edema recurrence and macular capillary network destruction in branch retinal vein occlusion
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RESEARCH ARTICLE
Open Access
Correlation between macular edema recurrence and macular capillary network destruction in branch retinal vein occlusion Ji Hye Jang1,2* , Yu Cheol Kim1
and Jae Pil Shin3
Abstract Background: The aim of this study was to evaluate the correlation between changes in the macular capillary network and macular edema (ME) recurrence with branch retinal vein occlusion (BRVO) using swept-source optical coherence tomography angiography (SS-OCTA). Methods: We reviewed the data for 43 patients with treatment-naïve ME associated with BRVO. Patients who received intravitreal bevacizumab injection were divided into two groups based on ME recurrence at 6 months after edema resolution. The perifoveal capillary morphology and the macular capillary vessel density (VD) were retrospectively analyzed using en face SS-OCTA after ME resolution. Results: The perifoveal capillary ring loss in the superficial capillary plexus (SCP) and deep capillary plexus (DCP) was more common in the ME recurrence group (n = 22) than in the no ME recurrence group (p = 0.047 and p = 0.002). Relative to the findings in the no ME recurrence groups, the destruction of the perifoveal capillary ring was more severe in the DCP (30.0° vs 87.3°, p = 0.001) than in the SCP (17.3° vs 69.5°, p = 0.006) in the ME recurrence group. The hemi-VD disparity between the affected and the unaffected areas in the SCP and DCP showed significant differences (p = 0.031 and p = 0.017), while macular VD showed no differences between the groups. Conclusions: Destruction of the perifoveal capillary ring and hemi-VD disparity could be related to ME recurrence in BRVO. Therefore, these factors may be helpful in predicting ME recurrence. Keywords: Branch retinal vein occlusion, Macular capillary network, Macular edema, Optical coherent tomography angiography, Vessel density
Background Macular edema (ME) is the most common cause of visual loss in patients with branch retinal vein occlusion (BRVO). It is caused by physical destruction of the inner blood-retinal barrier due to elevated venous pressure as a result of vein occlusion at the arteriovenous crossing site [1, 2]. With respect to the natural progression of * Correspondence: [email protected] 1 Department of Ophthalmology, Keimyung Universtiy School of Medicine, Daegu, Republic of Korea 2 Keimyung University Institute for Medical Science, Daegu, Republic of Korea Full list of author information is available at the end of the article
BRVO, ME occurs in 5–15% of the cases within 1 year from the initial onset. While spontaneous resolution is achieved in less than half the cases, recovery of visual acuity to 20/40 or better is rare [3]. Other factors involved in the onset of ME include increased vascular permeability caused by vascular endothelial growth factors (VEGFs) or various inflammatory cytokines [4, 5]. Increased levels of intravitreal VEGFs are associated with nonperfusion areas in the retinal capillaries and the severity of ME [5, 6]. However, many cases still require re-treatment because of
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