Angiographic Risk Features of Branch Retinal Vein Occlusion Onset as Determined by Optical Coherence Tomography Angiography

Abstract

Citation: Kogo T, Muraoka Y, Iida Y, et al. Angiographic risk features of branch retinal vein occlusion onset as determined by optical coherence tomography angiography. Invest Ophthalmol Vis Sci. 2020;61(2):8. https://doi.org/10.1167/iovs.61.2.8 PURPOSE.Examine associations between the vasculature at arteriovenous (AV) crossings and the onset of branch retinal vein occlusion (BRVO). METHODS.We included 78 patients with major BRVO, 35 patients with macular BRVO, and 110 controls without BRVO and determined the vessel positions at AV crossings, where the first-or second-order branches of the retinal veins associate, using a viewing angle of 12 × 12 mm 2 in optical coherence tomography angiography (OCTA). RESULTS.We reviewed 1349 and 1276 AV crossings in BRVO patients and control subjects, respectively. The proportions of venous overcrossing were 26.5%, 28.6%, and 26.8% at non-causative crossings in BRVO eyes, non-BRVO fellow eyes, and unaffected control eyes, respectively; however, the rate of venous overcrossings at the causative crossings was 45.1%. In OCTA analyses, we divided the branches into macular-or non-macular veins. The rate of venous overcrossing was 52.5% at causative crossings in major BRVO but was 28.6% in macular BRVO. Odds ratios for whether venous overcrossing was a risk factor for BRVO were 3.09 (95% confidence interval [CI], 1.96-4.88) and 0.94 (95% CI, 0.44-2.00) for non-macular veins and macular veins, respectively. The patients with major BRVO caused by venous overcrossing were younger than patients for whom the cause was arterial overcrossing (P < 0.001). The onset of macular BRVO did not differ between crossing patterns at causative crossings (P = 0.60). CONCLUSIONS.In eyes with BRVO, venous overcrossing was a common angiographic feature at causative crossings and might be a risk factor for major BRVO onset.

Microvascular and functional changes according to the fundus location of the affected arteriovenous crossing in patients with branch retinal vein occlusion

“…The order of AV crossing at which the vein was occluded in BRVO was previously counted from the optic disc onwards as a first-order or second-order AV crossing. [ 5 33 ] In the study by Staurenghi et al ,[ 34 ] 26% of patients with BRVO had first-order occlusions and 74% had second-order occlusions. They argued that symptoms may be reduced because of the greater distance from the macula, causing underestimation of the prevalence of first-order occlusions.…”

Review: The Development of Risk Factors and Cytokines in Retinal Vein Occlusion

“…At intravenous crossings, the veins anterior to the arteries were more severely compressed between the inner limiting membrane and the rigid arterial wall ( Figure 2 ). These veins were stenotic and the NPA of the retina in BRVO was further enlarged due to venous intersections ( 42 ). Therefore, the location of arteries and veins can greatly influence BRVO pathogenesis.…”

Hypothetical proposal for the course of retinal blood vessels in the posterior pole—description and its clinical implications

“…In addition, OCT and OCT angiography studies suggest that BRVO in regions where the vein crosses over the artery is more common than previously reported [9,28]. The patterns of change at causative and non-causative AV crossings in patients with BRVO and healthy controls was also recently studied using OCT angiography [29]. However, this author found no reports of how consecutive AV crossings behave from one crossing to the next.…”