Holland Stephen M, Dodwell David G, Krimmel Darrel A, de Fiebre Christopher M
Illinois Retina Center, Springfield, IL, 62704, USA.
Southern Illinois University School of Medicine, Springfield, IL, 62702, USA.
BMC Ophthalmol. 2015 Sep 4;15:117. doi: 10.1186/s12886-015-0107-y.
Optical coherence tomography has focused mainly on central subfield thickness to quantify macular edema in central and branch retinal vein occlusion. We examined macular fields other than the central subfield to determine if they are possibly independent indicators of recurrent macular edema.
Single center, retrospective, consecutive case study of patients with recurrent macular edema secondary to either central or branch retinal vein occlusion. Thickness estimates of serial domain optical coherence tomography macular fields were obtained at the time of recurrent macular edema and analyzed retrospectively. Changes were expressed as a percentage of previous baseline levels. Change in thickness at each retreatment episode as well as average changes in thickness were calculated for each macular field for each eye. Data were analyzed via analysis of variance and Fisher's post hoc analyses. The macular field which most frequently had the largest percent increase at the time of recurrence was also assessed using averages for each subject as well as for each retreatment episode. Individual episodes of recurrent macular edema were also examined to ascertain the frequency in which there was minimal foveal edema (<15 μm increase), but non-foveal edema was considered severe enough to warrant retreatment.
429 episodes of recurrent macular edema in 80 eyes were examined. In addition to the central subfield, the average mean change in thickness of the most affected quadrant (central vein occlusion) or hemisphere (branch vein occlusion) of the extrafoveal 3 mm band had the largest mean changes and also most frequently had the largest increases at the time of recurrent macular edema. In approximately 20 % of both central and branch occlusions, recurrent macular edema was detected in non-central macular fields in the absence of significant edema in the central subfield.
Analyses of non-central macular fields as well as the central subfield may be useful in the early detection and treatment of recurrent macular edema in retinal vein occlusion.
光学相干断层扫描主要聚焦于中心子区域厚度，以量化视网膜中央静脉阻塞和分支静脉阻塞中的黄斑水肿。我们检查了中心子区域以外的黄斑区域，以确定它们是否可能是复发性黄斑水肿的独立指标。
对视网膜中央静脉阻塞或分支静脉阻塞继发复发性黄斑水肿的患者进行单中心、回顾性、连续病例研究。在复发性黄斑水肿时获取系列域光学相干断层扫描黄斑区域的厚度估计值，并进行回顾性分析。变化以先前基线水平的百分比表示。计算每只眼睛每个黄斑区域每次再治疗时的厚度变化以及厚度的平均变化。通过方差分析和Fisher事后分析对数据进行分析。还使用每个受试者以及每次再治疗时的平均值评估复发时最常出现最大百分比增加的黄斑区域。还检查了复发性黄斑水肿的个体发作，以确定存在最小黄斑中心凹水肿（增加<15μm）但非黄斑中心凹水肿被认为严重到需要再治疗的频率。
检查了80只眼中的429次复发性黄斑水肿发作。除中心子区域外，黄斑中心凹外3mm带中受影响最严重的象限（中央静脉阻塞）或半球（分支静脉阻塞）的平均厚度变化最大，并且在复发性黄斑水肿时也最常出现最大增加。在大约20%的中央和分支阻塞病例中，在中央子区域无明显水肿的情况下，在非中央黄斑区域检测到复发性黄斑水肿。
分析非中央黄斑区域以及中心子区域可能有助于视网膜静脉阻塞中复发性黄斑水肿的早期检测和治疗。
