Changes of choroidal thickness in patients with superior temporal branch retinal vein occlusion complicated with macular edema_Chinese Journal of Ocular Fundus Diseases

Authors：

 Xu Xuemei , Guan Liying , Guo Litao , Su Ruifeng , Deng Zhihong , Shi Jing

Department of Ophthalmology, The Affiliated Hospital of Chengde Medical College, Chengde 067000, China;

Corresponding author：

Xu Xuemei, Email: 112243021@qq.com

Keywords：

Retinal vein occlusion; Macular edema; Choroid; Tomography, optical coherence

DOI：

10.3760/cma.j.cn511434-20211026-00605

Video：

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Objective To observe the characteristics of choroidal thickness in patients with macular edema secondary to superior temporal branch retinal vein occlusion (BRVO-ME). Methods A retrospective control study. From November 2020 to September 2021, 30 patients (30 eyes) with BRVO-ME (BRVO-ME group) were diagnosed by ophthalmology examination in Department of Ophthalmology, The Affiliated Hospital of Chengde Medical College and 14 healthy volunteers (28 eyes) were enrolled in the study. The choroidal thickness of macular area was measured by enhanced deep imaging technique of frequency domain optical coherence tomography. According to the subdivision of the diabetic retinopathy treatment group, the choroid within the 6 mm of the macular fovea was divided into three concentric circles with the macular fovea as the center, namely, the central area with the diameter of 1 mm, the inner ring of 1-3 mm and the outer ring of 3-6 mm. The inner ring area and the outer ring area are divided into upper, lower, nasal and temporal sides, respectively, which are denoted as S3, I3, N3, T3 and S6, I6, N6, T6, totaling 9 areas. To observe the distribution characteristics of choroidal thickness in different regions of two groups of eyes. The choroidal thickness of different macular regions was compared by independent sample t-test. Results The choroidal thicknesses in the central area, S3, T3, I3, N3, S6, T6, I6, and N6 of the eyes in the control group and BRVO-ME group were 214.11±56.04, 207.89±57.92, 214.07±54.82, 207.14±61.54, 180.18±53.53, 204.25±59.60, 193.93±51.50, 190.54±51.21, 139.82±39.84 μm and 258.00±71.14, 256.43±68.70, 252.07±72.97, 244.37±68.49, 243.10±70.93, 247.20±68.36, 221.00±61.28, 223.77±58.64, 183.20±60.15 μm. In both groups, the choroidal thickness was the thickest in the central area, gradually thinning to the nasal side and temporal side, and the nasal choroidal thickness was thinner than other regions, and N6 area was the thinnest. Compared with the control group, the choroidal thickness of central area, S3, T3, I3, N3, S6, I6 and N6 in BRVO-ME group were significantly thicker (t=－2.899, －2.229, －2.172,－3.250, －2.543, －2.292, －3.214; P＜0.05), there was no significant difference in T6 area (t=－1.814, P=0.075). Conclusion The choroidal thickness of macular area in patients with BRVO-ME is thicker than that in normal subjects.

Citation： Xu Xuemei, Guan Liying, Guo Litao, Su Ruifeng, Deng Zhihong, Shi Jing. Changes of choroidal thickness in patients with superior temporal branch retinal vein occlusion complicated with macular edema. Chinese Journal of Ocular Fundus Diseases, 2022, 38(9): 750-754. doi: 10.3760/cma.j.cn511434-20211026-00605 Copy

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6.	Rayess N, Rahimy E, Ying GS, et al. Baseline choroidal thickness as a short-term predictor of visual acuity improvement following antivascular endothelial growth factor therapy in branch retinal vein occlusion[J]. Br J Ophthalmol, 2019, 103(1): 55-59. DOI: 10.1136/bjophthalmol-2018-311898.
7.	吴冠男, 张笑天, 何广辉, 等. 阿柏西普治疗视网膜静脉阻塞继发黄斑水肿的视网膜微血管改变及视力预后分析[J]. 中华眼底病杂志, 2021, 37(4): 290-296. DOI: 10.3760/cma.j.cn511434-20201102-00529.Wu GN, Zhang XT, He GH, et al. Changes of retinal microvasculature and visual acuity prognostic of Aflibercept treatment in macular edema secondary to retinal vein occlusion[J]. Chin J Ocul Fundus Dis, 2021, 37(4): 290-296. DOI: 10.3760/cma.j.cn511434-20201102-00529.
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9.	何吕福. 脉络膜厚度研究进展[J]. 中华实验眼科杂志, 2017, 35(10): 949-954. DOI: 10.3760/cma.j.issn.2095-0160.2017.10.021.He LF. Review on progress of choroidal thickness[J]. Chin J Exp Ophthalmol, 2017, 35(10): 949-954. DOI: 10.3760/cma.j.issn.2095-0160.2017.10.021.
10.	Fawzi AA, Pappuru RR, Sarraf D, et al. Acute macular neuroretinopathy: long-term insights revealed by multimodal imaging[J]. Retina, 2012, 32(8): 1500-1513. DOI: 10.1097/IAE.0b013e318263d0c3.
11.	Nnickla DL, Wallman J. The multifunctional choroid[J]. Prog Retin Eye Res, 2010, 29(2): 144-168. DOI: 10.1016/j.preteyeres.2009.12.002.
12.	Spaide RF. Age-related choroidal atrophy[J]. Am J Ophthalmol, 2009, 147(5): 801-810. DOI: 10.1016/j.ajo.2008.12.010.
13.	雍红芳, 戚卉, 吴瑛洁, 等. 视网膜静脉阻塞继发黄斑水肿发病机制及黄斑水肿影响视功能的研究进展[J]. 国际眼科杂志, 2019, 19(11): 1888-1891. DOI: 10.3980/j.issn.1672-5123.2019.11.17.Yong HF, Qi H, Wu YJ, et al. Research progress on the pathogenesis of macular edema secondary to retinal vein occlusion and the effect of macular edema on visual function[J]. Int Eye Sci, 2019, 19(11): 1888-1891. DOI: 10.3980/j.issn.1672-5123.2019.11.17.
14.	李玲娜, 李田, 高钰寒, 等. 视网膜颞上分支静脉阻塞合并黄斑水肿的SD-OCT特征及视野分析[J]. 眼科新进展, 2020, 40(5): 449-452. DOI: 10.13389/j.cnki.rao.2020.0103.Li LN, Li T, Gao YH, et al. SD-OCT features in patients with superior temporal branch retinal vein occlu-sion combined with macular edema and relevant analysis of visual field[J]. Rec Adu Ophthalmol, 2020, 40(5): 449-452. DOI: 10.13389/j.cnki.rao.2020.0103.
15.	Klien BA. Ischemic infarcts of the choroid (Elschnig spots). A cause of retinal separation in hypertensive disease with renal insufficiency. A clinical and histopathology study[J]. Am J Ophthalmol, 1968, 66(6): 1069-1074. DOI: 10.1016/0002-9394(68)90815-5.
16.	Rehak J, Rehak M. Branch retinal vein occlusion: pathoenesis, visnal prognosis, and treatment modalities[J]. Curr Eye Res, 2008, 33(2): 111-131. DOI: 10.1080/02713680701851902.
17.	Chung YK, Shin JA, Park YH. Choroidal volume in branch retinal vein occlusion before and after intravitreal anti-VEGF injection[J]. Retina, 2015, 35(6): 1234-1239. DOI: 10.1097/IAE.0000000000000455.
18.	Maruko I, Iida T, Sugano Y, et al. Subfoveal choroidal thickness in fellow eyes of patients with central serous chorioretinopathy[J]. Retina, 2011, 31(8): 1603-1608. DOI: 10.1097/IAE.0b013e31820f4b39.
19.	Mrejen S, Spaide RF. Optical coherence tomography: imaging of the choroid and beyond[J]. Surv Ophthalmol, 2013, 58(5): 387-429. DOI: 10.1016/j.survophthal.2012.12.001.
20.	杨治坤, 于伟泓, 陈有信. 视网膜分支静脉阻塞继发黄斑水肿患眼玻璃体腔注射康柏西普治疗后黄斑区微血管结构改变[J]. 中华眼底病杂志, 2021, 37(9): 675-680. DOI: 10.3760/cma.j.cn511434-20210508-00238.Yang ZK, Yu WH, Chen YX. Microvascular changes of macular edema secondary to branch retinal vein occlusion treated with intravitreal conbercept injection[J]. Chin J Ocul Fundus Dis, 2021, 37(9): 675-680. DOI: 10.3760/cma.j.cn511434-20210508-00238.
21.	付艳, 杨娜, 李丽英, 等. 抗血管内皮生长因子药物治疗对视网膜静脉阻塞合并黄斑水肿患眼脉络膜厚度的影响[J]. 中华眼底病杂志, 2021, 37(9): 681-686. DOI: 10.3760/cma.j.cn511434-20200901-00423.Fu Y, Yang N, Li LY, et al. The influence of the choroidal thickness of the affected eye about anti-vascular endothelial growth factor drug treatment for retinal vein occlusion with macular edema[J]. Chin J Ocul Fundus Dis, 2021, 37(9): 681-686. DOI: 10.3760/cma.j.cn511434-20200901-00423.
22.	金楠, 史雪影, 张红梅, 等. 天津医科大学本科学生脉络膜厚度分布及其影响因素[J]. 中华眼底病杂志, 2018, 34(4): 363-367. DOI: 10.3760/cma.j.issn.1005-1015.2018.04.011.

1. 马景学. 视网膜病[M]//杨培增, 范先群. 眼科学. 北京: 人民卫生出版社, 2018: 192.Ma JX. Retinopathy[M]//Yang PZ, Fan XQ. Ophthalmology. Beijing: People's Medical Publishing House, 2018: 192.
2. Yeh S, Kim SJ, Ho AC, et al. Therapies for macular edema associated with central retinal vein occlusion: a report by the American Academy of Ophthalmology[J]. Ophthalmology, 2015, 122(4): 769-778. DOI: 10.1016/j.ophtha.2014.10.013.
3. Noma H, Minamoto A, Funatsu H, et al. Intravitreal levels of vascular endothelial growth factor and interleukin-6 are correlated with macular edema in branch retinal vein occlusion[J]. Graefe's Arch Clin Exp Ophthalmol, 2006, 244(3): 309-315. DOI: 10.1007/s00417-004-1087-4.
4. 刘宁朴, 刘熙朴. 脉络膜的组织解剖学特点及其临床意义[M]//张承芬, 董方田, 陈有信, 等. 眼底病学. 北京: 人民卫生出版社, 2010: 15.Liu NP, Liu XP. Histoanatomical characteristics of choroid and its clinical significance[M]//Zhang CF, Dong FT, Chen YX, et al. Diseases of ocular fundus[M]. Beijing: People's Medical Publishing House, 2010: 15.
5. Lee EK, Han JM, Hyon JY, et al. Changes in choroidal thickness after intravitreal dexamethasone implantinjection in retinal vein occlusion[J]. Br Ophthalmol, 2015, 99(11): 1543-1549. DOI: 10.1136/bjophthalmol-2014-306417.
6. Rayess N, Rahimy E, Ying GS, et al. Baseline choroidal thickness as a short-term predictor of visual acuity improvement following antivascular endothelial growth factor therapy in branch retinal vein occlusion[J]. Br J Ophthalmol, 2019, 103(1): 55-59. DOI: 10.1136/bjophthalmol-2018-311898.
7. 吴冠男, 张笑天, 何广辉, 等. 阿柏西普治疗视网膜静脉阻塞继发黄斑水肿的视网膜微血管改变及视力预后分析[J]. 中华眼底病杂志, 2021, 37(4): 290-296. DOI: 10.3760/cma.j.cn511434-20201102-00529.Wu GN, Zhang XT, He GH, et al. Changes of retinal microvasculature and visual acuity prognostic of Aflibercept treatment in macular edema secondary to retinal vein occlusion[J]. Chin J Ocul Fundus Dis, 2021, 37(4): 290-296. DOI: 10.3760/cma.j.cn511434-20201102-00529.
8. 《中国高血压防治指南》修订委员会. 中国高血压防治指南2018年修订版[J]. 心脑血管病防治, 2019, 19(1): 1-44. DOI: 10.3969/j.issn.1009-816X.2019.01.001.“Chinese guidelines for the management of hypertension” Revised Commission. The 2018 revision of the Chinese guidelines for the prevention and treatment of hypertension[J]. Prevention and Treatment of Cardio-Cerebral-Vascular Disease, 2019, 19(1): 1-44. DOI: 10.3969/j.issn.1009-816X.2019.01.001.
9. 何吕福. 脉络膜厚度研究进展[J]. 中华实验眼科杂志, 2017, 35(10): 949-954. DOI: 10.3760/cma.j.issn.2095-0160.2017.10.021.He LF. Review on progress of choroidal thickness[J]. Chin J Exp Ophthalmol, 2017, 35(10): 949-954. DOI: 10.3760/cma.j.issn.2095-0160.2017.10.021.
10. Fawzi AA, Pappuru RR, Sarraf D, et al. Acute macular neuroretinopathy: long-term insights revealed by multimodal imaging[J]. Retina, 2012, 32(8): 1500-1513. DOI: 10.1097/IAE.0b013e318263d0c3.
11. Nnickla DL, Wallman J. The multifunctional choroid[J]. Prog Retin Eye Res, 2010, 29(2): 144-168. DOI: 10.1016/j.preteyeres.2009.12.002.
12. Spaide RF. Age-related choroidal atrophy[J]. Am J Ophthalmol, 2009, 147(5): 801-810. DOI: 10.1016/j.ajo.2008.12.010.
13. 雍红芳, 戚卉, 吴瑛洁, 等. 视网膜静脉阻塞继发黄斑水肿发病机制及黄斑水肿影响视功能的研究进展[J]. 国际眼科杂志, 2019, 19(11): 1888-1891. DOI: 10.3980/j.issn.1672-5123.2019.11.17.Yong HF, Qi H, Wu YJ, et al. Research progress on the pathogenesis of macular edema secondary to retinal vein occlusion and the effect of macular edema on visual function[J]. Int Eye Sci, 2019, 19(11): 1888-1891. DOI: 10.3980/j.issn.1672-5123.2019.11.17.
14. 李玲娜, 李田, 高钰寒, 等. 视网膜颞上分支静脉阻塞合并黄斑水肿的SD-OCT特征及视野分析[J]. 眼科新进展, 2020, 40(5): 449-452. DOI: 10.13389/j.cnki.rao.2020.0103.Li LN, Li T, Gao YH, et al. SD-OCT features in patients with superior temporal branch retinal vein occlu-sion combined with macular edema and relevant analysis of visual field[J]. Rec Adu Ophthalmol, 2020, 40(5): 449-452. DOI: 10.13389/j.cnki.rao.2020.0103.
15. Klien BA. Ischemic infarcts of the choroid (Elschnig spots). A cause of retinal separation in hypertensive disease with renal insufficiency. A clinical and histopathology study[J]. Am J Ophthalmol, 1968, 66(6): 1069-1074. DOI: 10.1016/0002-9394(68)90815-5.
16. Rehak J, Rehak M. Branch retinal vein occlusion: pathoenesis, visnal prognosis, and treatment modalities[J]. Curr Eye Res, 2008, 33(2): 111-131. DOI: 10.1080/02713680701851902.
17. Chung YK, Shin JA, Park YH. Choroidal volume in branch retinal vein occlusion before and after intravitreal anti-VEGF injection[J]. Retina, 2015, 35(6): 1234-1239. DOI: 10.1097/IAE.0000000000000455.
18. Maruko I, Iida T, Sugano Y, et al. Subfoveal choroidal thickness in fellow eyes of patients with central serous chorioretinopathy[J]. Retina, 2011, 31(8): 1603-1608. DOI: 10.1097/IAE.0b013e31820f4b39.
19. Mrejen S, Spaide RF. Optical coherence tomography: imaging of the choroid and beyond[J]. Surv Ophthalmol, 2013, 58(5): 387-429. DOI: 10.1016/j.survophthal.2012.12.001.
20. 杨治坤, 于伟泓, 陈有信. 视网膜分支静脉阻塞继发黄斑水肿患眼玻璃体腔注射康柏西普治疗后黄斑区微血管结构改变[J]. 中华眼底病杂志, 2021, 37(9): 675-680. DOI: 10.3760/cma.j.cn511434-20210508-00238.Yang ZK, Yu WH, Chen YX. Microvascular changes of macular edema secondary to branch retinal vein occlusion treated with intravitreal conbercept injection[J]. Chin J Ocul Fundus Dis, 2021, 37(9): 675-680. DOI: 10.3760/cma.j.cn511434-20210508-00238.
21. 付艳, 杨娜, 李丽英, 等. 抗血管内皮生长因子药物治疗对视网膜静脉阻塞合并黄斑水肿患眼脉络膜厚度的影响[J]. 中华眼底病杂志, 2021, 37(9): 681-686. DOI: 10.3760/cma.j.cn511434-20200901-00423.Fu Y, Yang N, Li LY, et al. The influence of the choroidal thickness of the affected eye about anti-vascular endothelial growth factor drug treatment for retinal vein occlusion with macular edema[J]. Chin J Ocul Fundus Dis, 2021, 37(9): 681-686. DOI: 10.3760/cma.j.cn511434-20200901-00423.
22. 金楠, 史雪影, 张红梅, 等. 天津医科大学本科学生脉络膜厚度分布及其影响因素[J]. 中华眼底病杂志, 2018, 34(4): 363-367. DOI: 10.3760/cma.j.issn.1005-1015.2018.04.011.

Chinese Journal of Ocular Fundus Diseases

Changes of choroidal thickness in patients with superior temporal branch retinal vein occlusion complicated with macular edema

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