International Ophthalmology

, Volume 32, Issue 4, pp 369–377 | Cite as

Macular edema in central retinal vein occlusion: correlation between optical coherence tomography, angiography and visual acuity

  • Virginie Martinet
  • Benjamin Guigui
  • Agnès Glacet-Bernard
  • Alain Zourdani
  • Gabriel Coscas
  • Gisèle Soubrane
  • Eric H. Souied


To analyze the characteristics and the course of macular edema secondary to central retinal vein occlusion (CRVO) using optical coherence tomography (OCT) and to determine correlations between clinical, tomographic and angiographic data, in particular including retinal ischemia. In this retrospective study, 53 consecutive patients with CRVO were included. At each follow-up visit, patients underwent complete ophthalmological examination, including best-corrected visual acuity (BCVA) and OCT. Fluorescein angiography was performed at baseline and on demand during follow-up. 243 OCTs were analyzed. Mean age was 61 years and mean follow-up 13 months. The first structural change, observed very early after the onset of the occlusion, was a diffuse increase at the level of the outer nuclear layer without change at the level of the inner retina. This early change seemed characteristic of retinal vein occlusion. Cystoid spaces were subsequently observed in all retinal layers and were combined with serous retinal detachment in 51 %. During the first 6 months, central retinal thickness was higher in ischemic CRVO (mean, 691 μm) than in non-ischemic CRVO (mean, 440 μm, p < 0.01). In eyes with foveal thickness (central retinal thickness without subretinal fluid) of 700 μm or greater, peripheral ischemia was present in 69 % of eyes, final BCVA was 20/200 or less in 75 % and never reached 20/40 during follow-up. The integrity of the junction of the photoreceptors’ inner and outer segments was correlated with a better prognosis (p < 0.05). Foveal thickness was inversely correlated to BCVA at each visit and could have a prognostic value. OCT examination in CRVO revealed useful data for the diagnosis of CRVO and its prognosis. The largest macular edemas seemed to be the hallmark of ischemic CRVO.


Central retinal vein occlusion Fluorescein angiography Ischemic CRVO Macular edema Optical coherence tomography Prognosis 


Conflict of Interest

No financial support. No financial interest.


  1. 1.
    Shahidi M, Ogura Y, Blair NP, Rusin MM, Zeimer R (1991) Retinal thickness analysis for quantitative assessment of diabetic macular edema. Arch Ophthalmol 109:1115–1119PubMedCrossRefGoogle Scholar
  2. 2.
    Nussenblatt RB, Kaufman SC, Palestine AG, Davis MD, Ferris FL III (1987) Macular thickening and visual acuity. Measurement in patients with cystoid macular edema. Ophthalmology 94:1134–1139PubMedGoogle Scholar
  3. 3.
    Suzuma K, Kita M, Yamana T et al (1998) Quantitative assessment of macular edema with retinal vein occlusion. Am J Ophthalmol 126:409–416PubMedCrossRefGoogle Scholar
  4. 4.
    Catier A, Tadayoni R, Paques M et al (2005) Characterization of macular edema from various etiologies by optical coherence tomography. Am J Ophthalmol 140:200–206PubMedCrossRefGoogle Scholar
  5. 5.
    Spaide RF, Lee JK, Klancnik JK Jr, Gross NE (2003) Optical coherence tomography of branch retinal vein occlusion. Retina 23:343–347PubMedCrossRefGoogle Scholar
  6. 6.
    Shroff D, Mehta DK, Arora R, Narula R, Chauhan D (2008) Natural history of macular status in recent-onset branch retinal vein occlusion: an optical coherence tomography study. Int Ophthalmol 28:261–268PubMedCrossRefGoogle Scholar
  7. 7.
    Yamaike N, Tsujikawa A, Ota M et al (2008) Three-dimensional imaging of cystoid macular edema in retinal vein occlusion. Ophthalmology 115:355–362PubMedCrossRefGoogle Scholar
  8. 8.
    Ota M, Tsujikawa A, Murakami T et al (2009) Association between integrity of foveal photoreceptor layer and visual acuity in branch retinal vein occlusion. Br J Ophthalmol 91:1644–1649CrossRefGoogle Scholar
  9. 9.
    Ota M, Tsujikawa A, Kita M et al (2008) Integrity of foveal photoreceptor layer in central retinal vein occlusion. Retina 28:1502–1508PubMedCrossRefGoogle Scholar
  10. 10.
    Lima VC, Yeung L, Castro LC, Landa G, Rosen RB (2011) Correlation between spectral domain optical coherence tomography findings and visual outcomes in central retinal vein occlusion. Clin Ophthalmol 5:299–305PubMedCrossRefGoogle Scholar
  11. 11.
    Jittpoonkuson T, Garcia P, Rosen RB (2010) Correlation between fluorescein angiography and spectral domain optical coherence tomography in the diagnosis of cystoid macular edema. Br J Ophthalmol 94:1197–1200PubMedCrossRefGoogle Scholar
  12. 12.
    Brar M, Yuson R, Kozak I et al (2010) Correlation between morphologic features on spectral-domain optical coherence tomography and angiographic leakage patterns in macular edema. Retina 30:383–389PubMedCrossRefGoogle Scholar
  13. 13.
    The Central Vein Occlusion Study Group M Report (1995) Evaluation of grid pattern photocoagulation for macular edema in central vein occlusion. Ophthalmology 102:1425–1433Google Scholar
  14. 14.
    Chung EJ, Roh MI, Kwon OW, Koh HJ (2008) Effects of macular ischemia on the outcome of intravitreal bevacizumab therapy for diabetic macular edema. Retina 28:957–963PubMedCrossRefGoogle Scholar
  15. 15.
    Lujan BJ (2011) Revealing Henle’s Fiber Layer using spectral-domain OCT. Invest Ophthalmol Vis Sci 52:1486–1492PubMedCrossRefGoogle Scholar
  16. 16.
    Paques M, Tadayoni R, Sercombe R et al (2003) Structural and hemodynamic analysis of the mouse retinal microcirculation. Invest Ophthalmol Vis Sci 44:4960–4967PubMedCrossRefGoogle Scholar
  17. 17.
    Noma H, Funatsu H, Mimura T, Harino S, Hori S (2010) Aqueous humor levels of vasoactive molecules correlate with vitreous levels and macular edema in central retinal vein occlusion. Eur J Ophthalmol 20:402–409PubMedGoogle Scholar
  18. 18.
    Otani T, Kishi S, Maruyama Y (1999) Patterns of diabetic macular edema with optical coherence tomography. Am J Ophthalmol 127:688–693PubMedCrossRefGoogle Scholar
  19. 19.
    Zhang HR, Wang X, Lu XR, Yang YF, Liu F (2005) Measurement of macular edema in retinal vein occlusion using optical coherence tomography and its visual prognosis. Zhonghua Yan Ke Za Zhi 41:910–916PubMedGoogle Scholar
  20. 20.
    Helb HM, Issa PC, Fleckenstein M et al (2010) Clinical evaluation of simultaneous confocal scanning laser ophthalmoscopy imaging combined with high-resolution, spectral-domain optical coherence tomography. Acta Ophthalmol 88:842–849PubMedCrossRefGoogle Scholar
  21. 21.
    Shin HJ, Chung H, Kim HC (2011) Association between integrity of foveal photoreceptor layer and visual outcome in retinal vein occlusion. Acta Ophthalmol 89:e35–e40PubMedCrossRefGoogle Scholar
  22. 22.
    Glacet-Bernard A, Coscas G, Chabanel A, Zourdani A, Lelong F, Samama MM (1996) Prognostic factors for retinal vein occlusion: prospective study of 175 cases. Ophthalmology 103:551–560PubMedGoogle Scholar
  23. 23.
    Ach T, Hoeh AE, Schaal KB, Scheuerle AF, Dithmar S (2010) Predictive factors for changes in macular edema in intravitreal bevacizumab therapy of retinal vein occlusion. Graefes Arch Clin Exp Ophthalmol 248:155–159PubMedCrossRefGoogle Scholar
  24. 24.
    Scott IU, Vanveldhuisen PC, Oden NL, Ip MS, Blodi BA, Hartnett ME, Cohen G, Standard Care Versus Corticosteroid for Retinal Vein Occlusion Study Investigator Group (2011) Baseline predictors of visual acuity and retinal thickness outcomes in patients with retinal vein occlusion: Standard Care Versus COrticosteroid for REtinal Vein Occlusion Study report 10. Ophthalmology 118:345–352PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2012

Authors and Affiliations

  • Virginie Martinet
    • 1
    • 2
  • Benjamin Guigui
    • 1
  • Agnès Glacet-Bernard
    • 1
  • Alain Zourdani
    • 1
  • Gabriel Coscas
    • 1
  • Gisèle Soubrane
    • 1
  • Eric H. Souied
    • 1
  1. 1.Department of Ophthalmology, Hôpital Intercommunal Créteil and Hôpital Henri Mondor (Assistance Publique des Hôpitaux de Paris)Paris-Est Créteil UniversityParisFrance
  2. 2.Fondation Ophtalmologique Adolphe de RothschildParisFrance

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