September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016

Comparison of OCT Angiography and Conventional Fluorescein Angiography in the Evaluation of Collateralization in Acute versus Chronic Branch or Hemi Retinal Vein Occlusion
Author Affiliations & Notes
  • Bryan Paul Jones
    Department of Ophthalmology, New York University School of Medicine, New York, New York, United States
  • Michael H Chen
    Silicon Valley Eyecare, Santa Clara, California, United States
  • Jesse J Jung
    East Bay Retina Consultants, Inc., Oakland, California, United States
  • Quan V Hoang
    Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University College of Physicians and Surgeons, New York, New York, United States
  • Maiko Inoue
    Vitreous Retina Macula Consultants of New York, New York, New York, United States
    The LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear and Throat Hospital, New York, New York, United States
  • Chandra Bala
    Vitreous Retina Macula Consultants of New York, New York, New York, United States
  • K Bailey Freund
    Vitreous Retina Macula Consultants of New York, New York, New York, United States
    The LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear and Throat Hospital, New York, New York, United States
  • Lawrence A. Yannuzzi
    Vitreous Retina Macula Consultants of New York, New York, New York, United States
    The LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear and Throat Hospital, New York, New York, United States
  • Soraya Rofagha
    East Bay Retina Consultants, Inc., Oakland, California, United States
    Department of Ophthalmology, University of California, San Francisco, San Francisco, California, United States
  • Scott Lee
    East Bay Retina Consultants, Inc., Oakland, California, United States
  • Footnotes
    Commercial Relationships   Bryan Jones, None; Michael Chen, Carl Zeiss Meditec (C); Jesse Jung, Carl Zeiss Meditec (C), Optos (C); Quan Hoang, None; Maiko Inoue, None; Chandra Bala, None; K Bailey Freund, Genentech (C), Heidelberg Engineering (C), Ohr Pharmaceutical (C), Optos (C), Optovue (C), REGENXBIO (C), ThromboGenics (C); Lawrence A. Yannuzzi, None; Soraya Rofagha, Carl Zeiss Meditec (C); Scott Lee, Carl Zeiss (C)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 5473. doi:
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    • Get Citation

      Bryan Paul Jones, Michael H Chen, Jesse J Jung, Quan V Hoang, Maiko Inoue, Chandra Bala, K Bailey Freund, Lawrence A. Yannuzzi, Soraya Rofagha, Scott Lee;
      Comparison of OCT Angiography and Conventional Fluorescein Angiography in the Evaluation of Collateralization in Acute versus Chronic Branch or Hemi Retinal Vein Occlusion. Invest. Ophthalmol. Vis. Sci. 2016;57(12):5473.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose :
To describe the role of optical coherence tomography angiography (OCTA) in identifying collateralization in acute versus chronic branch retinal vein occlusion (BRVO) or hemi-retinal vein occlusion (HRVO).

Methods :
This retrospective cohort study reviewed 32 patients with BRVO/HRVO who were imaged with spectral-domain (RTVue XR Avanti, Optovue, Inc.; Cirrus AngioPlex, Carl Zeiss Meditec) or swept-source OCTA (Prototype, Carl Zeiss Meditec) at two retinal practices. Medical charts were reviewed for collateral vessels seen during clinical exam. En-face OCTA images of the superficial (SCP) and deep capillary plexuses (DCP) were generated and reviewed. Patients were categorized according to chronicity, with acute defined as < 6 months vs. chronic (≥ 6 months) from initial diagnosis. The likelihood of collateral vessels on OCTA in acute versus chronic groups was compared. Fisher exact test was used to assess agreement regarding identification of collaterals on OCTA, fluorescein angiography (FA) and clinical exam. Statistical significance was defined as p<0.05.

Results :
The 32 patients (19 female) had a mean age of 65 (range 42-93). Of the patients, 41% had acute and 59% had chronic BRVO/HRVO. Best-correct visual acuity was 20/56 (range 20/20–CF@6’, 0.45+/-0.43, mean+/-SD in logMAR). OCTA identified collateral vessels in 22/32 (69%) of cases (2 (9%) in SCP, 5 (23%) in DCP and 15 (68%) in both). Of the 17 patients that underwent both FA and OCTA, collateral vessels were identified by clinical exam in 9 (28%), by FA in 11 (34%) and OCTA in 11 (34%). OCTA and clinical examination for collaterals were in good agreement (p=0.002), with both FA and OCTA identifying collaterals in two cases not noted on clinical exam alone. There was perfect agreement between OCTA and FA in all 17 cases (p=0.000). Overall on OCTA, collateral vessels were significantly more likely found (t-test, p=0.024) in chronic (14/19, 74%) than acute cases (5/13, 38%).

Conclusions :
OCTA has depth-encoded information and is able to reliably identify collateral vessels in patients with BRVO/HRVO in perfect agreement with FA. Collateral vessels are seen within both capillary plexuses. Identifiable collateralization typically occurs after ≥ 6 months from the initial diagnosis of BRVO/HRVO.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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