Michael Mimouni1, Or Segev2, Dalia Dori1, Noa Geffen2, Victor Flores1, Ori Segal3. 1. Department of Ophthalmology, Rambam Health Care Campus, Affiliated to the Technion - Israel Institute of Technology, Haifa, Israel. 2. Department of Ophthalmology, Meir Medical Center, Kfar Saba, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. 3. Department of Ophthalmology, Meir Medical Center, Kfar Saba, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: orisegal@gmail.com.
Abstract
PURPOSE: To determine whether spectral-domain optical coherence tomography (SD-OCT) disorganization of the retinal inner layers (DRIL) is predictive of best-corrected visual acuity (BCVA) in retinal vein occlusion macular edema (RVO-ME). DESIGN: Retrospective cohort study. METHODS: Setting: Two tertiary centers. PATIENTS: Treatment-naïve RVO-ME receiving monthly intravitreal bevacizumab. OBSERVATION PROCEDURES: Spectral-domain optical coherence tomography (SD-OCT) images from baseline, 4-month, and 8-month visits. The DRIL extent and additional parameters were evaluated in the 1-mm-wide foveal centered area. MAIN OUTCOME MEASURES: BCVA at each visit. RESULTS: A total of 136 eyes were included in this study. Greater DRIL extent at baseline correlated with worse baseline BCVA (point estimate, 0.04; 95% CI, 0.01-0.07 per 100 μm, P = .003). In multivariate analysis extent of DRIL (P = .03) and ellipsoid zone disruption (P < .001) correlated with baseline BCVA. Four-month DRIL reduction was associated with 8-month BCVA improvement (point estimate, 0.02; 95% CI, 0.01-0.04, P = .01), with only DRIL remaining significant in multivariate analysis (P = .02). Baseline DRIL predicted 8-month improvement in BCVA (point estimate, 0.03; 95% CI, 0.01-0.05, P = .04), with only DRIL remaining significant in multivariate analysis (P = .006). Eight-month DRIL change was associated with 8-month BCVA change (point estimate, 0.03, 95% CI 0.01-0.05, P = .001), with only DRIL remaining significant in multivariate analysis (P = .002). CONCLUSIONS: The change of the DRIL extent following the first 3 monthly injections identifies eyes with a high likelihood of subsequent BCVA improvement or decline. Therefore, the extent of DRIL before and after treatment is an additional SD-OCT parameter that may serve as a biomarker for patients with RVO-ME.
PURPOSE: To determine whether spectral-domain optical coherence tomography (SD-OCT) disorganization of the retinal inner layers (DRIL) is predictive of best-corrected visual acuity (BCVA) in retinal vein occlusion macular edema (RVO-ME). DESIGN: Retrospective cohort study. METHODS: Setting: Two tertiary centers. PATIENTS: Treatment-naïve RVO-ME receiving monthly intravitreal bevacizumab. OBSERVATION PROCEDURES: Spectral-domain optical coherence tomography (SD-OCT) images from baseline, 4-month, and 8-month visits. The DRIL extent and additional parameters were evaluated in the 1-mm-wide foveal centered area. MAIN OUTCOME MEASURES: BCVA at each visit. RESULTS: A total of 136 eyes were included in this study. Greater DRIL extent at baseline correlated with worse baseline BCVA (point estimate, 0.04; 95% CI, 0.01-0.07 per 100 μm, P = .003). In multivariate analysis extent of DRIL (P = .03) and ellipsoid zone disruption (P < .001) correlated with baseline BCVA. Four-month DRIL reduction was associated with 8-month BCVA improvement (point estimate, 0.02; 95% CI, 0.01-0.04, P = .01), with only DRIL remaining significant in multivariate analysis (P = .02). Baseline DRIL predicted 8-month improvement in BCVA (point estimate, 0.03; 95% CI, 0.01-0.05, P = .04), with only DRIL remaining significant in multivariate analysis (P = .006). Eight-month DRIL change was associated with 8-month BCVA change (point estimate, 0.03, 95% CI 0.01-0.05, P = .001), with only DRIL remaining significant in multivariate analysis (P = .002). CONCLUSIONS: The change of the DRIL extent following the first 3 monthly injections identifies eyes with a high likelihood of subsequent BCVA improvement or decline. Therefore, the extent of DRIL before and after treatment is an additional SD-OCT parameter that may serve as a biomarker for patients with RVO-ME.
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