Secondary Logo

Institutional members access full text with Ovid®

Share this article on:

FELLOW EYE CHANGES IN PATIENTS WITH NONISCHEMIC CENTRAL RETINAL VEIN OCCLUSION: Assessment of Perfused Foveal Microvascular Density and Identification of Nonperfused Capillaries

Pinhas, Alexander BA*,†; Dubow, Michael MD*,†; Shah, Nishit MD*; Cheang, Eric*,‡; Liu, Chun L.*,§; Razeen, Moataz MD*,¶; Gan, Alexander MD*; Weitz, Rishard BEng, MBA*; Sulai, Yusufu N. PhD**; Chui, Toco Y. PhD*,†; Dubra, Alfredo PhD††,‡‡,§§; Rosen, Richard B. MD*,†

doi: 10.1097/IAE.0000000000000586
Original Study

Purpose: Eyes fellow to nonischemic central retinal vein occlusion (CRVO) were examined for abnormalities, which might explain their increased risk for future occlusion, using adaptive optics scanning light ophthalmoscope fluorescein angiography.

Methods: Adaptive optics scanning light ophthalmoscope fluorescein angiography foveal microvascular densities were calculated. Nonperfused capillaries adjacent to the foveal avascular zone were identified. Spectral domain optical coherence tomography, ultrawide field fluorescein angiographies, and microperimetry were also performed.

Results: Ten fellow eyes of nine nonischemic CRVO and 1 nonischemic hemi-CRVO subjects and four affected eyes of three nonischemic CRVO and one nonischemic hemi-CRVO subjects were imaged. Ninety percent of fellow eyes and 100% of affected eyes demonstrated at least 1 nonperfused capillary compared with 31% of healthy eyes. Fellow eye microvascular density (35 ± 3.6 mm−1) was significantly higher than that of affected eyes (25 ± 5.2 mm−1) and significantly lower than that of healthy eyes (42 ± 4.2 mm−1). Compared with healthy controls, spectral domain optical coherence tomography thicknesses showed no significant difference, whereas microperimetry and 2/9 ultrawide field fluorescein angiography revealed abnormalities in fellow eyes.

Conclusion: Fellow eye changes detectable on adaptive optics scanning light ophthalmoscope fluorescein angiography reflect subclinical pathology difficult to detect using conventional imaging technologies. These changes may help elucidate the pathogenesis of nonischemic CRVO and help identify eyes at increased risk of future occlusion.

Eyes fellow to nonischemic central retinal vein occlusion, known to be at higher risk for future occlusion compared with the general population, were found to have microvascular densities midway between affected and healthy eyes, when studied with adaptive optics scanning light ophthalmoscope fluorescein angiography.

*Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York;

Icahn School of Medicine at Mount Sinai, New York, New York;

Stuyvesant High School, New York, New York;

§Bronx High School of Science, Bronx, New York;

Alexandria Faculty of Medicine, University of Alexandria, Alexandria, Egypt;

**The Institute of Optics, University of Rochester, Rochester, New York;

††Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, Wisconsin;

‡‡Department of Biomedical Engineering, Marquette University, Milwaukee, Wisconsin; and

§§Department of Biophysics, Medical College of Wisconsin, Milwaukee, Wisconsin.

Reprint requests: Richard B. Rosen, MD, Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York 10003, NY; e-mail: rrosen@nyee.edu

Supported by Marrus Family Foundation, Bendheim–Lowenstein Family Foundation, Wise Family Foundation, RD & Linda Peters Foundation, Edith C. Blum Foundation, Chairman's Research Fund of the New York Eye and Ear Infirmary of Mount Sinai, the Glaucoma Research Foundation, an unrestricted departmental grant from Research to Prevent Blindness, and National Institutes of Health grants P30EY001931 and UL1TR000055. A. Dubra is the recipient of a Career Development Award from Research to Prevent Blindness and a Career Award at the Scientific Interface from the Burroughs Wellcome Fund.

A. Dubra: US Patent No: 8,226,236: Code P (Patent). R. B. Rosen: Clarity: Code C (Consultant); Opticology: Code C (Consultant); OD–OS: Code C (Consultant); Allergan: Code C (Consultant); Carl Zeiss Meditec: Code C (Consultant); Optovue: Code C (Consultant); Advanced Cellular Technologies: Code C (Consultant). The other authors do not have any conflicting interests to disclose.

© 2015 by Ophthalmic Communications Society, Inc.