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Abstract
BackgroundTo evaluate macular microstructure alterations in the parafoveal nonperfusion areas of eyes with branch retinal vein occlusions (BRVO), and to investigate their impact on retinal sensitivity.MethodsThis was a cross-sectional study including thirteen BRVO patients with parafoveal capillary nonperfusion areas (NPA). Multiple modalities including microperimetry, optical coherence tomography angiography, and optical coherence tomography were performed to measure retinal sensitivity and thickness, and to identify the microstructure changes and perfusion status.ResultsThe retinal sensitivity and thickness in the NPA were significantly lower than those in the perfusion areas (PA) (P = 0.001, P = 0.003). Microstructure changes, including disorganization of the retinal inner layers (DRIL), disruption of the outer retinal layers, and cysts were more frequently observed in NPA (P = 0.002, P = 0.018, P = 0.068). Within NPA, the retinal sensitivity of areas with DRIL, and outer retinal layers disruption was significantly lower than that of the areas without DRIL (P = 0.016), and with intact outer retinal layers (P < 0.001), respectively. 1dB increase in retinal sensitivity was correlated with 2.2 μm (95 % confidence interval, 1.71–2.7) increase of the thickness (P < 0.001). The retinal sensitivity was significantly lower at points with both DRIL and outer retinal layers disruption than at the points with DRIL or outer retina layers disruption alone (P = 0.001, P = 0.001).ConclusionsAlterations in the macular microstructure are associated with ischemia, especially DRIL. DRIL and outer retinal layers disruption are imaging features that have important implications for local retinal sensitivity in the ischemic areas, and where the microstructure of both inner and outer retinal layers is disrupted the function is further destructed.
Highlights
To evaluate macular microstructure alterations in the parafoveal nonperfusion areas of eyes with branch retinal vein occlusions (BRVO), and to investigate their impact on retinal sensitivity
Polat et al reported that ischemic retinal vein occlusion (RVO) caused greater macular edema and disruption in macular microstructures compared to nonischemic RVO, especially in terms of disorganization of the retinal inner layers (DRIL) and disrupted external limiting membrane (ELM) [6]
Cysts were more frequently observed in nonperfusion areas (NPA), while the difference in proportion of cysts between NPA and perfusion areas (PA) was not statistically significant (P = 0.068)
Summary
To evaluate macular microstructure alterations in the parafoveal nonperfusion areas of eyes with branch retinal vein occlusions (BRVO), and to investigate their impact on retinal sensitivity. Polat et al reported that ischemic retinal vein occlusion (RVO) caused greater macular edema and disruption in macular microstructures compared to nonischemic RVO, especially in terms of disorganization of the retinal inner layers (DRIL) and disrupted external limiting membrane (ELM) [6]. DRIL is an imaging feature of spectral domainoptical coherence tomography (SD-OCT) that has become recognized as a sign of impaired visual function [7,8,9,10,11,12], and a reliable predictor of capillary nonperfusion areas [13, 14]
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