J Korean Ophthalmol Soc.  2019 Nov;60(11):1058-1063. 10.3341/jkos.2019.60.11.1058.

Prognosis and Disorganization of Retinal Inner Layers in Central Retinal Vein Occlusion with Dexamethasone Implantation

Affiliations
  • 1Department of Ophthalmology, Gyeongsang National University College of Medicine, Jinju, Korea. oocee@hanmail.net
  • 2Department of Ophthalmology, Gyeongsang National University Hospital, Jinju, Korea.
  • 3Institute of Health Sciences, Gyeongsang National University, Jinju, Korea.

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).
CONCLUSIONS
The extents of baseline DRIL and DRIL changes after treatment with intravitreal dexamethasone implants for macular edema secondary to CRVO may be useful parameter for visual acuity improvement.

Keyword

Dexamethasone; Disorganization of retinal inner layers; Macular edema; Retinal vein occlusion

MeSH Terms

Dexamethasone*
Humans
Macular Edema
Membranes
Prognosis*
Retinal Vein Occlusion
Retinal Vein*
Retinaldehyde*
Retrospective Studies
Visual Acuity
Dexamethasone
Retinaldehyde

Figure

  • 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.


Reference

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