Prognosis and Disorganization of Retinal Inner Layers in Central Retinal Vein Occlusion with Dexamethasone Implantation

Abstract

Purpose: To examine whether disorganization of retinal inner layers (DRILs) at baseline and after treatment was associated with visual acuity in patients with macular edema secondary to central retinal vein occlusion (CRVO) who were treated with intravitreal dexamethasone implants. Methods: A retrospective review of records of 22 patients with treatment-naive CRVO with centrally involved macular edema treated with intravitreal dexamethasone implants. Spectral domain-optical coherence tomography images were obtained during each visit. The DRIL extent and additional parameters were evaluated in a 2,000 mu m-wide foveal centered area. Results: In the 22 patients (74.5 +/- 8.92 years), baseline DRIL was observed in 21 eyes (94.5%). Using univariate analysis, base-line best corrected visual acuity (BCVA) was significantly associated with the extent of baseline DRIL ( p = 0.005, r = -0.58), and the extent of external limiting membrane disruption and ellipsoid zone ( p = 0.015, r = -0.51; p = 0.011, r = -0.533, respectively). The final BCVA was significantly correlated with the baseline BCVA ( p < 0.001, r = 0.74) and extent of DRIL ( p = 0.04, r = -0.35). Changes in the BCVA were correlated with changes of DRIL between baseline and the final visit ( p = 0.041, r = 0.439). Conclusions: The extents of baseline DRIL and DRIL changes after treatment with intravitreal dexamethasone implants for macular edema secondary to CRVO may be useful parameter for visual acuity improvement.