Smooth Border Between Inner Nuclear/Outer Plexiform Layers: Branch Retinal Vein Occlusion Biomarker of Fewer Macular Edema Recurrences

Abstract Purpose: To determine if the status of the border between the inner nuclear layer (INL) and outer plexiform layer (OPL) is associated with the number of macular edema (ME) recurrences secondary to branch retinal vein occlusion (BRVO).Methods: Thirty-seven consecutive eyes with BRVO treated with anti-vascular endothelial growth factor (VEGF) drugs were included. In optical coherence tomography (OCT) images at the initial visit, the border between the INL and OPL within the 1.5-mm vertical line from the fovea was manually traced using ImageJ software. The jagged ratio (JR), i.e., the border length divided by the spline curve length of the border was calculated using the “Spline fit” mode in the software.Results: The mean JR was 1.1± 0.07 (range, 1.01-1.27). The JR was correlated significantly with the number of anti-VEGF injections/year (P<0.0001, r=0.721). Among 37 eyes, nine (24.3%) received two or fewer injections/year, and their JRs were less than 1.05. The multivariate linear regression analysis showed that only the JR was correlated significantly with the number of anti-VEGF injections/year (P<0.0001). Conclusions: A smooth border between the INL and the OPL on OCT images at the initial visit may be a biomarker for fewer ME recurrences in eyes with BRVO.