Diurnal variation of macular oedema in CRVO: prospective study
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Abstract
Introduction
Patients with central retinal vein occlusion (CRVO) may experience reduced vision in the morning. This may be due to increased cystoid macular oedema (CMO), which can be measured on optical coherence tomography (OCT).
Methods
A prospective study was performed on ten patients. Retinal thickness measurements were made with the Topcon 3D OCT-1000: at 9 a.m., 11 a.m., 1 p.m., 3 p.m., 5 p.m. In addition, at 9 a.m. and 5 p.m. visual acuity was recorded using ETDRS LogMAR.
Results
There were seven males and three females with average age of 59.4 years (range 40–80 years). The average duration of symptoms was 5.4 months (range 3–9 months). In eyes with CRVO, median central macular thickness (CMT) significantly reduced from 571 µm at 9 a.m. to 475 µm at 5 p.m. (p < 0.05). Comparison of CMT at 9 a.m. to each of the subsequent time intervals found that there was a significant reduction in the central macula thickness late in the day (p < 0.05). There was no statistical difference in the visual acuity and change in macular thickness did not correlate with change in visual acuity in eyes affected by CRVO.
Discussion
Patients with CRVO demonstrate increase in CMO in morning compared with late morning and afternoon. Possible causes are diurnal variation in blood pressure, retinal metabolism and erect posture. Interventions designed to influence these factors could be used to try to reduce CMO severity
Keywords
Central retinal vein occlusion(CRVO) Diurnal variation Macular oedema Optical coherence tomography(OCT)References
- 1.Williamson TH (1997) Central retinal vein occlusion: what’s the story? Br J Ophthalmol 81:698–704PubMedCrossRefGoogle Scholar
- 2.Weinberg DV (2000) Venous occlusive disease of the retina. In: Albert DM, Jakobiec FA, Azar DT et al (eds) Principles and practice of ophthalmology, 2nd edn. WB Saunders Co, Philadelphia, PA, pp 1887–1900Google Scholar
- 3.Frank RN, Schulz L, Abe K, Iezzi R (2004) Temporal variation in diabetic macular edema measured by optical coherence tomography. Ophthalmology 111:211–217, doi: 10.1016/j.ophtha.2003.05.031 PubMedCrossRefGoogle Scholar
- 4.Larsen M, Wang M, Sander B (2005) Overnight thickness variation in diabetic macular oedema. Invest Ophthalmol Vis Sci 46:2313–2316, doi: 10.1167/iovs.04-0893 PubMedCrossRefGoogle Scholar
- 5.Polito A, Polini G, Chiodini RG, Isola M, Soldano F, Bandello F (2007) Effect of posture on the diurnal variation in clinically significant diabetic macular oedema. Invest Ophthalmol Vis Sci 48:3318–3323, doi: 10.1167/iovs.06-1526 PubMedCrossRefGoogle Scholar
- 6.Polito A, Del Borrello M, Polini G, Furlan F, Isola M, Bandello F (2006) Diurnal variation in clinically significant diabetic macular edema measured by the stratus OCT. Retina 26:14–20, doi: 10.1097/00006982-200601000-00003 PubMedCrossRefGoogle Scholar
- 7.Diabetic Retinopathy Clinical Research Network (2006) Diurnal variation in retinal thickening measurement by optical coherence tomography in center-involved diabetic macular oedema. Arch Ophthalmol 124:1701–1707CrossRefGoogle Scholar
- 8.Paques M, Massin P, Sahel JA, Gaudric A, Bergmann JF, Azancot S, Lévy BI, Vicaut E (2005) Circadian fluctuations of macular oedema in patients with morning vision blurring: correlation with arterial pressure and effect of light deprivation. Invest Ophthalmol Vis Sci 46:4707–4711, doi: 10.1167/iovs.05-0638 PubMedCrossRefGoogle Scholar
- 9.Braun RD, Linsenmeier RA, Goldstick TK (1995) Oxygen consumption in the inner and outer retina of the cat. Invest Ophthalmol Vis Sci 36:542–554PubMedGoogle Scholar
- 10.Linsenmeier RA (1986) Effects of light and darkness on oxygen distribution and consumption in the cat retina. J Gen Physiol 88:521–542, doi: 10.1085/jgp.88.4.521 PubMedCrossRefGoogle Scholar
- 11.Cringle SJ, Yu DY, Yu PK, Su EN (2002) Intraretinal oxygen consumption in the rat in vivo. Invest Ophthalmol Vis Sci 43:1922–1927PubMedGoogle Scholar
- 12.Ganong WF (1989) Review of medical physiology, 14th edn. Appleton & Lange, Norwalk, CT, p 498Google Scholar
- 13.Millar-Craig MW, Bishop CN, Raftery EB (1978) Circadian variation of blood-pressure. Lancet 1:795–797, doi: 10.1016/S0140-6736(78)92998-7 PubMedCrossRefGoogle Scholar
- 14.Chang YH, Chen PL, Tai MC, Chen CH, Lu DW, Chen JT (2006) Hyperbaric oxygen therapy ameliorates the blood—retinal barrier breakdown in diabetic retinopathy. Clin Experiment Ophthalmol 34:584–589, doi: 10.1111/j.1442-9071.2006.01207.x PubMedCrossRefGoogle Scholar