Clinical Features According to the Occlusion Site in Patients with Branch Retinal Vein Occlusion

Ka Hee Park; Kyung Seek Choi

doi:10.3341/jkos.2013.54.8.1248

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Park and Choi: Clinical Features According to the Occlusion Site in Patients with Branch Retinal Vein Occlusion

Original Article

J Korean Ophthalmol Soc 2013;54(8):1248-1254.

Published online: 7 September 2013

DOI: https://doi.org/10.3341/jkos.2013.54.8.1248

Clinical Features According to the Occlusion Site in Patients with Branch Retinal Vein Occlusion

Ka Hee Park, MD, Kyung Seek Choi, MD

Department of Ophthalmology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea

Address reprint requests to Kyung Seek Choi, MD Department of Ophthalmology, Soonchunhyang University Seoul Hospital #59 Daesagwan-ro, Yongsan-gu, Seoul 140-743, Korea Tel: 82-2-709-9354, Fax: 82-2-710-3196, E-mail: ckseek@schmc.ac.kr

Received 25 May 201214 March 2013 Accepted 5 June 2013

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate clinical patterns according to the occlusion site in patients with branch retinal vein occlusion.

Methods

Ninety-one branch retinal vein occlusion patients were divided into 4 groups according to the occlusion site based on the description by Duke-Elder and Wybar: Papillary retinal vein occlusion group (group A), main retinal vein oc-clusion group (group B), minor retinal vein occlusion group (group C), and retinal venule occlusion group (group D). The following factors were analyzed retrospectively: baseline/final visual acuity, visual improvement, macular thickness, and macular circulatory states.

Results

The macular thickness (μ m) was 575.33 ± 178.44 in group A, 511.92 ± 218.02 in group B, 397.21 ± 144.51 in group C, and 336.68 ± 120.55 in group D. The retinal ischemic area (DD) was 22.00 ± 13.28 in group A, 18.26 ± 10.12 in group B, 12.52 ± 10.52 in group C, and 12.36 ± 11.92 in group D, which was found to be significantly greater in the group with the higher branch occlusion site (p < 0.05). However, visual acuity, macular circulatory states and other clinical char-acteristics were not significantly different.

Conclusions

Occlusion site is a relating factor for retinal ischemic area and macular thickness in patients with Branch reti-nal vein occlussion, but which is not a prognostic factor for final visual acuity.

Keywords: Branch retinal vein occlusion, Occlusion site

References

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Figure 1.

Four sites of occlusion defined in this study based on the description by Duke-Elder and Wybar.¹³ (a) papillary vein; (b) major retinal vein; (c) minor retinal vein; (d) retinal venule.

Figure 2.

Comparison of baseline visual acuity (A), final visual acuity (B), retinal ischemic area (C) and macular thickness (D) among the four groups which were divided by occlusion site in the branch retinal vein occlusion patients. DD = disc diameter; log MAR = logarithm of the minimal angle of resolution. ^* Statistical significance was found with ANOVA, Scheffe test (p < 0.05).

Table 1.

Characteristics of retinal vein occlusion patients

Characteristics	Subjects (n = 91)
Mean age (years, range)	60.19 ± 11.42 (33-87)
Sex (male : female)	32 (35.16) : 59 (64.84)
Duration of follow up (months)	9.53 ± 3.18
Laterality (right : left)	43 (47.25) : 48 (52.75)
Location
Superotemporal	62 (68.13)
Inferotemporal	29 (31.87)
Diabetes mellitus	13 (14.29)
Hypertension	34 (37.36)
Base visual acuity (log MAR)	0.66 ± 0.47
Final visual acuity (log MAR)	0.37 ± 0.33
Base mean IOP (mm Hg)	14.38 ± 3.03
Final mean IOP (mm Hg)	13.84 ± 2.95
Mean macular thickness (μ m)	460.96 ± 194.22

Values are presented as mean ± SD or (n).

IOP = intraocular pressure; log MAR = logarithm of the minimal angle of resolution.

Table 2.

Characteristics of four groups which were divided by occlusion site in retinal vein occlusion subjects

Characteristics	Papillary RV group (n = 15)	Main RV group (n = 34)	Minor RV group (n = 28)	Retinal venule group (n = 14)	p-value
Mean age (years)	64.67 ± 6.80	59.42 ± 12.91	58.75 ± 11.40	60.07 ± 11.58	0.413^*
Sex (M:F)	4:11	14:20	11:17	3:11	0.497^†
Laterality (R:L)	7:8	18:16	12:16	6:8	0.857^†
Location					0.139^†
Superotemporal	8	25	22	7
Inferotemporal	7	9	6	7
Treatment					0.424^†
IVB	8	20	11	5
IVTA	2	6	6	4
IVB + IVTA	5	5	8	4
Baseline VA (log MAR)	0.74 ± 0.40	0.72 ± 0.46	0.64 ± 0.53	0.49 ± 0.43	0.402^*
Final VA (log MAR)	0.34 ± 0.27	0.38 ± 0.65	0.39 ± 0.33	0.28 ± 0.21	0.625^*
Mean IOP (mm Hg)	14.20 ± 2.83	14.42 ± 3.49	14.54 ± 2.86	14.15 ± 2.61	0.977^*
Macular thickness (μ m)	575.33 ± 178.44	511.92 ± 218.02	397.21 ± 144.51	336.68 ± 120.55	0.001^*,‡

Values are presented as mean ± SD or (n).

VA = visual acuity; IOP = intraocular pressure; RV = retinal vein; IVB = intravitreal bevacizumab injection; IVTA = intravitreal triamcinolone injection; log MAR = logarithm of the minimal angle of resolution.

^* ANOVA;

^† Chi-square test;

^‡ p < 0.05 was considered to be significant.

Table 3.

Retinal ischemic area according to the occlusion site in branch retinal vein occlusion

	Papillary RV group (n = 15)	Main RV group (n = 34)	Minor RV group (n = 28)	Retinal venule group (n = 14)	p-value
Retinal ischemic area (DD)	22.00 ± 13.28	18.26 ± 10.12	12.52 ± 10.52	12.36 ± 11.92	0.025^*,‡
≤5 DD	1	3	8	6	0.002^‡,‡
5-10 DD	0	3	7	4
10-20 DD	9	19	9	0
20 DD ≤	5	9	4	4

DD = disc diameter

^* ANOVA;

^† Chi-square test;

^‡ p < 0.05 was considered to be significant.

Table 4.

Perifoveal capillary ring state according to the occlusion site in branch retinal vein occlusion

	Papillary RV group (n = 15)	Main RV group (n = 34)	Minor RV group (n = 28)	Retinal venul grou (n = 14)	p p-value
Intact	10	14	17	8	0.286^*
broken	5	20	11	6

^* Chi-square test.

Table 5.

Macular ischemic area according to the occlusion site in branch retinal vein occlusion

	Papillary RV group (n = 15)	Main RV group (n = 34)	Minor RV group (n = 28)	Retinal venule grou (n = 14)	up p-value
<90°	1	3	7	1	0.080^*
90-180°	7	6	8	7
180-270°	1	8	5	0
270-360°	6	17	8	6

^* Chi-square test.

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