Correlation Between Morphological Changes Of Photoreceptors And Visual Acuity In Patients With Macular Edema Associated With RVO

Purpose:To observe the baseline optical coherence tomograph characteristics of macular edema due to retinal vein occlusion.Evaluate the correlation between the macular edema’s morphology and visual acuity,so as to summarize related factors affecting vision to provide theoretical basis for clinical treatment.Methods:In this retrospective study,55 eyes of 55patients were enrolled;the baseline best corrected visual acuity(BCVA[LogMAR])and the final BCVA were recorded,central retinal thickness(CRT),photoreceptor layer thickness(PLT),outer nuclear layer thickness(ONLT),macular deformation index(MDI)and the distribution of macular edema were measured by using Heidelberg Spectralis optical coherence tomography(OCT)when patients for the first time;CRT,PLT,ONLT,MDI,the integrity of ellipsoid zone and external limiting membrane were measured by OCT When the macular edema reduced.The results were analyzed by SPSS20.0 statistical software.Result:1.Initial BCVA correlated with initial CRT,MDI,ONLT(r=0.512,P=0.000;r=0.315,P=0.19;r=0.439,P=0.001,respectively),it also correlated with the distribution of macular edema(r=-0.382,P=0.004);whereas BCVA was not correlated with PLT(r=0.081,P=0.559);but the only individual predictor of initial BCVA among patients was the CRT(β=0.02,P=0.000,stepwise multiple regression).2.final BCVA correlated with initial BCVA,final PLT,the integrity of ellipsoid zone and external limiting membrane(ELM)(r=0.648,P=0.000,r=-0.339,P=0.011;r=0.850,P=0.000;r=-0.754,P=0.000,respectively);final BCVA was not correlated with CRT,MDI,ONLT(r=0.002,P=0.991;r=0.088,P=0.524;r=0.154,P=0.260,respectively);but the strongest predictor of final BCVA was the initial BCVA(β=0.650,P=0.000,stepwise multiple regression),followed by the integrity of ellipsoid zone(β=0.298,P=0.000,stepwise multiple regression),and the ELM status(β=0.247,P=0.000,stepwise multiple regression).3.Macular edema located in the central macular and keep away from the centre macular’s mean initial BCVA(LogMAR)were 0.68±0.30,1.16±0.66 respectively,there were significant differences in mean initial BCVA between the two groups(t=-3.71,P=0.000,two independent samples t-test);4.The mean final BCVA(LogMAR)among the status of ellipsoid zone were 0.26±0.15、0.48± 0.29、1.53± 0.59 respectively,there were significant differences in mean final BCVA among the groups(P=0.000);then use LSD pairwise comparison,Except the groups with a complete ellipsoid zone and still continuous ellipsoid zone were no statistically significant difference(P=0.107),The difference between the other groups was statistically significant(P=0.000,respectively).The mean final BCVA(LogMAR)between the intact ELM and disrupted ELM were 0.38± 0.27 and 1.42± 0.66,there were significant differences in mean final BCVA between the two groups(t=-0.91,P=0.000).Conclusion:1.Initial BCVA was correlated with initial CRT,MDI,ONLT,it also closely related with the location of the macular edema,The closer the edema is to the center,the worse the BCVAis;The CRT was a factor influencing the initial visit acuity;2.Final BCVA was correlated with initial BCVA and final PLT;Final BCVA associated with the integrity of ellipsoid zone and external limiting membrane,when they have a complete structure,they will have a good BCVA.The strongest individual predictor of final BCVA among patietns with ME due to RVO was the initial BCVA,but the most efficient model was the integrity of ellipsoid zone,ELM status and baseline BCVA.