Assessment of ischemia in acute central retinal vein occlusion from inner retinal reflectivity on spectral domain optical coherence tomography

David J Browning, Omar S Punjabi, Chong Lee Department of Ophthalmology, Charlotte Eye, Ear, Nose and Throat Associates, P.A., Charlotte, NC, USA Purpose: To determine the relationship between different spectral domain optical coherence tomography (SD-OCT) signs of retinal ischemia in acute central...

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Autores principales:	Browning DJ, Punjabi OS, Lee C
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2016
Materias:	central retinal vein occlusion spectral-domain optical coherence tomography ischemia prominent middle limiting membrane sign paracentral acute middle maculopathy Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/3c6d7c2a632a4d6eb89ca13afbff45f1
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spelling	oai:doaj.org-article:3c6d7c2a632a4d6eb89ca13afbff45f12021-12-02T02:05:25ZAssessment of ischemia in acute central retinal vein occlusion from inner retinal reflectivity on spectral domain optical coherence tomography1177-5483https://doaj.org/article/3c6d7c2a632a4d6eb89ca13afbff45f12016-12-01T00:00:00Zhttps://www.dovepress.com/assessment-of-ischemia-in-acute-central-retinal-vein-occlusion-from-in-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483David J Browning, Omar S Punjabi, Chong Lee Department of Ophthalmology, Charlotte Eye, Ear, Nose and Throat Associates, P.A., Charlotte, NC, USA Purpose: To determine the relationship between different spectral domain optical coherence tomography (SD-OCT) signs of retinal ischemia in acute central retinal vein occlusion (CRVO) and whether they predict anterior segment neovascularization (ASNV).Design: Retrospective, observational study.Subjects: Thirty-nine consecutive patients with acute CRVO and 12 months of follow-up.Methods: We graded baseline SD-OCTs for increased reflectivity of the inner retina, loss of definition of inner retinal layers, presence of a prominent middle-limiting membrane (p-MLM) sign, and presence of paracentral acute middle maculopathy (PAMM). Graders were masked with respect to all clinical information.Results: The intraclass correlation coefficients (ICCs) of grading–regrading by graders 1 and 2 were 0.8104, 95% confidence interval (CI) (0.6686, 0.8956), and 0.7986, 95% CI (0.6475, 0.8892), respectively. The intragrader coefficients of repeatability (COR) for graders 1 and 2 were 0.94 and 0.92, respectively. The ICC of graders 1 compared with 2 was 0.8039, 95% CI (0.6544, 0.8916). The intergrader COR was 0.80. SD-OCT grades of baseline ischemia were not associated with baseline visual acuity (VA), central subfield mean thickness (CSMT), or relative afferent pupillary defect; 12-month VA, CSMT, change in VA, change in CSMT, number of antivascular endothelial growth factor injections or corticosteroid injections, or proportion of eyes developing ASNV. SD-OCT grades of ischemia did not correlate with the proportion of eyes having the p-MLM sign or PAMM. PAMM and p-MLM are milder signs of ischemia than increased reflectivity of the inner retinal layers. Eyes with PAMM can evolve, losing PAMM and gaining the p-MLM sign.Conclusion: Grading of ischemia from SD-OCT in acute CRVO was repeatable within graders and reproducible across graders for the graders in this study. SD-OCT signs of ischemia are not correlated with each other and do not reliably predict subsequent ASNV. Close monitoring of eyes with acute CRVO continues to be the safest method to avoid missing ASNV and neovascular glaucoma. Keywords: central retinal vein occlusion, spectral domain optical coherence tomography, ischemia, prominent middle-limiting membrane sign, paracentral acute middle maculopathy, rubeosis iris, anterior segment neovascularization, iris neovascularizationBrowning DJPunjabi OSLee CDove Medical Pressarticlecentral retinal vein occlusionspectral-domain optical coherence tomographyischemiaprominent middle limiting membrane signparacentral acute middle maculopathyOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 11, Pp 71-79 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	central retinal vein occlusion spectral-domain optical coherence tomography ischemia prominent middle limiting membrane sign paracentral acute middle maculopathy Ophthalmology RE1-994
spellingShingle	central retinal vein occlusion spectral-domain optical coherence tomography ischemia prominent middle limiting membrane sign paracentral acute middle maculopathy Ophthalmology RE1-994 Browning DJ Punjabi OS Lee C Assessment of ischemia in acute central retinal vein occlusion from inner retinal reflectivity on spectral domain optical coherence tomography
description	David J Browning, Omar S Punjabi, Chong Lee Department of Ophthalmology, Charlotte Eye, Ear, Nose and Throat Associates, P.A., Charlotte, NC, USA Purpose: To determine the relationship between different spectral domain optical coherence tomography (SD-OCT) signs of retinal ischemia in acute central retinal vein occlusion (CRVO) and whether they predict anterior segment neovascularization (ASNV).Design: Retrospective, observational study.Subjects: Thirty-nine consecutive patients with acute CRVO and 12 months of follow-up.Methods: We graded baseline SD-OCTs for increased reflectivity of the inner retina, loss of definition of inner retinal layers, presence of a prominent middle-limiting membrane (p-MLM) sign, and presence of paracentral acute middle maculopathy (PAMM). Graders were masked with respect to all clinical information.Results: The intraclass correlation coefficients (ICCs) of grading–regrading by graders 1 and 2 were 0.8104, 95% confidence interval (CI) (0.6686, 0.8956), and 0.7986, 95% CI (0.6475, 0.8892), respectively. The intragrader coefficients of repeatability (COR) for graders 1 and 2 were 0.94 and 0.92, respectively. The ICC of graders 1 compared with 2 was 0.8039, 95% CI (0.6544, 0.8916). The intergrader COR was 0.80. SD-OCT grades of baseline ischemia were not associated with baseline visual acuity (VA), central subfield mean thickness (CSMT), or relative afferent pupillary defect; 12-month VA, CSMT, change in VA, change in CSMT, number of antivascular endothelial growth factor injections or corticosteroid injections, or proportion of eyes developing ASNV. SD-OCT grades of ischemia did not correlate with the proportion of eyes having the p-MLM sign or PAMM. PAMM and p-MLM are milder signs of ischemia than increased reflectivity of the inner retinal layers. Eyes with PAMM can evolve, losing PAMM and gaining the p-MLM sign.Conclusion: Grading of ischemia from SD-OCT in acute CRVO was repeatable within graders and reproducible across graders for the graders in this study. SD-OCT signs of ischemia are not correlated with each other and do not reliably predict subsequent ASNV. Close monitoring of eyes with acute CRVO continues to be the safest method to avoid missing ASNV and neovascular glaucoma. Keywords: central retinal vein occlusion, spectral domain optical coherence tomography, ischemia, prominent middle-limiting membrane sign, paracentral acute middle maculopathy, rubeosis iris, anterior segment neovascularization, iris neovascularization
format	article
author	Browning DJ Punjabi OS Lee C
author_facet	Browning DJ Punjabi OS Lee C
author_sort	Browning DJ
title	Assessment of ischemia in acute central retinal vein occlusion from inner retinal reflectivity on spectral domain optical coherence tomography
title_short	Assessment of ischemia in acute central retinal vein occlusion from inner retinal reflectivity on spectral domain optical coherence tomography
title_full	Assessment of ischemia in acute central retinal vein occlusion from inner retinal reflectivity on spectral domain optical coherence tomography
title_fullStr	Assessment of ischemia in acute central retinal vein occlusion from inner retinal reflectivity on spectral domain optical coherence tomography
title_full_unstemmed	Assessment of ischemia in acute central retinal vein occlusion from inner retinal reflectivity on spectral domain optical coherence tomography
title_sort	assessment of ischemia in acute central retinal vein occlusion from inner retinal reflectivity on spectral domain optical coherence tomography
publisher	Dove Medical Press
publishDate	2016
url	https://doaj.org/article/3c6d7c2a632a4d6eb89ca13afbff45f1
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Assessment of ischemia in acute central retinal vein occlusion from inner retinal reflectivity on spectral domain optical coherence tomography

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