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Aude Couturier, Dan Chetrit, Sophie Bonnin, Valerie Mane, Alain Gaudric, Ramin Tadayoni; Pseudophakic cystoid macular edema imaged by Optical Coherence Tomography Angiography. Invest. Ophthalmol. Vis. Sci. 2017;58(8):1644. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To study macular capillary changes and capillary density (CD) using optical coherence tomography angiography (OCTA) in pseudophakic cystoid macular edema (PCME) before treatment and after resolution of the edema.
This retrospective study included consecutive patients with PCME naive of treatment and age-matched control eyes, imaged using OCTA (RTVue XR Avanti, Optovue). The diagnostic criteria for PCME were: vision loss after cataract surgery and occurrence of intraretinal cystoid spaces with a central macular thickness of at least 321 µm on postoperative OCT. Qualitative changes in macular capillary plexus were assesed by two independant examiners. Automated flow density acquired by a new prototype AngioVue software (with remove artifact tool) was used to assess the CD in the 3x3 mm angiograms in the superficial capillary plexus (SCP) and deep capillary plexus (DCP) in PCME and control eyes.
Eight eyes of 7 patients with PCME were imaged and compared to 8 age-matched control eyes. The first visual symptoms occurred in a mean time of 38.1 ± 22.3 days after the surgery. At initial examination, the pattern of SCP remained nearly normal although the DCP was altered and disorganized. The CD was significantly decreased in both plexus in PCME eyes compared with control eyes (whole en face CD in the SCP: 47.9 ± 3.8% and 52.9 ± 4.0% respectively, P = 0.01; whole en face CD in the DCP: 43.6 ± 7.1% and 54.2 ± 3.2% respectively, P = 0.001). All eyes were treated with dexamethasone and ketorolac drops associated with oral acetazolamide. After resolution of edema, in a mean time of 79.4 ± 35.1 days, DCP architecture recovered in all eyes. The CD increased in both plexus and the difference with control eyes was no longer significant (whole en face CD was 49.8 ± 3.9 % in the SCP and 53.4 ± 6.1% in the DCP; P = 0.23 and 0.6 respectively, compared with control eyes).
This first OCTA study of capillaries changes in PCME showed that in the acute phase, the DCP was mainly altered and disorganized with a significant decrease of CD compared to healthy control eyes. After macular edema resolution under topical and systemic therapy, the pattern of DCP recovered and its CD returned to normal.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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