Session Title: FP-14 Vascular Diseases and Diabetic Retinopathy IV
Session Date/Time: Saturday 13/09/2014 | 16:30-18:00
Paper Time: 16:46
Venue: Boulevard F
First Author: : D.Chakraborty INDIA
Co Author(s): : T.K. Sinha A. Das S. Boral B. DuttaChoudhury
Retinal vein occlusion (RVO) is a common, retinal vascular disorder. Clinical features prognosis & response to treatment are influenced by location of occlusion and by the extent of retinal nonperfusion and edema. With increasing use of Spectral domain Optical Coherence Tomography(SDOCT) role of Vitreoretinal (VR) interface in retinal vascular disease is becoming evident. Aim of Study • Spectral Domain OCT (SD OCT) evaluation of Vitreoretinal Interface(VRI) in eyes with Central retinal vein occlusion(CRVO) or Branch retinal vein occlusion (BRVO) to note incidence of – An attached posterior vitreous cortex – Epiretinal membranes – Vitreomacular traction
Setting : Prospective evaluation of patients at a tertiary care referral hospital
• Randomised prospective one time evaluation of vitreoretinal interface using spectral domain(SD) OCT of 204 RVO patients • Study period- Jan to Dec 2013 • Patients underwent detailed ophthalmic examination including vision, slit lamp examination, intraocular pressure measurement, fundus examination, digital fundus photography & SD OCT • Inclusion criteria: patients presenting with BRVO or CRVO (onset / history of decreased vision for ≤ 3 months). Age>.40 years • Exclusion criteria: previous history of treatment, duration of decreased vision≥ 3 months, co-existent diabetic retinopathy, vitreous hemorrhage media opacity significant enough to prevent OCT examination, inflammation in the eyes, past history of vitreoretinal surgery due to any cause Statistical analyses Intra-session repeatability was assessed using coefficient of variation and intra-class correlation coefficient. Data was analysed using Fisher’s exact t-test. Intrasession repeatability was assessed using coefficient of variation and intra-class correlation coefficient. The visual acuity of these patients was recorded in Snellen’s chart and converted into decimals for statistical purposes.
Out of the 204 eyes we had 127 (62.2%) eyes with BRVO and 77 (37.5%) eyes had CRVO. There were 141 males and 63 females. The mean age of the patients was 46.5 years and the range was fro 40 – 50 years. The mean age of the control group was 48.5 years (range was 40 – 50 years). The mean visual acuity in the control group was 1.0. The mean visual acuity in the BRVO group was 0.29, (range was from 0.66 – 0.1) . In the In the CRVO group the mean Visual acuity was 0.18.(range was from 0.25- 0.1) In the BRVO group, the number of patients with complete vitreous detachment was 23(18.1%). Number of patients with Posterior vitreous detachment (PVD) were more in the control group 89(64.2%). In the brvo group vitreomacular traction in some form was noted in 29 eyes(22.83%) where as in the crvo group vitreomacular traction was much more prominent with 30eyes (38.96%) in the control group. Vitreomacular traction was noted in 1eye (0.07%) . Epi retinal membranes were noted in 24 eyes (18.89%) eyes in the BRVO group and 26 eyes (33.76%) in the CRVO group.
Increased awareness of the VR interface has been possible due to development of SD OCT. The VR interface may play an important role in pathogenesis of different retinal pathologies. A partially attached posterior vitreous can boost vitreoretinal pathologies. This study is different from other’s as it utilises SD OCT for assessing VR interface in RVO. Number of patients with Posterior vitreous detachment (PVD) were more in the control group 89(64.2%) (p<0.001)- the difference was highly significant when compared to the study group. Other vitreoretinal interface abnormalities such as Vitreomacular traction and epiretinal membrane were more common in the vein occlusion group (p<0.001). In the brvo group vitreomacular traction in some form was noted in 29 eyes(22.83%) where as in the crvo group vitreomacular traction was more prominent with 30eyes (38.96%) in the control group. Vitreomacular traction was noted in 1eye (0.07%). Epi retinal membranes were noted in 24 eyes (18.89%) eyes in the BRVO group and 26 eyes (33.76%) in the CRVO group. This in turn point out to the fact that vitreo-macular pathology is more common in RVO. This observation may help in better management of RVO patients.