Abstract
The development of a retinal vein occlusion (RVO) is multifactorial. This study investigates pachychoroid as a risk factor for RVO or as an entity sharing common pathophysiology with RVO. A database screening at the University Eye Hospital, Ludwig-Maximilian University Munich, Germany was performed for patients diagnosed with central or branch RVO (CRVO/BRVO). In every patient a complete ophthalmologic examination was performed, including posterior segment enhanced depth spectral domain optical coherence tomography (EDI-SD-OCT). The SD-OCT scans of respective partner eyes without history of RVO were compared to an age- and refraction-matched, randomly recruited normal control group. In total, 312 eyes of 312 patients were included in this study, with 162 eyes in the RVO and 150 eyes in the control group. A significantly higher subfoveal choroidal thickness (SFCT) was found in the RVO (310.3 ± 72.5 (94 to 583) µm) as compared to the control group (237.0 ± 99.0 (62 to 498); p < 0.00001). Moreover, the RVO group showed a significantly higher prevalence of a symptomatic pachychoroid (22 vs. 9 eyes; odds ratio: 2.46; 95 CI: 1.10 to 5.53; p = 0.029). Since pachychoroid disease represents a bilateral entity, it might be a risk factor for RVO, or share risk factors with RVO.
Highlights
The development of a retinal vein occlusion (RVO) is multifactorial
Any factor contributing to narrowing of the vein and/or to an increase in turbulence of flow may increase the likelihood of a retinal vein occlusion (RVO)[2]
Nagia et al found peripapillary pachychoroid features in partner eyes of eyes with non-arteriitic anterior ischemic optic neuropathy (NAION), leading to the hypothesis that a thicker choroid may be associated with a higher risk for the development of NAION due to narrowing of the optic sheath[3]
Summary
This study investigates pachychoroid as a risk factor for RVO or as an entity sharing common pathophysiology with RVO. In central retinal vein occlusions (CRVO), multiple risk factors have been described, including arterial hypertension, diabetes mellitus, increased intraocular pressure and h ypercoaguability[1]. It is commonly assumed that the occlusion of the central retinal vein follows a thrombotic event, mostly at the passage through the lamina cribrosa. In this segment, the central retinal vein narrows, blood flow is more turbulent and thrombus formation is promoted. This study was designed to investigate choroidal morphology, thickness and associated pachychoroid phenotypes in patients with CRVO or branch retinal vein occlusion (BRVO)
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