Progressive retinal nonperfusion in ischemic central retinal vein occlusion.
RETINA-THE JOURNAL OF RETINAL AND VITREOUS DISEASES(2015)
Abstract
BACKGROUND:Serial wide-field fluorescein angiography was performed on eyes with preproliferative (ischemic) central retinal vein occlusion to evaluate retinal perfusion.
METHODS:Serial wide-field fluorescein angiography was performed on 12 preproliferative central retinal vein occlusion eyes in the 3-year Rubeosis Anti-VEGF (RAVE) trial using the Staurenghi lens (Ocular Staurenghi 230SLO Retina Lens) with a scanning laser ophthalmoscope (Heidelberg HRA Spectralis). "Disk area" was defined anatomically for each eye.
RESULTS:Mean total field of gradable retina was 290 disk areas (range, 178-452). All eyes demonstrated extensive areas of retinal nonperfusion; at baseline, mean area of retinal perfusion was 106 disk areas (range, 37-129), correlating with a mean of 46.5% perfused retinal area (range, 19.1-56.4%). The area of retinal nonperfusion increased in all eyes with a mean loss of approximately 8.1% of perfused retinal area per year (range, 4.3-12.4%), which corresponded to a mean 15-disk areas (range, 12-35) of retina evolving from perfused to nonperfused annually. The extent of baseline and final nonperfusion was not significantly different between eyes that developed neovascularization and eyes that did not.
CONCLUSION:In this population of severe central retinal vein occlusion eyes, profound retinal nonperfusion was observed with wide-field fluorescein angiography at baseline and the extent of nonperfusion progressed while undergoing anti-vascular endothelial growth factor therapy.
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Key words
central retinal vein occlusion,RAVE,quantification,nonperfusion,anti-VEGF,perfusion,ischemia,capillary dropout,wide-field,Ischemic Index,preproliferative,ranibizumab,fluorescein angiography
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