1. Relationship Between Nerve Fiber Layer Hemorrhages and Outcomes in Central Retinal Vein Occlusion
- Author
-
Thais F. Conti, Jiwon Baek, Christelle Grondin, Claudio Iovino, Yoshimi Sugiura, Khalil Ghasemi Falavarjani, Enrico Borrelli, Nopasak Phasukkijwatana, Mehmet Yasin Teke, Frederic Gunnemann, Anat Loewenstein, Michael S. Ip, Jean-Pierre Hubschman, Daniel Pauleikhoff, Gerardo Ledesma-Gil, Srinivas R. Sadda, Ismael Chehaibou, K. Bailey Freund, Brittany Powell, Giuseppe Querques, Won Ki Lee, Tyler E. Greenlee, Mee Yon Lee, Riccardo Sacconi, Adrian T. Fung, Lawrence A. Yannuzzi, Marie Louise Farecki, Assaf Hilely, Jackson Scharf, Dinah Zur, Rishi P Singh, Adrian Au, Grant L Hom, Yasha S. Modi, Richard B Rosen, Netan Choudhry, V. Krivosic, David Sarraf, Marco Battista, Enrico Peiretti, Derrick Wang, Au, A., Hilely, A., Scharf, J., Gunnemann, F., Wang, D., Chehaibou, I., Iovino, C., Grondin, C., Farecki, M. -L., Falavarjani, K. G., Phasukkijwatana, N., Battista, M., Borrelli, E., Sacconi, R., Powell, B., Hom, G., Greenlee, T. E., Conti, T. F., Ledesma-Gil, G., Teke, M. Y., Choudhry, N., Fung, A. T., Krivosic, V., Baek, J., Lee, M. Y., Sugiura, Y., Querques, G., Peiretti, E., Rosen, R., Lee, W. K., Yannuzzi, L. A., Zur, D., Loewenstein, A., Pauleikhoff, D., Singh, R., Modi, Y., Hubschman, J. P., Ip, M., Sadda, S., Freund, K. B., and Sarraf, D.
- Subjects
Male ,Fovea Centralis ,genetic structures ,Nerve fiber layer ,Severity of Illness Index ,Neovascularization ,chemistry.chemical_compound ,Nerve Fibers ,0302 clinical medicine ,Central retinal vein occlusion ,Ischemia ,Retrospective Studie ,Correlation of Data ,0303 health sciences ,Neovascularization, Pathologic ,medicine.diagnostic_test ,Retinal Hemorrhage ,Middle Aged ,Fluorescein angiography ,medicine.anatomical_structure ,Nerve Fiber ,Acute Disease ,Female ,medicine.symptom ,Human ,medicine.medical_specialty ,Retina ,03 medical and health sciences ,Ophthalmology ,Retinal Vein Occlusion ,medicine ,Humans ,nerve fiber layer hemorrhages ,Macular edema ,Retrospective Studies ,Nerve fiber layer hemorrhage ,Aged ,030304 developmental biology ,Plexus ,Fovea Centrali ,business.industry ,Retinal ,medicine.disease ,eye diseases ,chemistry ,030221 ophthalmology & optometry ,business - Abstract
PURPOSE. To evaluate the depth and pattern of retinal hemorrhage in acute central retinal vein occlusion (CRVO) and to correlate these with visual and anatomic outcomes. METHODS. Retinal hemorrhages were evaluated with color fundus photography and fluorescein angiography at baseline and follow-up. Snellen visual acuity (VA), central foveal thickness (CFT), extent of retinal ischemia, and development of neovascularization were analyzed. RESULTS. 108 eyes from 108 patients were evaluated. Mean age was 63.6 ± 16.1 years with a predilection for the right eye (73.1%). Average follow-up was 17.2 ± 19.2 months. Mean VA at baseline was 20/126 and 20/80 at final follow-up. Baseline (P = 0.005) and final VA (P = 0.02) in eyes with perivascular nerve fiber layer (NFL) hemorrhages were significantly worse than in eyes with deep hemorrhages alone. Baseline CFT was greater in the group with perivascular hemorrhages (826 ± 394 μm) compared to the group with deep hemorrhages alone (455 ± 273 μm, P < 0.001). The 10 disc areas of retinal ischemia was more common in patients with perivascular (80.0%) and peripapillary (31.3%) versus deep hemorrhages alone (16.1%, P < 0.001). Neovascularization of the iris was more common, although this differrence was not significant, in the groups with peripapillary (14.3%) and perivascular (2.0%) NFL versus deep hemorrhages alone (0.0%). CONCLUSIONS. NFL retinal hemorrhages at baseline correlate with more severe forms of CRVO, with greater macular edema, poorer visual outcomes, and greater risk of ischemia and neovascularization. This may be related to the organization of the retinal capillary plexus. The depth and pattern of distribution of retinal hemorrhages in CRVO may provide an easily identifiable early biomarker of CRVO prognosis.
- Published
- 2020
- Full Text
- View/download PDF