Kang Wang1,2,3, Khalil Ghasemi Falavarjani1,2,4, Muneeswar G Nittala1, Min Sagong5, Charles C Wykoff6, Jano van Hemert7, Michael Ip1,2, SriniVas R Sadda1,2. 1. Doheny Image Reading Center, Doheny Eye Institute, Los Angeles, California, United States. 2. Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, California, United States. 3. Department of Ophthalmology, Beijing Friendship Hospital, Capital Medical University, Beijing, China. 4. Eye Research Center and Eye Department, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran. 5. Department of Ophthalmology, Yeungnam University College of Medicine, Daegu, South Korea. 6. Blanton Eye Institute & Houston Methodist Hospital, Houston, Texas, United States. 7. Optos PLC, Dunfermline, United Kingdom.
Abstract
Purpose: The purpose of this study was to compare the use of central and montaged ultra-wide-field fluorescein angiography (UWFFA) images for calculating the area of nonperfusion (NP) and ischemic index (ISI) in patients with retinal vein occlusion (RVO) and macular edema (ME) and to correlate these measurements with best-corrected visual acuity (BCVA) and central macular thickness (CMT). Methods:Thirty eyes of 30 RVO patients with recurrent ME were enrolled. Baseline UWFA images were sent to the Doheny Image Reading Center for quantitative analysis by certified graders. The association between ISI from the various zones and BCVA and CMT was examined by Spearman rank correlation and compared. Generalized linear models (GLMs) were used to analyze associations between BCVA and disease status. Results: The NP area and ISI for central and montaged images were not significantly different for any retinal zone. A modest but statistically significant negative linear correlation was observed between BCVA and ISI, ranging from r = -0.3825 in the perimacular area (PMA) to r = -0.584 in the far peripheral area (FPA). On GLM analysis, both PMA (β = -1.059; 95% confidence interval: -1.74 to -0.378) and FPA (β = -0.505; 95% confidence interval: -0.988 to -0.021) were significant independent predictors of BCVA. We found no correlation between ISI from the various zones and CMT in this cohort. Conclusions: Montaging of UWFFA images may not be required to adequately quantify and represent areas of NP in eyes with RVO. NP in both the PMA and peripheral retina appear relevant to visual function, highlighting the importance of evaluating the retinal periphery in these individuals.
RCT Entities:
Purpose: The purpose of this study was to compare the use of central and montaged ultra-wide-field fluorescein angiography (UWFFA) images for calculating the area of nonperfusion (NP) and ischemic index (ISI) in patients with retinal vein occlusion (RVO) and macular edema (ME) and to correlate these measurements with best-corrected visual acuity (BCVA) and central macular thickness (CMT). Methods: Thirty eyes of 30 RVO patients with recurrent ME were enrolled. Baseline UWFA images were sent to the Doheny Image Reading Center for quantitative analysis by certified graders. The association between ISI from the various zones and BCVA and CMT was examined by Spearman rank correlation and compared. Generalized linear models (GLMs) were used to analyze associations between BCVA and disease status. Results: The NP area and ISI for central and montaged images were not significantly different for any retinal zone. A modest but statistically significant negative linear correlation was observed between BCVA and ISI, ranging from r = -0.3825 in the perimacular area (PMA) to r = -0.584 in the far peripheral area (FPA). On GLM analysis, both PMA (β = -1.059; 95% confidence interval: -1.74 to -0.378) and FPA (β = -0.505; 95% confidence interval: -0.988 to -0.021) were significant independent predictors of BCVA. We found no correlation between ISI from the various zones and CMT in this cohort. Conclusions: Montaging of UWFFA images may not be required to adequately quantify and represent areas of NP in eyes with RVO. NP in both the PMA and peripheral retina appear relevant to visual function, highlighting the importance of evaluating the retinal periphery in these individuals.