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Neuroretinal atrophy following resolution of macular oedema in retinal vein occlusion.
Br J Ophthalmol. 2019 01; 103(1):36-42.BJ

Abstract

BACKGROUND/AIMS

To characterise neuroretinal atrophy in retinal vein occlusion (RVO).

METHODS

We included patients with central/branch RVO (CRVO=196, BRVO=107) who received ranibizumab according to a standardised protocol for 6 months. Retinal atrophy was defined as the presence of an area of retinal thickness (RT) <260 µm outside the foveal centre. Moreover, the thickness of three distinct retinal layer compartments was computed as follows: (1) retinal nerve fibre layer to ganglion cell layer, (2) inner plexiform layer (IPL) to outer nuclear layer (ONL) and (3) inner segment/outer segment junction to retinal pigment epithelium. To characterise atrophy further, we assessed perfusion status on fluorescein angiography and best-corrected visual acuity (BCVA), and compared these between eyes with/without atrophy.

RESULTS

23 patients with CRVO and 11 patients with BRVO demonstrated retinal atrophy, presenting as sharply demarcated retinal thinning confined to a macular quadrant. The mean RT in the atrophic quadrant at month 6 was 249±26 µm (CRVO) and 244±29 µm (BRVO). Individual layer analysis revealed pronounced thinning in the IPL to ONL compartment. Change in BCVA at 6 months was similar between the groups (BRVO, +15 vs +18 letters; CRVO, +14 vs +18 letters).

CONCLUSIONS

In this exploratory analysis, we describe the characteristics of neuroretinal atrophy in RVO eyes with resolved macular oedema after ranibizumab therapy. Our analysis shows significant, predominantly retinal thinning in the IPL to ONL compartment in focal macular areas in 11% of patients with RVO. Eyes with retinal atrophy did not show poorer BCVA outcomes.

Authors+Show Affiliations

Christian Doppler Laboratory for Ophthalmic Image Analysis, Vienna Reading Center, Department of Ophthalmology, Medical University of Vienna, Vienna, Austria.Christian Doppler Laboratory for Ophthalmic Image Analysis, Vienna Reading Center, Department of Ophthalmology, Medical University of Vienna, Vienna, Austria.Christian Doppler Laboratory for Ophthalmic Image Analysis, Vienna Reading Center, Department of Ophthalmology, Medical University of Vienna, Vienna, Austria.Center for Medical Statistics, Informatics, and Intelligent Systems (CeMSIIS), Medical University of Vienna, Vienna, Austria.Christian Doppler Laboratory for Ophthalmic Image Analysis, Vienna Reading Center, Department of Ophthalmology, Medical University of Vienna, Vienna, Austria.Christian Doppler Laboratory for Ophthalmic Image Analysis, Vienna Reading Center, Department of Ophthalmology, Medical University of Vienna, Vienna, Austria.Christian Doppler Laboratory for Ophthalmic Image Analysis, Vienna Reading Center, Department of Ophthalmology, Medical University of Vienna, Vienna, Austria.Christian Doppler Laboratory for Ophthalmic Image Analysis, Vienna Reading Center, Department of Ophthalmology, Medical University of Vienna, Vienna, Austria.Christian Doppler Laboratory for Ophthalmic Image Analysis, Vienna Reading Center, Department of Ophthalmology, Medical University of Vienna, Vienna, Austria.

Pub Type(s)

Clinical Trial, Phase III
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

29511062

Citation

Podkowinski, Dominika, et al. "Neuroretinal Atrophy Following Resolution of Macular Oedema in Retinal Vein Occlusion." The British Journal of Ophthalmology, vol. 103, no. 1, 2019, pp. 36-42.
Podkowinski D, Philip AM, Vogl WD, et al. Neuroretinal atrophy following resolution of macular oedema in retinal vein occlusion. Br J Ophthalmol. 2019;103(1):36-42.
Podkowinski, D., Philip, A. M., Vogl, W. D., Gamper, J., Bogunovic, H., Gerendas, B. S., Haj Najeeb, B., Waldstein, S. M., & Schmidt-Erfurth, U. (2019). Neuroretinal atrophy following resolution of macular oedema in retinal vein occlusion. The British Journal of Ophthalmology, 103(1), 36-42. https://doi.org/10.1136/bjophthalmol-2017-311614
Podkowinski D, et al. Neuroretinal Atrophy Following Resolution of Macular Oedema in Retinal Vein Occlusion. Br J Ophthalmol. 2019;103(1):36-42. PubMed PMID: 29511062.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Neuroretinal atrophy following resolution of macular oedema in retinal vein occlusion. AU - Podkowinski,Dominika, AU - Philip,Ana-Maria, AU - Vogl,Wolf-Dieter, AU - Gamper,Jutta, AU - Bogunovic,Hrvoje, AU - Gerendas,Bianca S, AU - Haj Najeeb,Bilal, AU - Waldstein,Sebastian M, AU - Schmidt-Erfurth,Ursula, Y1 - 2018/03/06/ PY - 2017/11/14/received PY - 2018/02/13/revised PY - 2018/02/16/accepted PY - 2018/3/8/pubmed PY - 2019/9/21/medline PY - 2018/3/8/entrez KW - imaging KW - retina SP - 36 EP - 42 JF - The British journal of ophthalmology JO - Br J Ophthalmol VL - 103 IS - 1 N2 - BACKGROUND/AIMS: To characterise neuroretinal atrophy in retinal vein occlusion (RVO). METHODS: We included patients with central/branch RVO (CRVO=196, BRVO=107) who received ranibizumab according to a standardised protocol for 6 months. Retinal atrophy was defined as the presence of an area of retinal thickness (RT) <260 µm outside the foveal centre. Moreover, the thickness of three distinct retinal layer compartments was computed as follows: (1) retinal nerve fibre layer to ganglion cell layer, (2) inner plexiform layer (IPL) to outer nuclear layer (ONL) and (3) inner segment/outer segment junction to retinal pigment epithelium. To characterise atrophy further, we assessed perfusion status on fluorescein angiography and best-corrected visual acuity (BCVA), and compared these between eyes with/without atrophy. RESULTS: 23 patients with CRVO and 11 patients with BRVO demonstrated retinal atrophy, presenting as sharply demarcated retinal thinning confined to a macular quadrant. The mean RT in the atrophic quadrant at month 6 was 249±26 µm (CRVO) and 244±29 µm (BRVO). Individual layer analysis revealed pronounced thinning in the IPL to ONL compartment. Change in BCVA at 6 months was similar between the groups (BRVO, +15 vs +18 letters; CRVO, +14 vs +18 letters). CONCLUSIONS: In this exploratory analysis, we describe the characteristics of neuroretinal atrophy in RVO eyes with resolved macular oedema after ranibizumab therapy. Our analysis shows significant, predominantly retinal thinning in the IPL to ONL compartment in focal macular areas in 11% of patients with RVO. Eyes with retinal atrophy did not show poorer BCVA outcomes. SN - 1468-2079 UR - https://www.unboundmedicine.com/medline/citation/29511062/Neuroretinal_atrophy_following_resolution_of_macular_oedema_in_retinal_vein_occlusion_ L2 - https://bjo.bmj.com/lookup/pmidlookup?view=long&amp;pmid=29511062 DB - PRIME DP - Unbound Medicine ER -