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Abstract
Purpose
To examine whether disorganization of retinal inner layers (DRILs) at baseline and after treatment was associated with visual acuity in patients with macular edema secondary to central retinal vein occlusion (CRVO) who were treated with intravitreal dexamethasone implants.
Methods
A retrospective review of records of 22 patients with treatment-naive CRVO with centrally involved macular edema treated with intravitreal dexamethasone implants. Spectral domain-optical coherence tomography images were obtained during each visit. The DRIL extent and additional parameters were evaluated in a 2,000 µm-wide foveal centered area.
Results
In the 22 patients (74.5 ± 8.92 years), baseline DRIL was observed in 21 eyes (94.5%). Using univariate analysis, baseline best corrected visual acuity (BCVA) was significantly associated with the extent of baseline DRIL (p = 0.005, r = −0.58), and the extent of external limiting membrane disruption and ellipsoid zone (p = 0.015, r = −0.51; p = 0.011, r = −0.533, respectively). The final BCVA was significantly correlated with the baseline BCVA (p < 0.001, r = 0.74) and extent of DRIL (p = 0.04, r = −0.35). Changes in the BCVA were correlated with changes of DRIL between baseline and the final visit (p = 0.041, r = 0.439).
Figures and Tables
Figure 1
Spectral domain-optical coherence tomography of disorganization of retinal inner layers (DRIL) in a representative case. The yellow lines highlight the inner retinal layer interfaces, which disappear in the areas of DRIL.
Figure 2
Mean best corrected visual acuity (BCVA) at baseline, 4 months, and 8 months after treatment. BCVA showed increase in 4 months and 8 months after treatment. M = months.
Figure 3
Mean central retinal thickness (CRT) at baseline, 4 months, and 8 months after treatment. CRT was decreased in 4 months and 8 months after treatment. M = months.
Figure 4
Mean extent of disorganization of inner retinal layers (DRIL) at baseline, 4 months, and 8 months after treatment. DRIL was decreased in 4 months and 8 months after intravitreal dexamethasone implant injection. M = months.
Figure 5
Scatter plot graph between the change of best-corrected visual acuity (BCVA) and the decrease of disorganization of retinal inner layers (DRIL) extent. It shows that more DRIL extent decrease associated with more improvement of BCVA with statistically significant.
Table 1
Baseline characteristics and initial SD-OCT parameters of patients
Values are presented as mean ± standard deviation or number unless otherwise indicated.
SD-OCT = spectral domain optical coherence tomography; M:F = male:female; R:L = right:left; FA = fluorescein angiography; DM = diabetes mellitus; RVO = retinal vein occlusion; BCVA = best corrected visual acuity; CRT = central retinal thickness; DRIL = dIsorganization of retinal inner layers; IRC = intra retinal cyst; SRF = sub retinal fluid; ELM = external limiting membrane; EZ = ellipsoid zone.
Table 2
Association of baseline SD-OCT parameters with baseline BCVA
SD-OCT = spectral domain optical coherence tomography; BCVA = best corrected visual acuity; CRT = central retinal thickness; DRIL = disorganization of retinal inner layers; IRC = intra retinal cyst; SRF = sub retinal fluid; ELM = external limiting membrane; EZ = ellipsoid zone.
*Pearson correlation.
Table 3
Association of baseline SD-OCT parameters with final BCVA
SD-OCT = spectral domain-optical coherence tomography; BCVA = best corrected visual acuity; CRT = central retinal thickness; DRIL = disorganization of retinal inner layers; IRC = intra retinal cyst; SRF = sub retinal fluid; ELM = external limiting membrane; EZ = ellipsoid zone.
*Pearson correlation coefficient.
References
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