Abstract
PurposeTo investigate the clinical features of a macrophage-like cell (MLC) obtained by en face optical coherence tomography (OCT) in retinal vein occlusion (RVO).MethodsThe study involved 36 patients with treatment-naïve unilateral acute RVO, including 21 branch RVO (BRVO) and 15 central RVO. Vessel density and macular thickness were quantified using OCT angiography. A 3-μm en face OCT slab on the inner limiting membrane in the optic nerve head (ONH) region or macular region was used to visualize the MLCs. The MLCs were binarized and quantified using a semiautomated method. The unaffected fellow eyes served as the control group.ResultsThe morphology of MLCs appeared larger and plumper in RVO eyes. The mean MLC density in the ONH and macular regions was 2.46 times and 2.86 times higher than their fellow eyes, respectively (p < 0.001). The macular MLC density of the occlusive region was significantly lower than that of the unaffected region in BRVO (p = 0.01). The ONH and macular MLC densities in the non-perfused region were significantly lower than those in the perfused region in all RVO eyes (p < 0.001). The ONH MLC density in RVO eyes was negatively correlated with radial peripapillary capillary vessel density (r = −0.413, p = 0.012). Both ONH and macular MLC densities were positively correlated with macular thickness (r = 0.505, p = 0.002; r = 0.385, p = 0.02, respectively).ConclusionThe increased density and changes of morphology characterized by OCT may indicate generalized activation and aggregation of MLCs in RVO. More MLCs are recruited in the perfused region rather than the non-perfused region. RVO eyes with a higher density of MLCs tend to suffer from the thicker macula.
Highlights
Retinal vein occlusion (RVO) is the second most common retinal vascular disease after diabetic retinopathy, and it is an important cause of visual impairment [1]
Macular vessel densities in both the superficial capillary plexus (SCP) and deep capillary plexus (DCP) were significantly lower in the RVO eyes (45.51 ± 3.46 vs. 48.75 ± 3.74, p = 0.002 and 43.62 ± 4.68 vs. 47.32 ± 5.86, p = 0.003 respectively)
The number of optic nerve head (ONH) and macular macrophage-like cells (MLCs) of all RVO eyes were elevated in comparison to the fellow eyes (261.75 ± 119.77 vs. 106.58 ± 64.68, p < 0.001 and 459.43 ± 264.78 vs. 160.44 ± 116.41, p < 0.001 respectively)
Summary
Retinal vein occlusion (RVO) is the second most common retinal vascular disease after diabetic retinopathy, and it is an important cause of visual impairment [1]. A previous study reported that RVO leads to retinal tissue ischemia and hypoxia, followed by inflammation related to macrophage-like cells (MLCs) like microglia and hyalocytes [3]. Hyalocytes are considered resident macrophages of cortical vitreous, which can be an exacerbating factor in eyes with inflammation [4]. Hyalocytes are mainly distributed close to the inner limiting membrane in the posterior hyaloid and at the vitreous base [4]. Previous studies found that hyalocytes play important roles in various aspects of pathophysiology, which involve diabetic macular edema, epiretinal membrane formation, proliferative vitreoretinopathy, and proliferative diabetic retinopathy [4–8]. Microglia is a type of macrophage located primarily in the inner plexiform layer and outer plexiform layer of the normal retina. A smaller proportion resides in the ganglion cell layer, nerve fiber layer, and near the inner limiting membrane [9, 10]. The microglia is able to proliferate and move rapidly towards damaged areas and resolve tissue damage [11]
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