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Disorganisation of retinal inner layers is associated with reduced contrast sensitivity in retinal vein occlusion
  1. Jay Wang,
  2. Ying Cui,
  3. Filippos Vingopoulos,
  4. Megan Kasetty,
  5. Rebecca F Silverman,
  6. Raviv Katz,
  7. Leo Kim,
  8. John B Miller
  1. Harvard Medical School, Department Of Ophthalmology, Retina Service, Massachusetts Eye and Ear Infirmary Department of Ophthalmology, Boston, Massachusetts, USA
  1. Correspondence to John B Miller, Retina Service, Mass. Eye and Ear, Harvard Medical School, 243 Charles St, Boston, MA 02114, USA; john_miller{at}


Background/Aims To determine if disorganisation of retinal inner layers (DRIL) is associated with reduced contrast sensitivity (CS) in patients with retinal vein occlusion (RVO) with a history of macular oedema (ME).

Methods Prospective, observational cohort study. Patients with a history of ME secondary to central retinal vein occlusion (CRVO) or branch retinal vein occlusion (BRVO) from October 2017 to July 2019 at a single institution were included. Patients underwent complete ophthalmic examination, spectral domain optical coherence tomography (SD-OCT) and CS testing using the quick contrast sensitivity function (qCSF) method. Eyes with coexisting macular disease were excluded. SD-OCT images were analysed for presence and extent of DRIL, intraretinal fluid (IRF), subretinal fluid (SRF), hyperreflective foci, epiretinal membrane (ERM), external limiting membrane (ELM) disruption, ellipsoid zone (EZ) disruption, central macular thickness (CMT) and central foveal thickness (CFT). Multivariable mixed-effect linear regressions were performed for the area under the log contrast sensitivity function (AULCSF) using Stata (StataCorp). P values <0.05 were considered significant.

Results 58 visits from 31 patients were included (1.9±1.2 visits per patient). 29 (50%) were for CRVO. The average age was 63.9±10.5 years. On multivariable analysis, DRIL extent (p<0.001), CMT (p=0.007), CFT (p=0.024) and moderate cataract (p=0.001) were significantly associated with worse AULCSF.

Conclusions DRIL extent is associated with reduced CS in eyes with ME secondary to RVO. DRIL is an imaging feature that has important implications for visual function.

  • Imaging
  • Macula
  • Retina
  • Visual perception

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  • Twitter John B. Miller @JohnBMillerMD.

  • Contributors JCW was involved in conception, planning, conduct and reporting of the work; YC was involved in conception, planning, conduct and reporting of the work; FV was involved in conduct and reporting of the work; MK was involved in conduct of the work; RS was involved in conduct of the work; RK was involved in conduct of the work; LK was involved in conception and planning of the work; JBM was involved in conception, planning and reporting of the work.

  • Funding The Manifold Contrast device used in this study was purchased as part of a grant to JBM from the Lions Club International Foundation and the Lions of Massachusetts (Grant # 530125).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request.

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