Disorganization of the Retinal Inner Layers as a Predictor of Visual Acuity in Eyes With Macular Edema Secondary to Vein Occlusion

Abstract

To determine whether spectral-domain optical coherence tomography (SD-OCT) disorganization of the retinal inner layers (DRIL) is predictive of best-corrected visual acuity (BCVA) in retinal vein occlusion macular edema (RVO-ME). Retrospective cohort study. Setting: Two tertiary centers. Treatment-naïve RVO-ME receiving monthly intravitreal bevacizumab. Spectral-domain optical coherence tomography (SD-OCT) images from baseline, 4-month, and 8-month visits. The DRIL extent and additional parameters were evaluated in the 1-mm-wide foveal centered area. BCVA at each visit. A total of 136 eyes were included in this study. Greater DRIL extent at baseline correlated with worse baseline BCVA (point estimate, 0.04; 95% CI, 0.01-0.07 per 100μm, P= .003). In multivariate analysis extent of DRIL (P= .03) and ellipsoid zone disruption (P < .001) correlated with baseline BCVA. Four-month DRIL reduction was associated with 8-month BCVA improvement (point estimate, 0.02; 95% CI, 0.01-0.04, P= .01), with only DRIL remaining significant in multivariate analysis (P= .02). Baseline DRIL predicted 8-month improvement in BCVA (point estimate, 0.03; 95% CI, 0.01-0.05, P= .04), with only DRIL remaining significant in multivariate analysis (P= .006). Eight-month DRIL change was associated with 8-month BCVA change (point estimate, 0.03, 95% CI 0.01-0.05, P= .001), with only DRIL remaining significant in multivariate analysis (P= .002). The change of the DRIL extent following the first 3monthly injections identifies eyes with a high likelihood of subsequent BCVA improvement or decline. Therefore, the extent of DRIL before and after treatment is an additional SD-OCT parameter that mayserve as a biomarker for patients with RVO-ME.