Correlation between optical coherence tomographic hyperreflective foci and visual outcomes after intravitreal bevacizumab for macular edema in branch retinal vein occlusion.

PURPOSE: To investigate the correlation between hyperreflective foci (HF) on spectral-domain optical coherence tomography at baseline and visual outcomes after intravitreal bevacizumab injection (IVB) in branch retinal vein occlusion.

METHODS: We retrospectively studied 97 eyes of 97 patients with macular edema secondary to BRVO, who were treated with IVB. The eyes were divided into three groups according to the location of HF on SD-OCT: HF in outer retinal layers, HF in inner retinal layers, and no HF. The baseline and final best-corrected visual acuity (BCVA), foveal thickness (FT), external limiting membrane (ELM) status, junction between photoreceptor inner and outer segments (IS/OS) status, and the number of HF were evaluated and compared among three groups.

RESULTS: Baseline BCVA was correlated with baseline FT (R = 0.366, p < 0.001), but final BCVA was not correlated with final FT (R = -0.008, p = 0.942). Baseline BCVA was significantly better in eyes with intact ELM at baseline (p = 0.006), and final BCVA was significantly better in eyes with intact ELM and IS/OS at final visit (p <  0.001, p = 0.003 respectively). At the final visit, 15 of 37 eyes (40.5%) with HF in outer retinal layers had a disrupted ELM (p = 0.001), while 28 of 37 eyes (75.7%) with HF in outer retinal layers had a disrupted IS/OS (p <  0.001). Final BCVA was poorer in eyes with HF in outer retinal layers groups than those in the other two groups (p <  0.001), although baseline BCVA was not different between them.

CONCLUSIONS: HF on SD-OCT at baseline might predict the photoreceptor status and final VA after IVB in BRVO.