Huang Ryan S, Mihalache Andrew, Popovic Marko M, Munn Colyn, Melo Isabela Martins, Pecaku Aurora, Kamintsky Lyna, Friedman Alon, Wong David T, Muni Rajeev H
Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada.
Can J Ophthalmol. 2025 Jun;60(3):177-185. doi: 10.1016/j.jcjo.2024.08.002. Epub 2024 Aug 31.
To examine the association between quantitative vascular parameters extracted from intravenous fluorescein angiography (IVFA) and baseline clinical characteristics of patients with retinal vein occlusion (RVO).
Our prospective single-centre study in Toronto, Canada, recruited patients with a diagnosis of macular edema secondary to RVO presenting with a central macular thickness (CMT) ≥310 μm from 2017 to 2023. IVFA images were captured using an ultra-widefield scanning laser ophthalmoscope and processed using the artificial intelligence-based RETICAD system to extract quantitative measurements of blood flow, perfusion, and blood-retinal barrier (BRB) permeability. Univariable and multivariable regression models were used to investigate associations between quantitative IVFA parameters and baseline best-corrected visual acuity (BCVA), CMT, and macular volume.
The study included 41 eyes from 41 RVO patients. In the multivariable analysis, BRB permeability was significantly associated with both CMT (p < 0.001) and macular volume (p = 0.005). Subgroup analyses revealed that in central RVO patients, central BRB permeability remained significantly associated with CMT (p = 0.022) and macular volume (p = 0.010); however, there was no association with BCVA (p = 0.921). In branch RVO patients, central BRB permeability was significantly associated with BCVA (p = 0.006) and CMT (p = 0.009), but not with macular volume (p = 0.723). Additionally, both central and peripheral BRB permeability were significantly higher in patients with RVO compared to healthy controls (p < 0.001).
Our investigation reveals novel associations between baseline clinical characteristics and quantitative IVFA parameters in RVO patients, which may serve as clinically relevant biomarkers. Future studies should explore these associations in diverse RVO patient populations with extended follow-up.
研究从静脉荧光血管造影（IVFA）中提取的定量血管参数与视网膜静脉阻塞（RVO）患者基线临床特征之间的关联。
我们在加拿大多伦多进行的前瞻性单中心研究，纳入了2017年至2023年期间诊断为继发于RVO的黄斑水肿且中心黄斑厚度（CMT）≥310μm的患者。使用超广角扫描激光检眼镜采集IVFA图像，并使用基于人工智能的RETICAD系统进行处理，以提取血流、灌注和血视网膜屏障（BRB）通透性的定量测量值。采用单变量和多变量回归模型研究IVFA定量参数与基线最佳矫正视力（BCVA）、CMT和黄斑体积之间的关联。
该研究纳入了41例RVO患者的41只眼。在多变量分析中，BRB通透性与CMT（p < 0.001）和黄斑体积（p = 0.005）均显著相关。亚组分析显示，在中心性RVO患者中，中心BRB通透性与CMT（p = 0.022）和黄斑体积（p = 0.010）仍显著相关；然而，与BCVA无关（p = 0.921）。在分支性RVO患者中，中心BRB通透性与BCVA（p = 0.006）和CMT（p = 0.009）显著相关，但与黄斑体积无关（p = 0.723）。此外，与健康对照组相比，RVO患者的中心和周边BRB通透性均显著更高（p < 0.001）。
我们的研究揭示了RVO患者基线临床特征与IVFA定量参数之间的新关联，这些关联可能作为临床相关的生物标志物。未来的研究应在不同的RVO患者群体中进行更长期的随访，以探索这些关联。
