FELLOW EYE CHANGES IN PATIENTS WITH NONISCHEMIC CENTRAL RETINAL VEIN OCCLUSION: Assessment of Perfused Foveal Microvascular Density and Identification of Nonperfused Capillaries.
OBJECTIVE
Eyes fellow to nonischemic central retinal vein occlusion (CRVO) were examined for abnormalities, which might explain their increased risk for future occlusion, using adaptive optics scanning light ophthalmoscope fluorescein angiography.


METHODS
Adaptive optics scanning light ophthalmoscope fluorescein angiography foveal microvascular densities were calculated. Nonperfused capillaries adjacent to the foveal avascular zone were identified. Spectral domain optical coherence tomography, ultrawide field fluorescein angiographies, and microperimetry were also performed.


RESULTS
Ten fellow eyes of nine nonischemic CRVO and 1 nonischemic hemi-CRVO subjects and four affected eyes of three nonischemic CRVO and one nonischemic hemi-CRVO subjects were imaged. Ninety percent of fellow eyes and 100% of affected eyes demonstrated at least 1 nonperfused capillary compared with 31% of healthy eyes. Fellow eye microvascular density (35 ± 3.6 mm(-1)) was significantly higher than that of affected eyes (25 ± 5.2 mm(-1)) and significantly lower than that of healthy eyes (42 ± 4.2 mm(-1)). Compared with healthy controls, spectral domain optical coherence tomography thicknesses showed no significant difference, whereas microperimetry and 2/9 ultrawide field fluorescein angiography revealed abnormalities in fellow eyes.


CONCLUSIONS
Fellow eye changes detectable on adaptive optics scanning light ophthalmoscope fluorescein angiography reflect subclinical pathology difficult to detect using conventional imaging technologies. These changes may help elucidate the pathogenesis of nonischemic CRVO and help identify eyes at increased risk of future occlusion.
*Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York; †Icahn School of Medicine at Mount Sinai, New York, New York; ‡Stuyvesant High School, New York, New York; §Bronx High School of Science, Bronx, New York; ¶Alexandria Faculty of Medicine, University of Alexandria, Alexandria, Egypt; **The Institute of Optics, University of Rochester, Rochester, New York; ††Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, Wisconsin; ‡‡Department of Biomedical Engineering, Marquette University, Milwaukee, Wisconsin; and §§Department of Biophysics, Medical College of Wisconsin, Milwaukee, Wisconsin.
Alexander
A
Pinhas
Michael
M
Dubow
Nishit
N
Shah
Eric
E
Cheang
Chun L
CL
Liu
Moataz
M
Razeen
Alexander
A
Gan
Rishard
R
Weitz
Yusufu N
YN
Sulai
Toco Y
TY
Chui
Alfredo
A
Dubra
Richard B
RB
Rosen
D000328:Adult; D000368:Aged; D002196:Capillaries / Q000473:pathology; D005260:Female; D005451:Fluorescein Angiography; D007839:Functional Laterality / Q000502:physiology*; D006801:Humans; D007511:Ischemia / Q000175:diagnosis / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012039:Regional Blood Flow / Q000502:physiology*; D012170:Retinal Vein Occlusion / Q000175:diagnosis* / Q000503:physiopathology*; D012171:Retinal Vessels / Q000473:pathology*; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D058609:Visual Field Tests; D014794:Visual Fields / Q000502:physiology; D055815:Young Adult