Evaluation of Neurodegenerative and Microvascular Changes in Branch Retinal Vein Occlusion After Regression of the Macular Edema

Öz

Background: To evaluate the quadrantal effect of branch retinal vein occlusion (BRVO) on retinal microvasculature and ganglion cell-internal plexiform layer thickness (GC-IPL)
Materials and Methods: This retrospective study included 62 eyes of 31 patients diagnosed with unilateral BRVO. Participants had optical coherence tomography (OCT) and OCT angiography (OCTA) analyses after complete regression of the macular edema. The macular central subfield thickness (CST), GC-IPL thickness, vessel and perfusion density (VD and PD), and foveal avascular zone (FAZ) area of the superficial capillary plexus (SCP) were evaluated in both groups. We also compared the affected and opposite unaffected quadrant measurements in BRVO eyes with the corresponding quadrant to BRVO (BRVO-corresponding) in the fellow eye.
Results: The mean FAZ area, VD, and PD of SCP demonstrated no significant difference between BRVO and fellow eyes of BRVO (p>0.05 all). The mean GC-IPL thickness, the mean VD of the parafoveal and perifoveal ring, and mean PD of the perifoveal ring were significantly decreased in the affected quadrant of BRVO eyes (p<0.05 all). In the post hoc tests, the VD of the parafoveal and perifoveal ring was significantly lower in the affected quadrant than the unaffected and BRVO-corresponding quadrant (p<0.05 all). A post hoc analysis revealed that the PD was significantly lower in the affected quadrant than the unaffected and BRVO-corresponding quadrant (p=0.017, p=0.025).
Conclusions: The microvascular changes in the macular superficial capillary plexus accompany significant ganglion cell loss in BRVO. The microvascular and microstructural alterations were mainly localized to the distribution area of the occluded vein.

Key Words: Retinal blood vessels, Retinal vein occlusion, Macular edema

Anahtar Kelimeler

• branch retinal vein occlusion
• neurodegeneration
• vessel density

Retinal Ven Dal Tıkanıklığında Makula Ödeminin Gerilemesi Sonrası Mikrovasküler ve Nörodejeneratif Değişikliklerin İncelenmesi

Öz

Amaç: Retinal ven dal tıkanıklığının (RVDT) makuler mikrovasküler yapı ve ganglion hücre-iç pleksiform tabaka (GC-IPL) kalınlığı üzerindeki sektöryel etkilerini araştırmak.
Materyal ve Metod: Bu retrospektif çalışmaya, RVDT tanılı 31 olgunun hastalıktan etkilenen ve sağlıklı gözleri olmak üzere 62 göz dahil edildi. Olguların makula ödeminin gerilemesini takiben optik koherens tomografi (OKT) ve optik koherens tomografi anjiyografi (OKTA) ile görüntülemeleri yapıldı. İki grupta, santral makuler kalınlık, GC-IPL kalınlığı, yüzeyel kapiller pleksusun (SCP) damar yoğunluğu (VD), perfüzyon yoğunluğu (PD) ve foveal avasküler zon (FAZ) alanı analizi yapıldı. RVDT’li gözlerde etkilenen sektör ve etkilenmeyen sektörün ölçümleri hesaplanarak, sağlıklı gözlerde RVDT ile yöndeş (RVDT-yöndeş) olan sektöre ait ölçümlerle karşılaştırıldı.
Bulgular: RVDT’li gözler ve sağlıklı diğer gözleri arasında ortalama FAZ alanı açısından istatisitksel olarak anlamlı fark bulunmadı. SCP’nin VD ve PD ölçümleri açısından olguların RVDT’li ve diğer gözleri arasında istatistiksel olarak anlamlı fark bulunmadı. Ortalama GC-IPL kalınlığı, iç ve dış halka VD ve dış halka PD değerleri RVDT’li gözlerde istatistiksel olarak anlamlı düşüktü (p<0,05). Post-hoc analizlerde, iç ve dış halka VD ölçümleri etkilenen sektörde, etkilenmeyen sektör ve RVDT ile yöndeş sektöre göre istatistiksel olarak anlamlı düşüktü (p<0,05). Post-hoc analizine göre PD ölçümleri etkilenen sektörde, etkilenmeyen ve RVDT ile yöndeş sektöre göre istatisitksel olarak anlamlı düşük saptandı (p<0.05).
Sonuç: Maküler yüzeyel pleksustaki mikrovasküler değişiklikler, BRVO'da anlamlı ganglion hücre kaybına eşlik eder. Mikrovasküler ve mikroyapısal değişiklikler esas olarak tıkanmış damarın dağılım alanına lokalizedir.

Anahtar Kelimeler

• retina ven dal tıkanıklığı
• nörodejenerasyon
• damar yoğunluğu

Kaynakça

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