Abstract
Purpose
To characterize the ultra-widefield distribution and morphology of epiretinal macrophage-like cells (eMLCs) in retinal vein occlusion (RVO) and assess their associations with retinal ischemia and macular edema.Methods
This cross-sectional study included 68 eyes with unilateral branch or central RVO and 68 unaffected fellow eyes as controls. All eyes underwent 24 × 20 mm ultra-widefield swept-source optical coherence tomography angiography (OCTA). The eMLC density and morphology were quantified using a machine-learning-based pipeline. Foveal avascular zone (FAZ) metrics, central subfield thickness (CST), and nonperfusion areas (NPAs) were analyzed. Exploratory duration-based subgroup analyses were also performed.Results
Compared with fellow eyes, RVO eyes showed higher eMLC density (3.69 [2.43] vs. 2.24 [1.12] cells/mm²), greater total eMLCs area (5.31 [3.83] vs. 2.87 [1.74] mm²), greater CST (411.50 [374.75] vs. 290.50 [35.00] µm), and larger FAZ area (0.360 [0.375] vs. 0.220 [0.165] mm²; all P Conclusions
EMLCs are increased in RVO and show a spatially heterogeneous distribution pattern. In RVO eyes, eMLC count was associated with disease duration, prior anti-VEGF exposure, and ischemic status, whereas duration-based subgroup findings should be interpreted as exploratory.Translational relevance
Ultra-widefield OCTA-based eMLCs quantification may provide a clinically accessible imaging biomarker for inflammatory involvement in RVO.