Relationship Between Nerve Fiber Layer Hemorrhages and Outcomes in Central Retinal Vein Occlusion

To evaluate the depth and pattern of retinal hemorrhage in acute central retinal vein occlusion (CRVO) and to correlate these with visual and anatomic outcomes. Retinal hemorrhages were evaluated with color fundus photography and fluorescein angiography at baseline and follow-up. Snellen visual acui...

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Bibliographic Details
Published in:Investigative ophthalmology & visual science 2020-05, Vol.61 (5), p.54-54
Main Authors: Au, Adrian, Hilely, Assaf, Scharf, Jackson, Gunnemann, Frederic, Wang, Derrick, Chehaibou, Ismael, Iovino, Claudio, Grondin, Christelle, Farecki, Marie-Louise, Falavarjani, Khalil Ghasemi, Phasukkijwatana, Nopasak, Battista, Marco, Borrelli, Enrico, Sacconi, Riccardo, Powell, Brittany, Hom, Grant, Greenlee, Tyler E, Conti, Thais F, Ledesma-Gil, Gerardo, Teke, Mehmet Yasin, Choudhry, Netan, Fung, Adrian T, Krivosic, Valerie, Baek, Jiwon, Lee, Mee Yon, Sugiura, Yoshimi, Querques, Giuseppe, Peiretti, Enrico, Rosen, Richard, Lee, Won Ki, Yannuzzi, Lawrence A, Zur, Dinah, Loewenstein, Anat, Pauleikhoff, Daniel, Singh, Rishi, Modi, Yasha, Hubschman, Jean Pierre, Ip, Michael, Sadda, SriniVas, Freund, K Bailey, Sarraf, David
Format: Article
Language:English
Subjects:
Acute Disease
Aged
Correlation of Data
Female
Fovea Centralis - pathology
Humans
Ischemia - etiology
Male
Middle Aged
Neovascularization, Pathologic
Nerve Fibers - pathology
Retina
Retinal Hemorrhage - etiology
Retinal Hemorrhage - pathology
Retinal Vein Occlusion - complications
Retrospective Studies
Severity of Illness Index
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Summary:To evaluate the depth and pattern of retinal hemorrhage in acute central retinal vein occlusion (CRVO) and to correlate these with visual and anatomic outcomes. Retinal hemorrhages were evaluated with color fundus photography and fluorescein angiography at baseline and follow-up. Snellen visual acuity (VA), central foveal thickness (CFT), extent of retinal ischemia, and development of neovascularization were analyzed. 108 eyes from 108 patients were evaluated. Mean age was 63.6 ± 16.1 years with a predilection for the right eye (73.1%). Average follow-up was 17.2 ± 19.2 months. Mean VA at baseline was 20/126 and 20/80 at final follow-up. Baseline (P = 0.005) and final VA (P = 0.02) in eyes with perivascular nerve fiber layer (NFL) hemorrhages were significantly worse than in eyes with deep hemorrhages alone. Baseline CFT was greater in the group with perivascular hemorrhages (826 ± 394 µm) compared to the group with deep hemorrhages alone (455 ± 273 µm, P < 0.001). The 10 disc areas of retinal ischemia was more common in patients with perivascular (80.0%) and peripapillary (31.3%) versus deep hemorrhages alone (16.1%, P < 0.001). Neovascularization of the iris was more common, although this differrence was not significant, in the groups with peripapillary (14.3%) and perivascular (2.0%) NFL versus deep hemorrhages alone (0.0%). NFL retinal hemorrhages at baseline correlate with more severe forms of CRVO, with greater macular edema, poorer visual outcomes, and greater risk of ischemia and neovascularization. This may be related to the organization of the retinal capillary plexus. The depth and pattern of distribution of retinal hemorrhages in CRVO may provide an easily identifiable early biomarker of CRVO prognosis.
ISSN:1552-5783
0146-0404
1552-5783
DOI:10.1167/iovs.61.5.54