J Korean Ophthalmol Soc.  2016 Jan;57(1):63-70. 10.3341/jkos.2016.57.1.63.

Ganglion Cell Layer Thickness after Anti-Vascular Endothelial Growth Factor Treatment in Retinal Vein Occlusion

• Lee JY
• Kim HC

• KMID: 2213841
• DOI: http://doi.org/10.3341/jkos.2016.57.1.63

Abstract

PURPOSE
To evaluate the effect of repeated intravitreal injections of anti-vascular endothelial growth factor (anti-VEGF) on the thickness of the ganglion cell layer (GCL) in patients with retinal vein occlusion.
METHODS
The present retrospective study included 60 patients with branch retinal vein occlusion and central retinal vein occlusion who received more than 3 anti-VEGF injections. GCL thickness was measured using spectral-domain optical coherence tomography. GCL thickness measurements were made at 9 Early Treatment Diabetic Retinopathy Study grid regions. We evaluated correlations between changes in the GCL thickness and other factors such as intraocular pressure, times of injection, and changes in central macular thickness (CMT).
RESULTS
As a result of multiple intravitreal anti-VEGF treatments, GCL thickness was significantly decreased from 42.99 +/- 5.39 to 38.99 +/- 5.53 (p < 0.001). Changes in GCL thickness were correlated with CMT and the number of injections (p = 0.02 and p = 0.048, respectively). However, multivariate analysis showed the change in mean GCL thickness in the retinal vein occlusion (RVO) was strongly associated only with CMT (p < 0.001).
CONCLUSIONS
As a result of multiple intravitreal injections of anti-VEGF, GCL thickness decreased significantly in RVO patients and changes in GCL thickness and CMT were correlated.

Keyword

Autosegmentation; Ganglion cell layer; Intravitreal anti-vascular endothelial growth factor injection; Retinal vein occlusion; Spectral domain optical coherence tomography

MeSH Terms

Diabetic Retinopathy
Endothelial Growth Factors*
Ganglion Cysts*
Humans
Intraocular Pressure
Intravitreal Injections
Multivariate Analysis
Retinal Vein Occlusion*
Retinal Vein*
Retinaldehyde*
Retrospective Studies
Tomography, Optical Coherence
Endothelial Growth Factors
Retinaldehyde

Figure

• 

  Figure 1. Automatic segmentation of retina by SD-OCT. (A) Segmentation editor view of retina by SD-OCT Spectralis software ver-sion 0.6. A segmentation line marks and belongs to either a certain retinal structure (ILM, ELM, PR1, PR2, RPE, BM) or the outer boundary of a retinal or sub-retinal layer (RNFL, GCL, IPL, INL, OPL, ONL, CHO). (B) Thickness map of GCL, RNFL, and IPL. ILM = internal limiting membrane; RNFL = retinal nerve fiber layer; GCL = ganglion cell layer; IPL = inner plexiform layer; INL = inner nuclear layer; OPL = outer plexiform layer; ELM = external limiting membrane; PR1 = first photoreceptor layer; PR2 = second photoreceptor layer; RPE = retinal pigment epithelium; BM = Bruch's membrane; CHO = choroid; ETDRS = Early Treatment Diabetic Retinopathy Study; SD-OCT = spectral domain optical coherence tomography; ONL = outer nuclear layer.

• 

  Figure 2. Changes in GCL thickness after multiple anti-VEGF injections in BRVO. Right eye of a 60-year-old woman with BRVO. (A) Initial fundus photography and SD-OCT image with retinal hemorrhage at ST area and cystoid macular edema. (B) Initial thick-ness map of GCL in BRVO patient. (C) Fundus photography and SD-OCT image after 7 anti-VEGF injections show reduction of retinal hemorrhage and macular edema. (D) Thickness map of GCL in BRVO patient after 7 anti-VEGF injections. ETDRS = Early Treatment Diabetic Retinopathy Study; GCL = ganglion cell layer; VEGF = vascular endothelial growth factor; BRVO = branch retinal vein occlusion; SD-OCT = spectral domain optical coherence tomography; ST = superotemporal.

• 

  Figure 3. Changes in GCL thickness after multiple anti-VEGF injections in CRVO. Right eye of a 54-year-old man with CRVO. (A) Initial fundus photography and SD-OCT image with diffuse retinal hemorrhage at ST area and cystoid macular edema. (B) Initial thickness map of GCL in CRVO patient. (C) Fundus photography and SD-OCT image after 4 anti-VEGF injections show reduction of retinal hemorrhage and macular edema. (D) Thickness map of GCL in CRVO patient after 4 anti-VEGF injections. ETDRS = Early Treatment Diabetic Retinopathy Study; GCL = ganglion cell layer; VEGF = vascular endothelial growth factor; CRVO = central retinal vein occlusion; SD-OCT = spectral domain optical coherence tomography; ST = superotemporal.

Reference

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