Changes in peripapillary and subfoveal choroidal thickness in patients with central retinal vein occlusion.

Hae Min Kang,Hyoung Jun Koh,Sung Chul Lee,Jeong Hoon Choi,Se Woong Kang

doi:10.1371/journal.pone.0255182

Abstract

PurposeWe sought to evaluate changes of mean peripapillary choroidal thickness (PCT) and subfoveal choroidal thickness (SFCT) over 12 months in patients with unilateral central retinal vein occlusion (CRVO).MethodsOur retrospective, observational study included 19 patients with treatment-naïve, unilateral CRVO who completed at least 12 months of follow-up period. Mean PCT and mean SFCT in CRVO-affected eyes and unaffected contralateral eyes were measured at each follow-up visit, and then compared. Differences between baseline and 12 months (ΔSFCT and ΔPCT) and percentage changes (ΔSFCT or ΔPCT/baseline×100%) were determined. We also investigated the predictive factors for visual outcome in the CRVO-affected eyes.ResultsIn the CRVO-affected eyes, mean PCT was 146.7±41.9 μm at baseline, and 106.5±24.2 μm at 12 months (P < 0.001). Mean PCT of the contralateral eyes was 129.8±42.6 μm at baseline and 124.6±39.7 μm at 12 months (P = 0.089). Mean SFCT of CRVO-affected eyes was 225.8±77.9 μm at baseline, and 199.4±66.6 μm at 12 months (P = 0.009). Mean SFCT of the contralateral eyes was 218.4±83.0 μm at baseline, and 208.4±78.1 μm at 12 months (P = 0.089). Δ PCT was -41.6±25.3 μm in the CRVO-affected eyes, and -5.2±5.8 μm in the contralateral eyes (P<0.001). % PCT was -24.9±14.0% in the CRVO-affected eyes, and -4.0±0.4% in the contralateral eyes (P = 0.001). Δ SFCT was -26.4±24.6 μm in the CRVO-affected eyes, and -9.5±16.7μm in the contralateral eyes (P = 0.016). % SFCT was -10.4±9.8% in the CRVO-affected eyes, and -3.4±6.4% in the contralateral eyes (P = 0.015). Among the various factors, BCVA at baseline (β = 0.797, P = 0.001) and % SFCT (β = 0.712, P = 0.001) were significantly associated with visual outcome at 12 months in the CRVO-affected eyes.ConclusionBoth peripapillary and subfoveal choroidal thickness reduced significantly over 12 months in the CRVO-affected eyes, but not in the contralateral eyes. In addition, the absolute reduction amount and reduction ratio of PCT and SFCT were significantly greater in the CRVO-affected eyes than the contralateral eyes.

Highlights

Central retinal vein occlusion (CRVO) is a vision-threatening retinal vascular disease that can lead to permanent vision loss
In the CRVO-affected eyes, mean peripapillary choroidal thickness (PCT) was 146.7±41.9 μm at baseline, and 106.5±24.2 μm at 12 months (P < 0.001)
The absolute reduction amount and reduction ratio of PCT and subfoveal choroidal thickness (SFCT) were significantly greater in the CRVOaffected eyes than the contralateral eyes

Summary

Introduction

Central retinal vein occlusion (CRVO) is a vision-threatening retinal vascular disease that can lead to permanent vision loss. Several devastating complications can result from CRVO, including macular edema, retinal neovascularization, vitreous hemorrhage, and neovascular glaucoma, which can lead to permanent visual loss [1]. Anatomic variations at the level of the lamina cribrosa may be important in CRVO pathogenesis, as a thrombus occluding the lumen of the central retinal vein at or just proximal to the lamina cribrosa, a meshwork supporting the optic nerve head (ONH), was identified in a histopathological study [13]. Because the central retinal vein and central retinal artery penetrate the lamina cribrosa [14], these vessels are naturally compressed as they cross through the rigid, sieve-like openings in the lamina cribrosa [1]. Some studies have postulated that hemodynamic alterations induce stagnation of blood flow in the vein and result in primary thrombus formation in susceptible eyes [15,16]

Objectives

Methods

Results

Conclusion