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High Variation in Inner Retinal Reflectivity Predicts Poor Visual Outcome in Patients With Central Retinal Vein Occlusion: SCORE2 Report 21

06/2023

Journal Article

Authors:
Mehta, N.; Patil, S.; Modi, V.; Vardi, R.; Liu, K.; Singh, R. P.; Sarraf, D.; Oden, N. L.; VanVeldhuisen, P. C.; Scott, I. U.; Ip, M. S.; Blodi, B. A.; Modi, Y.

Volume:
12

Pagination:
21

Issue:
6

Journal:
Transl Vis Sci Technol

PMID:
37367722

URL:
https://www.ncbi.nlm.nih.gov/pubmed/37367722

DOI:
10.1167/tvst.12.6.21

Keywords:
Humans *Retinal Vein Occlusion/complications/diagnostic imaging/drug therapy Angiogenesis Inhibitors/therapeutic use Intravitreal Injections Retina/diagnostic imaging Valsartan/therapeutic use

Abstract:
PURPOSE: To assess the association of a novel spectral domain optical coherence tomography biomarker with 6-month visual acuity in in the Study of COmparative Treatments for REtinal Vein Occlusion 2. METHODS: Spectral domain optical coherence tomography volume scans were evaluated for inner retinal hyperreflectivity, quantified by optical intensity ratio (OIR) and OIR variation. Baseline visual acuity letter score (VALS), baseline OCT biomarkers, and month 1 OIR were correlated with VALS at month 6. Regression trees, a machine learning technique yielding readily interpretable models, were used to assess for variable interaction. RESULTS: Only baseline VALS correlated positively with month 6 VALS in multivariate regression. Regression trees detected a novel functional and anatomical interaction in a subgroup. Among patients with a baseline VALS worse than 43, those with an OIR variation at month 1 of more than 0.09 had a mean of 13 fewer letters of vision at 6 months compared with patients with an OIR variation of 0.09 or less. CONCLUSIONS: Baseline VALS was the strongest predictor of month 6 VALS. Regression tree analysis detected an interaction effect, in which higher OIR variation at month 1 predicted worse 6-month VALS in patients with low VALS at baseline. OIR variation may serve as a predictor for poor visual outcome despite treatment of macular edema secondary to retinal vein occlusion in patients with poor vision at baseline. TRANSLATIONAL RELEVANCE: Pixel heterogeneity in three-dimensional OCT data may serve as measure of disruption of the retinal laminations, and this factor may carry visually prognostic value.

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