Original article
Presence of Foveal Bulge in Optical Coherence Tomographic Images in Eyes With Macular Edema Associated With Branch Retinal Vein Occlusion

https://doi.org/10.1016/j.ajo.2013.10.007Get rights and content

Purpose

To determine whether a significant correlation exists between the presence of a bulge in the photoreceptor inner segment/outer segment (IS/OS) line and the best-corrected visual acuity (BCVA) in eyes with resolved macular edema associated with branch retinal vein occlusion (BRVO).

Design

Retrospective, observational case series.

Methods

We retrospectively reviewed the medical records of patients who had a complete resolution of macular edema and had an intact IS/OS line in the central fovea in the spectral-domain optical coherence tomographic (SDOCT) images. Thirty-one eyes with macular edema associated with BRVO (BRVO group) and 31 unaffected fellow eyes (control group) of 31 patients were evaluated. In normal eyes, the intact IS/OS line determined by SDOCT has a bulge at the central fovea, called the foveal bulge. The eyes in the BRVO group were classified by the presence or absence of foveal bulge, and the characteristics of the 2 groups were compared.

Results

A foveal bulge was present in 7 of 31 eyes in the BRVO group. The incidence of a foveal bulge was significantly lower in the BRVO group (22.6%) than in the control group (100%; P < .0001). All 7 eyes with foveal bulge had a decimal BCVA of ≥1.0 at the final visit. The incidence of a foveal bulge was significantly higher in eyes with BCVA of ≥1.0 (77.8%) than in the eyes with BCVA of <1.0 (0%; P < .0001).

Conclusions

The foveal bulge is a good marker of the functional properties of the fovea in eyes with resolved macular edema associated with BRVO.

Section snippets

Procedures and Patients

The procedures used in this study conformed to the tenets of the Declaration of Helsinki. Treatment of an intravitreal injection of bevacizumab was approved by the Institutional Review Board for Nara Medical University. An informed consent was obtained from all of the patients after an explanation of the procedures to be used and possible complications.

We studied the medical records of patients with a resolved macular edema associated with BRVO and with an intact IS/OS line at the central fovea

Results

The interobserver ICC for the measurement of the ONL thickness was 0.957, for the photoreceptor IS length was 0.871, and for the photoreceptor OS length was 0.970. These findings suggest that the measurement of each retinal layer had good reproducibility.

The average age of the 31 patients (15 men and 16 women) was 67.3 ± 8.6 years, with a range of 49-81 years. At the initial visit, all 31 affected eyes had macular edema associated with BRVO, and the macular edema had resolved completely and an

Discussion

Our results showed that the final decimal BCVA varied from 0.3-1.2 after a resolution of the macular edema even with an intact IS/OS line at the central fovea. Thus, it appears that the presence of an intact IS/OS line at the central fovea may not be an indicator of good visual recovery.

Our study indicates that the presence of the foveal bulge in the SDOCT image is a good indicator of better BCVA after resolution of the macular edema associated with BRVO. Our results showed that the percentage

Taiji Hasegawa, MD, graduated from the Fukushima Medical University School of Medicine, Fukushima, Japan in 2006. He is currently an Assistant Professor of the Department of Ophthalmology, Nara Medical University School of Medicine, Kashihara, Japan. He specializes in macular diseases.

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    • Taiji Hasegawa, MD, graduated from the Fukushima Medical University School of Medicine, Fukushima, Japan in 2006. He is currently an Assistant Professor of the Department of Ophthalmology, Nara Medical University School of Medicine, Kashihara, Japan. He specializes in macular diseases.

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