Structural Changes in Retinal Vein Occlusion: Implications for Functional Outcomes and Visual Field Deficits

Objectives: To investigate the relationship between structural retinal changes and functional visual field (VF) deficits in patients with branch retinal vein occlusion (BRVO), aiming to identify potential biomarkers for predicting visual impairment. Materials and methods: This cross-sectional study included 34 patients with unilateral BRVO who were recruited from two tertiary centers in Greece. Comprehensive ophthalmic examinations were performed, including visual acuity, intraocular pressure (IOP) and imaging studies such as optical coherence tomography (OCT), OCT angiography (OCT-A), and fundus photography. Retinal alterations, including atrophy, edema, hemorrhages and neovascularization, were assessed by two masked graders. Visual field testing was performed using Humphrey perimetry. Logistic regression analyses were employed to examine associations between imaging biomarkers and the presence of VF defects. Results: Patients included in the present study had a mean age of 69.1 ± 10.6 years and 58.8% of them were females. Visual field defects were present in 26.5% (9/34) of patients. Structural changes such as retinal atrophy and neovascularization were more prevalent in patients with VF defects. Univariate analysis did not identify OCT-A vessel density or central retinal thickness as significant predictors. Similarly, multivariate logistic regression found no statistically significant associations at the 0.05 level, although trends suggested a relationship between structural damage and functional impairment. Conclusions: Structural retinal changes, particularly atrophy and neovascularization, appear to be associated with VF defects in BRVO. Despite the lack of statistically significant predictors in multivariate models, these findings highlight the importance of comprehensive functional assessments beyond visual acuity. Future advancements in VF testing technologies may enhance early detection and management of functional deficits in BRVO patients.