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Background/Objectives: We sought to assess the relationship between contrast sensitivity (CS) and optical coherence tomography (OCT) findings, including ganglion cell–inner plexiform layer (GCIPL) thickness, in eyes with cystoid macular edema, secondary to branch retinal vein occlusion (BRVO-CME), treated with intravitreal ranibizumab (IVR). Methods: This prospective study included 44 patients with BRVO-CME who underwent treatment with IVR (three monthly injections and pro re nata) and were followed up for 12 months. We collected data on CS, best-corrected visual acuity (BCVA), and OCT findings (ellipsoid zone [EZ] and external limiting membrane status [ELM], central foveal thickness [CFT], and average GCIPL thickness) at the time of the final visit when macular edema was resolved. Multiple regression analysis was used to evaluate the relationship between visual functions and OCT findings, age, and lens status. Results: Multiple regression analysis revealed that lower GCIPL thickness was significantly associated with worse CS (β = 0.008; 95% CI, 0.002–0.014; p = 0.011), whereas this was not the case with BCVA. Lower CFT and mild cataracts were also associated with worse CS (CFT: β = 0.003; 95% CI, 0.001–0.004; p = 0.001; mild cataract: β = −0.182; 95% CI, −0.286–−0.078; p = 0.001) and worse BCVA (CFT: β = −0.002; 95% CI, −0.003–−0.001; p < 0.001; mild cataract: β = 0.079; 95% CI, 0.008–0.150; p = 0.029). Conclusions: GCIPL thickness may serve as a valuable biomarker for CS in eyes with BRVO-CME following IVR treatment.

This study was conducted to investigate the outcome of switching therapy from ranibizumab to aflibercept in Japanese patients with macular edema (ME) secondary to branch retinal vein occlusion (BRVO) in daily practice. This retrospective study enrolled 15 eyes in 15 Japanese patients with ME secondary to BRVO who had been receiving a pro re nata regimen of ranibizumab and had provided written informed consent to switch to aflibercept therapy. The intravitreal injection interval, central retinal thickness, and visual acuity were evaluated before and after switching. The mean period of ranibizumab treatment was 11.8±4.2 months. The mean observation period after switching to aflibercept was 10.6±3.4 months, and seven patients were observed for more than 12 months after switching. The mean intravitreal injection interval was prolonged by 23.6 days with aflibercept (68.2±26.4 days with ranibizumab vs 91.8±33.2 days with aflibercept; =0.0011). The mean intravitreal injection interval just before the switch was 81.3±35.6 days and was significantly prolonged to 100.8±34.2 days just after the switch to aflibercept ( =0.0309). The mean central retinal thickness did not change before or after the switch to aflibercept (295±55 μm with ranibizumab vs 276±25 μm with aflibercept; =0.12). The mean visual acuity also remained at an improved level after the switch. No systemic or ocular side effects were evident during the study period. Switching therapy from ranibizumab to aflibercept in Japanese patients with ME secondary to BRVO prolonged the intravitreal injection interval without anatomical or functional degradation.

Aim: To investigate the diurnal variation that is related to the incidence of branch retinal vein occlusion (BRVO). Methods: This is a cross-sectional study. 72 consecutive patients who were newly diagnosed with BRVO were precisely questioned about the time of their symptom onset. The clinical history, systemic illnesses, ocular findings, and body mass index were obtained for each patient. Results: Analysis of the diurnal variation of symptom onset showed a distribution with the peak in the period from 6 a.m. to noon compared with all the other time periods (p < 0.001). Multivariate analysis showed that involvement of the superior retina was the only factor that influenced the onset time of BRVO. Conclusion: Patients with symptomatic BRVO frequently noted their visual deterioration in the morning, which is the same as the other types of ocular and systemic vascular disease. Our results may be helpful for understanding the pathophysiology of BRVO. Our findings require conformation and further studies on this subject are certainly warranted.

Purpose To evaluate the relationship between duration of macular edema associated with retinal vein occlusion (RVO) and the achievement of vision gain in patients receiving dexamethasone intravitreal implant (DEX implant) in real-world clinical practice, and to define patterns of use of DEX implant and its efficacy and safety in the treatment of patients with RVO in clinical practice. Methods This prospective, open-label, multicenter, 6-month observational phase IV study conducted at 70 sites in Germany enrolled patients diagnosed with macular edema following branch or central RVO (BRVO, CRVO) who were given DEX implant. Follow-up visits and evaluations occurred in accordance with normal clinical practice. Re-treatment with DEX implant and use of other RVO therapies was at the discretion of the treating physician. The primary endpoint was mean change in best-corrected visual acuity (BCVA) from baseline at week 12. Results The analysis population consisted of 573 patients (64 % BRVO, 36 % CRVO). Patients received a mean of 1.17 DEX implant treatments during the study period; 84.3 % of patients received a single DEX implant and 19.9 % received adjunctive other RVO treatment. Among patients with analyzable BCVA data at baseline and week 12 ( n  = 351), mean change from baseline BCVA at week 12 was −0.16 (standard deviation, 0.30) logMAR (+7.8 approximate Early Treatment Diabetic Retinopathy Study [ETDRS] letters) ( p  < 0.001), and 33.9 % of patients had gained at least 3 lines in BCVA from baseline. Mean change from baseline BCVA at week 12 was +9.5, +7.3, and +5.4 approximate ETDRS letters in patients with macular edema duration < 90 days, from 90 to 180 days, and >180 days respectively. Improvement in BCVA through week 24 and decreases in central retinal thickness were seen in both BRVO and CRVO. The most common adverse drug reaction was increased intraocular pressure. No glaucoma incisional surgeries were required. Conclusions DEX implant was effective in improving BCVA and central retinal thickness in patients with BRVO and CRVO in real-world clinical practice. The largest gains in BCVA over 6 months occurred in patients with recent onset macular edema, confirming the benefit of early treatment. DEX implant was well tolerated and had an acceptable safety profile.

Optical coherence tomography (OCT) is widely used to detect and classify retinal diseases. However, OCT-image-based manual detection by ophthalmologists is prone to errors and subjectivity. Thus, various automation methods have been proposed; however, improvements in detection accuracy are required. Particularly, automated techniques using deep learning on OCT images are being developed to detect various retinal disorders at an early stage. Here, we propose a deep learning-based automatic method for detecting and classifying retinal diseases using OCT images. The diseases include age-related macular degeneration, branch retinal vein occlusion, central retinal vein occlusion, central serous chorioretinopathy, and diabetic macular edema. The proposed method comprises four main steps: three pretrained models, DenseNet-201, InceptionV3, and ResNet-50, are first modified according to the nature of the dataset, after which the features are extracted via transfer learning. The extracted features are improved, and the best features are selected using ant colony optimization. Finally, the best features are passed to the k-nearest neighbors and support vector machine algorithms for final classification. The proposed method, evaluated using OCT retinal images collected from Soonchunhyang University Bucheon Hospital, demonstrates an accuracy of 99.1% with the incorporation of ACO. Without ACO, the accuracy achieved is 97.4%. Furthermore, the proposed method exhibits state-of-the-art performance and outperforms existing techniques in terms of accuracy.

Branch retinal vein occlusion (BRVO) is a leading cause of visual impairment in working-age individuals, though predicting its occurrence from retinal vascular features alone remains challenging. We developed a deep learning model to predict BRVO based on pre-onset, metadata-matched fundus hemisection images. This retrospective cohort study included patients diagnosed with unilateral BRVO from two Korean tertiary centers (2005–2023), using hemisection fundus images from 27 BRVO-affected eyes paired with 81 unaffected hemisections (27 counter and 54 contralateral) for training. A U-net model segmented retinal optic discs and blood vessels (BVs), dividing them into upper and lower halves labeled for BRVO occurrence. Both unimodal models (using either fundus or BV images) and a BV-enhanced multimodal model were constructed to predict future BRVO. The multimodal model outperformed the unimodal models achieving an area under the receiver operating characteristic curve of 0.76 (95% confidence interval [CI], 0.66–0.83) and accuracy of 68.5% (95% CI 58.9–77.1%), with predictions focusing on arteriovenous crossing regions in the retinal vascular arcade. These findings demonstrate the potential of the BV-enhanced multimodal approach for BRVO prediction and highlight the need for larger, multicenter datasets to improve its clinical utility and predictive accuracy.

Background To investigate the association between the triglyceride-glucose (TyG) index and newly diagnosed branch retinal vein occlusion (BRVO) in patients. Methods The study included 57 individuals with BRVO and a control group comprising 50 healthy volunteers matched for age and gender. Detailed eye examinations were conducted, and various blood biochemistry and hematological parameters were recorded. The TyG index was calculated using fasting plasma glucose and triglyceride values. Results The mean age was 61.4 ± 9.6 years for the BRVO group and 60.6 ± 10.3 years for the control group. The TyG values were significantly higher in the BRVO group when compared to the control group (8.84 ± 0.41 vs. 8.52 ± 0.29, p  < 0.001). Multivariate analysis revealed that the TyG index independently predicted BRVO (odds ratio = 2.58, 95% confidence interval = 1.69–3.93; p  < 0.001). In receiver operating characteristics analysis, the TyG index had an area under the curve of 0.749, and a TyG index higher than 8.52 predicted BRVO with 83% sensitivity and 70% specificity. Conclusions This study establishes a significant association between an elevated TyG index and BRVO. Consequently, the TyG index could serve as a valuable predictive tool for identifying individuals at risk for BRVO.

The relationship between the triglyceride-glucose (TyG) index calculated using fasting blood glucose and triglyceride values ​​was evaluated among 62 patients diagnosed with retinal vein occlusion (RVO) and 57 healthy volunteers. Patients were classified as having branch (BRVO) or central (CRVO) retinal vein occlusion. The mean age was 64.6 ± 12.4 in the BRVO group of 35 patients, 65.2 ± 13.0 in the CRVO group of 27 patients, and 62.8 ± 12.5 in the control group ( p  = 0.7). The frequency of hypertension was significantly higher in both CRVO and BRVO groups ( p  = 0.002). Fasting blood glucose and triglyceride were significantly higher and HDL-C was significantly lower in BRVO and CRVO patients compared to the control group ( p  = 0.003, p  < 0.001, p  = 0.005). TyG index were found to be significantly higher in patients with BRVO and CRVO (9.0 ± 0.5) compared to the control group (8.4 ± 0.4) ( p  < 0.001). Multivariate logistic regression analysis revealed that TyG index independently predicted BRVO (odds ratio = 4.53; 95% confidence interval = 1.78–11.55; p  = 0.002) and any RVO (odds ratio = 6.82; 95% confidence interval = 2.75–16.90; p  < 0.001). In receiver operating characteristics analysis, TyG index had an area under the curve of 0.785, and a TyG index greater than 8.85 predicted any RVO with 65% sensitivity and 82% specificity ( p  < 0.001). There is a significant association between high levels of TyG index and, in particular, both BRVO and any RVO. The TyG index can be a valuable biomarker in identifying individuals at risk of RVO.