TY - JOUR T1 - Changes in choroidal structure following intravitreal aflibercept therapy for retinal vein occlusion JF - British Journal of Ophthalmology JO - Br J Ophthalmol SP - 704 LP - 710 DO - 10.1136/bjophthalmol-2020-316214 VL - 105 IS - 5 AU - Yoshinori Mitamura AU - Tserennadmid Enkhmaa AU - Hiroki Sano AU - Masanori Niki AU - Fumiko Murao AU - Mariko Egawa AU - Shozo Sonoda AU - Taiji Sakamoto Y1 - 2021/05/01 UR - http://bjo.bmj.com/content/105/5/704.abstract N2 - Aims To examine the choroidal change accompanying retinal vein occlusion (RVO) in detail, we measured changes in choroidal structure after intravitreal aflibercept (IVA) injections for RVO using binarisation of enhanced depth imaging optical coherence tomographic (EDI-OCT) images and assessed associations with clinical outcome.Methods Retrospective, observational case series. Forty treatment-naïve patients (10 central, 18 major branch and 12 macular branch RVO) were examined by EDI-OCT before and 1, 3 and 6 months after IVA injections. EDI-OCT images were binarised using ImageJ. Subfoveal cross-sectional areas of the luminal, stromal and total choroid over a 1500 µm span were measured and the stromal area to total choroidal area (S/C) ratio was calculated.Results Compared to normal contralateral eyes, afflicted eyes at baseline exhibited significantly greater stromal area (p<0.001), total choroidal area (p=0.001) and S/C ratio (p<0.001), but no difference in luminal area (p=0.083). The stromal area, S/C ratio and total choroidal area were significantly reduced in afflicted eyes at 1, 3 and 6 months after IVA (all p<0.006). Baseline S/C ratio was significantly correlated with baseline visual acuity (VA), baseline central retinal thickness (CRT) and VA and CRT improvement at 1, 3 and 6 months post-treatment even after adjusting for the axial length, age and sex (all p<0.012).Conclusion RVO induces substantial oedema of the choroidal stromal area that is detectable by binarisation of EDI-OCT images. This stromal oedema likely stems from high intraocular vascular endothelial growth factor levels. Changes in choroidal structure may be used to assess severity and prognosis of RVO. ER -