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Spencer Langevin, Jared Smedley, Matheiu Bakhoum, Flavia Tzani, Henry Perry, George Asimellis, A. John Kanellopoulos; OCT Angiography of the Optic Nerve and Macula Blood Flow Following Clear Cornea Cataract Surgery. Invest. Ophthalmol. Vis. Sci. 2016;57(12):5464.
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© ARVO (1962-2015); The Authors (2016-present)
Imaging of the retinal vasculature is an integral part of the evaluation of a large number of ocular diseases that may cause vision loss. Fluorescein angiography has been the modality of choice historically for evaluating retinal vasculature, however, there are risks of adverse effects and known defects in imaging all the layers of the retinal vasculature. Optical coherence tomography (OCT) angiography is a novel modality that can image vessels based on flow characteristics and may provide improved information. The purpose of this study was to evaluate the effect of small-incision clear-cornea cataract surgery on optic nerve and macula blood flow studied with OCT angiography, and to potentially screen for subclinical Irvine-Gass syndrome.
We evaluated 35 consecutive clear-cornea cataract surgery cases (17 phacoemulsification, 18 femtosecond laser-assisted (LenSx, Alcon, Ft. Worth, TX) capsulotomy and lens fragmentation. We evaluated visual acuity, refraction, keratometry, tomography, pachymetry, endothelial cell counts, and intraocular pressure. AngioVue Imaging System (Optovue, Fremont, CA) images of the optic nerve and macula were obtained preoperatively, at day-1, week-1 and week-4, constructing angiography of the retinal and choroidal microvasculature, with the ability to isolate vasculature and circulation in individual layers of customized height in the retina and choroid.
In 21/35 cases preoperative and postoperative images were of adequate quality to be analyzed and compared, largely due to cataract-related media opacity. Optic nerve angioflow showed transient blood flow increase (both at radial peripapillary level and on the optic disc) at day-1 in 5 cases (2 manual, 3 femto), not observed thereafter. There was no macula angioflow deviation detectable from baseline at any follow-up interval within all four levels studied: superficial capillary, deep capillary, outer retina, or choriocapillary layers. There was no statistical difference in the findings between the manual vs femto-assisted subgroups.
We present a novel, non-invasive objective technique in evaluating potential optic nerve and or macula microvascular changes. Transient vascular flow pathology was evident in uneventful clear cornea cataract surgery. This data may aid clinicians in the post-operative anti-inflammatory regimen choices and length of therapy.
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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