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Published in: Graefe's Archive for Clinical and Experimental Ophthalmology 9/2014

01-09-2014 | Retinal Disorders

Correlation between optical coherence tomographic hyperreflective foci and visual outcomes after intravitreal bevacizumab for macular edema in branch retinal vein occlusion

Authors: Joon-Won Kang, Hyungwoo Lee, Hyewon Chung, Hyung Chan Kim

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 9/2014

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Abstract

Purpose

To investigate the correlation between hyperreflective foci (HF) on spectral-domain optical coherence tomography at baseline and visual outcomes after intravitreal bevacizumab injection (IVB) in branch retinal vein occlusion.

Methods

We retrospectively studied 97 eyes of 97 patients with macular edema secondary to BRVO, who were treated with IVB. The eyes were divided into three groups according to the location of HF on SD-OCT: HF in outer retinal layers, HF in inner retinal layers, and no HF. The baseline and final best-corrected visual acuity (BCVA), foveal thickness (FT), external limiting membrane (ELM) status, junction between photoreceptor inner and outer segments (IS/OS) status, and the number of HF were evaluated and compared among three groups.

Results

Baseline BCVA was correlated with baseline FT (R = 0.366, p < 0.001), but final BCVA was not correlated with final FT (R = −0.008, p = 0.942). Baseline BCVA was significantly better in eyes with intact ELM at baseline (p = 0.006), and final BCVA was significantly better in eyes with intact ELM and IS/OS at final visit (p <  0.001, p = 0.003 respectively). At the final visit, 15 of 37 eyes (40.5 %) with HF in outer retinal layers had a disrupted ELM (p = 0.001), while 28 of 37 eyes (75.7 %) with HF in outer retinal layers had a disrupted IS/OS (p <  0.001). Final BCVA was poorer in eyes with HF in outer retinal layers groups than those in the other two groups (p <  0.001), although baseline BCVA was not different between them.

Conclusions

HF on SD-OCT at baseline might predict the photoreceptor status and final VA after IVB in BRVO.
Literature
1.
go back to reference Jaulim A, Ahmed B, Khanam T, Chatziralli IP (2013) Branch retinal vein occlusion: epidemiology, pathogenesis, risk factors, clinical features, diagnosis, and complications. An update of the literature. Retina 33:901–910PubMedCrossRef Jaulim A, Ahmed B, Khanam T, Chatziralli IP (2013) Branch retinal vein occlusion: epidemiology, pathogenesis, risk factors, clinical features, diagnosis, and complications. An update of the literature. Retina 33:901–910PubMedCrossRef
2.
go back to reference Channa R, Smith M, Campochiaro PA (2011) Treatment of macular edema due to retinal vein occlusions. Clin Ophthalmol 5:705–713PubMedCentralPubMed Channa R, Smith M, Campochiaro PA (2011) Treatment of macular edema due to retinal vein occlusions. Clin Ophthalmol 5:705–713PubMedCentralPubMed
3.
go back to reference Feucht N, Schonbach EM, Lanzl I, Kotliar K, Lohmann CP, Maier M (2013) Changes in the foveal microstructure after intravitreal bevacizumab application in patients with retinal vascular disease. Clin Ophthalmol 7:173–178PubMedCentralPubMedCrossRef Feucht N, Schonbach EM, Lanzl I, Kotliar K, Lohmann CP, Maier M (2013) Changes in the foveal microstructure after intravitreal bevacizumab application in patients with retinal vascular disease. Clin Ophthalmol 7:173–178PubMedCentralPubMedCrossRef
4.
go back to reference Lee JY, Yoon YH, Kim HK, Yoon HS, Kang SW, Kim JG, Park KH, Jo YJ (2013) Baseline characteristics and risk factors of retinal vein occlusion: a study by the Korean RVO Study Group. J Korean Med Sci 28:136–144PubMedCentralPubMedCrossRef Lee JY, Yoon YH, Kim HK, Yoon HS, Kang SW, Kim JG, Park KH, Jo YJ (2013) Baseline characteristics and risk factors of retinal vein occlusion: a study by the Korean RVO Study Group. J Korean Med Sci 28:136–144PubMedCentralPubMedCrossRef
5.
go back to reference Sakimoto S, Kamei M, Suzuki M, Yano S, Matsumura N, Sakaguchi H, Gomi F, Nishida K (2013) Relationship between grades of macular perfusion and foveal thickness in branch retinal vein occlusion. Clin Ophthalmol 7:39–45PubMedCentralPubMed Sakimoto S, Kamei M, Suzuki M, Yano S, Matsumura N, Sakaguchi H, Gomi F, Nishida K (2013) Relationship between grades of macular perfusion and foveal thickness in branch retinal vein occlusion. Clin Ophthalmol 7:39–45PubMedCentralPubMed
6.
go back to reference Aiello LP, Avery RL, Arrigg PG, Keyt BA, Jampel HD, Shah ST, Pasquale LR, Thieme H, Iwamoto MA, Park JE et al (1994) Vascular endothelial growth factor in ocular fluid of patients with diabetic retinopathy and other retinal disorders. N Engl J Med 331:1480–1487PubMedCrossRef Aiello LP, Avery RL, Arrigg PG, Keyt BA, Jampel HD, Shah ST, Pasquale LR, Thieme H, Iwamoto MA, Park JE et al (1994) Vascular endothelial growth factor in ocular fluid of patients with diabetic retinopathy and other retinal disorders. N Engl J Med 331:1480–1487PubMedCrossRef
7.
go back to reference Patz A (1984) Argon laser photocoagulation for macular edema in branch vein occlusion. Am J Ophthalmol 98:374–375PubMed Patz A (1984) Argon laser photocoagulation for macular edema in branch vein occlusion. Am J Ophthalmol 98:374–375PubMed
8.
go back to reference Jonas JB, Akkoyun I, Kamppeter B, Kreissig I, Degenring RF (2005) Branch retinal vein occlusion treated by intravitreal triamcinolone acetonide. Eye (Lond) 19:65–71CrossRef Jonas JB, Akkoyun I, Kamppeter B, Kreissig I, Degenring RF (2005) Branch retinal vein occlusion treated by intravitreal triamcinolone acetonide. Eye (Lond) 19:65–71CrossRef
9.
go back to reference Demir M, Oba E, Gulkilik G, Odabasi M, Ozdal E (2011) Intravitreal bevacizumab for macular edema due to branch retinal vein occlusion: 12-month results. Clin Ophthalmol 5:745–749PubMedCentralPubMedCrossRef Demir M, Oba E, Gulkilik G, Odabasi M, Ozdal E (2011) Intravitreal bevacizumab for macular edema due to branch retinal vein occlusion: 12-month results. Clin Ophthalmol 5:745–749PubMedCentralPubMedCrossRef
10.
go back to reference Hoeh AE, Ach T, Schaal KB, Scheuerle AF, Dithmar S (2009) Long-term follow-up of OCT-guided bevacizumab treatment of macular edema due to retinal vein occlusion. Graefes Arch Clin Exp Ophthalmol 247:1635–1641PubMedCrossRef Hoeh AE, Ach T, Schaal KB, Scheuerle AF, Dithmar S (2009) Long-term follow-up of OCT-guided bevacizumab treatment of macular edema due to retinal vein occlusion. Graefes Arch Clin Exp Ophthalmol 247:1635–1641PubMedCrossRef
11.
go back to reference Ota M, Tsujikawa A, Murakami T, Kita M, Miyamoto K, Sakamoto A, Yamaike N, Yoshimura N (2007) Association between integrity of foveal photoreceptor layer and visual acuity in branch retinal vein occlusion. Br J Ophthalmol 91:1644–1649PubMedCentralPubMedCrossRef Ota M, Tsujikawa A, Murakami T, Kita M, Miyamoto K, Sakamoto A, Yamaike N, Yoshimura N (2007) Association between integrity of foveal photoreceptor layer and visual acuity in branch retinal vein occlusion. Br J Ophthalmol 91:1644–1649PubMedCentralPubMedCrossRef
12.
go back to reference Ota M, Tsujikawa A, Kita M, Miyamoto K, Sakamoto A, Yamaike N, Kotera Y, Yoshimura N (2008) Integrity of foveal photoreceptor layer in central retinal vein occlusion. Retina 28:1502–1508PubMedCrossRef Ota M, Tsujikawa A, Kita M, Miyamoto K, Sakamoto A, Yamaike N, Kotera Y, Yoshimura N (2008) Integrity of foveal photoreceptor layer in central retinal vein occlusion. Retina 28:1502–1508PubMedCrossRef
13.
go back to reference Shin HJ, Lee SH, Chung H, Kim HC (2012) Association between photoreceptor integrity and visual outcome in diabetic macular edema. Graefes Arch Clin Exp Ophthalmol 250:61–70PubMedCrossRef Shin HJ, Lee SH, Chung H, Kim HC (2012) Association between photoreceptor integrity and visual outcome in diabetic macular edema. Graefes Arch Clin Exp Ophthalmol 250:61–70PubMedCrossRef
14.
go back to reference Hayashi H, Yamashiro K, Tsujikawa A, Ota M, Otani A, Yoshimura N (2009) Association between foveal photoreceptor integrity and visual outcome in neovascular age-related macular degeneration. Am J Ophthalmol 148:83–89PubMedCrossRef Hayashi H, Yamashiro K, Tsujikawa A, Ota M, Otani A, Yoshimura N (2009) Association between foveal photoreceptor integrity and visual outcome in neovascular age-related macular degeneration. Am J Ophthalmol 148:83–89PubMedCrossRef
15.
go back to reference Otani T, Yamaguchi Y, Kishi S (2010) Correlation between visual acuity and foveal microstructural changes in diabetic macular edema. Retina 30:774–780PubMedCrossRef Otani T, Yamaguchi Y, Kishi S (2010) Correlation between visual acuity and foveal microstructural changes in diabetic macular edema. Retina 30:774–780PubMedCrossRef
16.
go back to reference Oishi A, Hata M, Shimozono M, Mandai M, Nishida A, Kurimoto Y (2010) The significance of external limiting membrane status for visual acuity in age-related macular degeneration. Am J Ophthalmol 150:27–32PubMedCrossRef Oishi A, Hata M, Shimozono M, Mandai M, Nishida A, Kurimoto Y (2010) The significance of external limiting membrane status for visual acuity in age-related macular degeneration. Am J Ophthalmol 150:27–32PubMedCrossRef
17.
go back to reference Bolz M, Schmidt-Erfurth U, Deak G, Mylonas G, Kriechbaum K, Scholda C (2009) Optical coherence tomographic hyperreflective foci: a morphologic sign of lipid extravasation in diabetic macular edema. Ophthalmology 116:914–920PubMedCrossRef Bolz M, Schmidt-Erfurth U, Deak G, Mylonas G, Kriechbaum K, Scholda C (2009) Optical coherence tomographic hyperreflective foci: a morphologic sign of lipid extravasation in diabetic macular edema. Ophthalmology 116:914–920PubMedCrossRef
18.
go back to reference Ogino K, Murakami T, Tsujikawa A, Miyamoto K, Sakamoto A, Ota M, Yoshimura N (2012) Characteristics of optical coherence tomographic hyperreflective foci in retinal vein occlusion. Retina 32:77–85PubMedCrossRef Ogino K, Murakami T, Tsujikawa A, Miyamoto K, Sakamoto A, Ota M, Yoshimura N (2012) Characteristics of optical coherence tomographic hyperreflective foci in retinal vein occlusion. Retina 32:77–85PubMedCrossRef
19.
go back to reference Folgar FA, Chow JH, Farsiu S, Wong WT, Schuman SG, O'Connell RV, Winter KP, Chew EY, Hwang TS, Srivastava SK, Harrington MW, Clemons TE, Toth CA (2012) Spatial correlation between hyperpigmentary changes on color fundus photography and hyperreflective foci on SDOCT in intermediate AMD. Invest Ophthalmol Vis Sci 53:4626–4633PubMedCrossRef Folgar FA, Chow JH, Farsiu S, Wong WT, Schuman SG, O'Connell RV, Winter KP, Chew EY, Hwang TS, Srivastava SK, Harrington MW, Clemons TE, Toth CA (2012) Spatial correlation between hyperpigmentary changes on color fundus photography and hyperreflective foci on SDOCT in intermediate AMD. Invest Ophthalmol Vis Sci 53:4626–4633PubMedCrossRef
20.
go back to reference Christenbury JG, Folgar FA, O'Connell RV, Chiu SJ, Farsiu S, Toth CA (2013) Progression of intermediate age-related macular degeneration with proliferation and inner retinal migration of hyperreflective foci. Ophthalmology 120:1038–1045PubMedCentralPubMedCrossRef Christenbury JG, Folgar FA, O'Connell RV, Chiu SJ, Farsiu S, Toth CA (2013) Progression of intermediate age-related macular degeneration with proliferation and inner retinal migration of hyperreflective foci. Ophthalmology 120:1038–1045PubMedCentralPubMedCrossRef
21.
go back to reference Coscas G, De Benedetto U, Coscas F, Li Calzi CI, Vismara S, Roudot-Thoraval F, Bandello F, Souied E (2013) Hyperreflective dots: a new spectral-domain optical coherence tomography entity for follow-up and prognosis in exudative age-related macular degeneration. Ophthalmologica 229:32–37PubMedCrossRef Coscas G, De Benedetto U, Coscas F, Li Calzi CI, Vismara S, Roudot-Thoraval F, Bandello F, Souied E (2013) Hyperreflective dots: a new spectral-domain optical coherence tomography entity for follow-up and prognosis in exudative age-related macular degeneration. Ophthalmologica 229:32–37PubMedCrossRef
22.
go back to reference Framme C, Wolf S, Wolf-Schnurrbusch U (2010) Small dense particles in the retina observable by spectral-domain optical coherence tomography in age-related macular degeneration. Invest Ophthalmol Vis Sci 51:5965–5969PubMedCrossRef Framme C, Wolf S, Wolf-Schnurrbusch U (2010) Small dense particles in the retina observable by spectral-domain optical coherence tomography in age-related macular degeneration. Invest Ophthalmol Vis Sci 51:5965–5969PubMedCrossRef
23.
go back to reference Framme C, Schweizer P, Imesch M, Wolf S, Wolf-Schnurrbusch U (2012) Behavior of SD-OCT-detected hyperreflective foci in the retina of anti-VEGF-treated patients with diabetic macular edema. Invest Ophthalmol Vis Sci 53:5814–5818PubMedCrossRef Framme C, Schweizer P, Imesch M, Wolf S, Wolf-Schnurrbusch U (2012) Behavior of SD-OCT-detected hyperreflective foci in the retina of anti-VEGF-treated patients with diabetic macular edema. Invest Ophthalmol Vis Sci 53:5814–5818PubMedCrossRef
24.
go back to reference Uji A, Murakami T, Nishijima K, Akagi T, Horii T, Arakawa N, Muraoka Y, Ellabban AA, Yoshimura N (2012) Association between hyperreflective foci in the outer retina, status of photoreceptor layer, and visual acuity in diabetic macular edema. Am J Ophthalmol 153:710–717PubMedCrossRef Uji A, Murakami T, Nishijima K, Akagi T, Horii T, Arakawa N, Muraoka Y, Ellabban AA, Yoshimura N (2012) Association between hyperreflective foci in the outer retina, status of photoreceptor layer, and visual acuity in diabetic macular edema. Am J Ophthalmol 153:710–717PubMedCrossRef
25.
go back to reference El-Emam S, Chhablani J, Barteselli G, Wang H, Lee SN, Kozak I, Cheng L, Freeman WR (2013) Correlation of spectral domain optical coherence tomography characteristics with visual acuity in eyes with subfoveal scarring after treatment for wet age-related macular degeneration. Retina 33:1249–1257PubMedCrossRef El-Emam S, Chhablani J, Barteselli G, Wang H, Lee SN, Kozak I, Cheng L, Freeman WR (2013) Correlation of spectral domain optical coherence tomography characteristics with visual acuity in eyes with subfoveal scarring after treatment for wet age-related macular degeneration. Retina 33:1249–1257PubMedCrossRef
26.
go back to reference Oster SF, Mojana F, Brar M, Yuson RM, Cheng L, Freeman WR (2010) Disruption of the photoreceptor inner segment/outer segment layer on spectral domain-optical coherence tomography is a predictor of poor visual acuity in patients with epiretinal membranes. Retina 30:713–718PubMedCrossRef Oster SF, Mojana F, Brar M, Yuson RM, Cheng L, Freeman WR (2010) Disruption of the photoreceptor inner segment/outer segment layer on spectral domain-optical coherence tomography is a predictor of poor visual acuity in patients with epiretinal membranes. Retina 30:713–718PubMedCrossRef
27.
go back to reference Maheshwary AS, Oster SF, Yuson RM, Cheng L, Mojana F, Freeman WR (2010) The association between percent disruption of the photoreceptor inner segment–outer segment junction and visual acuity in diabetic macular edema. Am J Ophthalmol 150:63–67PubMedCentralPubMedCrossRef Maheshwary AS, Oster SF, Yuson RM, Cheng L, Mojana F, Freeman WR (2010) The association between percent disruption of the photoreceptor inner segment–outer segment junction and visual acuity in diabetic macular edema. Am J Ophthalmol 150:63–67PubMedCentralPubMedCrossRef
28.
go back to reference Baumuller S, Charbel Issa P, Scholl HP, Schmitz-Valckenberg S, Holz FG (2010) Outer retinal hyperreflective spots on spectral-domain optical coherence tomography in macular telangiectasia type 2. Ophthalmology 117:2162–2168PubMedCrossRef Baumuller S, Charbel Issa P, Scholl HP, Schmitz-Valckenberg S, Holz FG (2010) Outer retinal hyperreflective spots on spectral-domain optical coherence tomography in macular telangiectasia type 2. Ophthalmology 117:2162–2168PubMedCrossRef
29.
go back to reference Schuman SG, Koreishi AF, Farsiu S, Jung SH, Izatt JA, Toth CA (2009) Photoreceptor layer thinning over drusen in eyes with age-related macular degeneration imaged in vivo with spectral-domain optical coherence tomography. Ophthalmology 116:488–496PubMedCentralPubMedCrossRef Schuman SG, Koreishi AF, Farsiu S, Jung SH, Izatt JA, Toth CA (2009) Photoreceptor layer thinning over drusen in eyes with age-related macular degeneration imaged in vivo with spectral-domain optical coherence tomography. Ophthalmology 116:488–496PubMedCentralPubMedCrossRef
30.
go back to reference Scholl S, Kirchhof J, Augustin AJ (2010) Pathophysiology of macular edema. Ophthalmologica 224(Suppl 1):8–15PubMedCrossRef Scholl S, Kirchhof J, Augustin AJ (2010) Pathophysiology of macular edema. Ophthalmologica 224(Suppl 1):8–15PubMedCrossRef
31.
go back to reference Bunt-Milam AH, Saari JC, Klock IB, Garwin GG (1985) Zonulae adherentes pore size in the external limiting membrane of the rabbit retina. Invest Ophthalmol Vis Sci 26:1377–1380PubMed Bunt-Milam AH, Saari JC, Klock IB, Garwin GG (1985) Zonulae adherentes pore size in the external limiting membrane of the rabbit retina. Invest Ophthalmol Vis Sci 26:1377–1380PubMed
32.
go back to reference Tsujikawa A, Sakamoto A, Ota M, Kotera Y, Oh H, Miyamoto K, Kita M, Yoshimura N (2010) Serous retinal detachment associated with retinal vein occlusion. Am J Ophthalmol 149:291–301PubMedCrossRef Tsujikawa A, Sakamoto A, Ota M, Kotera Y, Oh H, Miyamoto K, Kita M, Yoshimura N (2010) Serous retinal detachment associated with retinal vein occlusion. Am J Ophthalmol 149:291–301PubMedCrossRef
33.
go back to reference Jaissle GB, Szurman P, Feltgen N, Spitzer B, Pielen A, Rehak M, Spital G, Heimann H, Meyer CH (2011) Predictive factors for functional improvement after intravitreal bevacizumab therapy for macular edema due to branch retinal vein occlusion. Graefes Arch Clin Exp Ophthalmol 249:183–192PubMedCentralPubMedCrossRef Jaissle GB, Szurman P, Feltgen N, Spitzer B, Pielen A, Rehak M, Spital G, Heimann H, Meyer CH (2011) Predictive factors for functional improvement after intravitreal bevacizumab therapy for macular edema due to branch retinal vein occlusion. Graefes Arch Clin Exp Ophthalmol 249:183–192PubMedCentralPubMedCrossRef
Metadata
Title
Correlation between optical coherence tomographic hyperreflective foci and visual outcomes after intravitreal bevacizumab for macular edema in branch retinal vein occlusion
Authors
Joon-Won Kang
Hyungwoo Lee
Hyewon Chung
Hyung Chan Kim
Publication date
01-09-2014
Publisher
Springer Berlin Heidelberg
Published in
Graefe's Archive for Clinical and Experimental Ophthalmology / Issue 9/2014
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI
https://doi.org/10.1007/s00417-014-2595-5

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