Retinal Oxygen Saturation Correlates With Visual Acuity but Does Not Predict Outcome After Anti-VEGF Treatment in Central Retinal Vein Occlusion.

Abstract

Occlusion of the central retinal vein (CRVO) is a frequent cause of visual loss. The occlusion induces hypoxia in the retina and the larger retinal veins, but the significance of retinal oxygen saturation for visual acuity at diagnosis and after anti-VEGF treatment for CRVO has not been studied in detail. Retinal oximetry was performed in 91 patients consecutively referred for specialist evaluation of CRVO. The correlation between oxygen saturation in larger retinal vessels and visual acuity at the primary examination and the predictive value of oxygen saturation for visual prognosis after three monthly intravitreal injections with anti-VEGF medication were studied. At referral, the oxygen saturation in larger retinal vessels of the affected eye was significantly higher in arterioles (100.7 ± 1.4% vs. 96.3 ± 0.6%) and significantly lower in venules (37.8 ± 2.6% vs. 58.2 ± 1.3%) than in the unaffected eye (P < 0.001 for both comparisons). Best-corrected visual acuity (BCVA) showed a significant negative correlation with the oxygen saturation in retinal arterioles (P = 0.002) and a significant positive correlation with the saturation in retinal venules (P = 0.013). Multiple linear regression showed that BCVA, but not oxygen saturations, contributed significantly to predicting visual outcome after three monthly intravitreal injections with VEGF inhibitor. The correlation between retinal oxygen saturation and BCVA at the time of diagnosis of CRVO may help understanding hemodynamic and visual changes in the acute stages of the disease. However, retinal oximetry cannot replace measures of retinal function as a predictive parameter for the visual outcome in CRVO after three monthly intravitreal anti-VEGF injections.