Optical Coherence Tomography Angiography (OCTA) in Retinal Vein Occlusion following Anti-Vascular Endothelial Growth Factor (VEGF) Therapy for Retinal Edema

Abstract

Purpose : To evaluate longitudinal changes in optical coherence tomography angiography (OCTA) in patients receiving anti-vascular endothelial growth factor (VEGF) therapy for retinal vein occlusion and correlate with visual acuity outcomes.

Methods : We performed retrospective chart reviews of 20 patients with history of central retinal vein occlusion (CRVO) or branch retinal vein occlusion (BRVO) treated with anti-VEGF therapy for retinal edema. OCTA images using AngioVue OCT-A system were obtained at “baseline” following resolution of macular edema and then for several follow-up visits after continued resolution of macular edema following ongoing treatment with anti-VEGF therapy. The unaffected eyes of these patients were used as controls. Eyes with poor quality OCTA images were excluded. Fourteen eyes with CRVO (n =11) or BRVO (n=3) and 7 control eyes met study criteria. Mean age is 65 ± 16.08. Two OCTA images per eye taken 7.7 months (range 3.9 - 14.3) apart were evaluated with ImageJ to obtain the foveal avascular zone (FAZ) area in superficial capillary plexus layer (SCPL). Patients received an average of 4 anti-VEGF injections (range 0-9) in this time interval. Paired t-test was performed to evaluate trends in FAZ area and BCVA over this time interval.

Results : Mean FAZ area for RVO eyes was 0.484 ± 0.227 mm² and 0.476 ± 0.240 mm² at baseline and last follow-up respectively. Mean FAZ area for control eyes at baseline and last follow-up was 0.423 ± 0.164 mm² and 0.419 ± 0.160 mm² respectively. There was no significant change in FAZ area between the baseline and follow-up OCTA scans in RVO eyes (p=0.51) or in control eyes (p=0.66). Mean BCVA was 0.295 ± 0.130 logMAR (Snellen 20/40) at baseline and 0.264 ± 0.165 logMAR (Snellen 20/40+2) at last follow-up and was not statistically significant (p=0.57) in RVO treated eyes.

Conclusions : There are no statistically significant changes in FAZ areas or BCVA in patients with RVO treated with anti-VEGF during the average 7.67 ± 2.62 month time interval. Other OCTA parameters including vessel density will be collected and multivariable analyses will be performed to examine associations of various OCTA parameters to visual acuity.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

 

Representative FAZ area in SCPL in eye of a 79-year-old woman with BRVO. FAZ area at baseline OCTA (left) was 0.919 mm² and follow-up OCTA (right) 6 months later was 0.911 mm².