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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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.	吳冠男, 張笑天, 何廣輝, 等. 阿柏西普治療視網膜靜脈阻塞繼發黃斑水腫的視網膜微血管改變及視力預后分析[J]. 中華眼底病雜志, 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.	何呂福. 脈絡膜厚度研究進展[J]. 中華實驗眼科雜志, 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.	雍紅芳, 戚卉, 吳瑛潔, 等. 視網膜靜脈阻塞繼發黃斑水腫發病機制及黃斑水腫影響視功能的研究進展[J]. 國際眼科雜志, 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, 高鈺寒, 等. 視網膜顳上分支靜脈阻塞合并黃斑水腫的SD-OCT特征及視野分析[J]. 眼科新進展, 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.	楊治坤, 于偉泓, 陳有信. 視網膜分支靜脈阻塞繼發黃斑水腫患眼玻璃體腔注射康柏西普治療后黃斑區微血管結構改變[J]. 中華眼底病雜志, 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.	付艷, 楊娜, 李麗英, 等. 抗血管內皮生長因子藥物治療對視網膜靜脈阻塞合并黃斑水腫患眼脈絡膜厚度的影響[J]. 中華眼底病雜志, 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, 張紅梅, 等. 天津醫科大學本科學生脈絡膜厚度分布及其影響因素[J]. 中華眼底病雜志, 2018, 34(4): 363-367. DOI: 10.3760/cma.j.issn.1005-1015.2018.04.011.

1. 馬景學. 視網膜病[M]//楊培增, 范先群. 眼科學. 北京: 人民衛生出版社, 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. 劉寧樸, 劉熙樸. 脈絡膜的組織解剖學特點及其臨床意義[M]//張承芬, 董方田, 陳有信, 等. 眼底病學. 北京: 人民衛生出版社, 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. 吳冠男, 張笑天, 何廣輝, 等. 阿柏西普治療視網膜靜脈阻塞繼發黃斑水腫的視網膜微血管改變及視力預后分析[J]. 中華眼底病雜志, 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. 《中國高血壓防治指南》修訂委員會. 中國高血壓防治指南2018年修訂版[J]. 心腦血管病防治, 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. 何呂福. 脈絡膜厚度研究進展[J]. 中華實驗眼科雜志, 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. 雍紅芳, 戚卉, 吳瑛潔, 等. 視網膜靜脈阻塞繼發黃斑水腫發病機制及黃斑水腫影響視功能的研究進展[J]. 國際眼科雜志, 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, 高鈺寒, 等. 視網膜顳上分支靜脈阻塞合并黃斑水腫的SD-OCT特征及視野分析[J]. 眼科新進展, 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. 楊治坤, 于偉泓, 陳有信. 視網膜分支靜脈阻塞繼發黃斑水腫患眼玻璃體腔注射康柏西普治療后黃斑區微血管結構改變[J]. 中華眼底病雜志, 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. 付艷, 楊娜, 李麗英, 等. 抗血管內皮生長因子藥物治療對視網膜靜脈阻塞合并黃斑水腫患眼脈絡膜厚度的影響[J]. 中華眼底病雜志, 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, 張紅梅, 等. 天津醫科大學本科學生脈絡膜厚度分布及其影響因素[J]. 中華眼底病雜志, 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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