Retinal Vasculature assessed by OCTA in Peripheral Arterial Disease

Abstract

Purpose : To investigate whether retinal and choriocapillary perfusion is altered in patients with peripheral arterial disease (PAD).

Methods : 114 eyes from patients with PAD and 38 eyes from healthy controls were imaged with swept-source optical coherence tomography angiography (OCTA, Zeiss PLEX Elite 9000). Macula centered 3x3 mm OCTA scans were acquired. For quantitative analysis the OCTA scans were binarized and retinal perfusion was evaluated for vessel density (VD) and choriocapillary perfusion for percentage of non-perfused area. Clinical examination included vascular ultrasound, ankle-brachial-pressure-index (ABI) and Fontaine staging. Media calcification was defined as ABI > 1.3.

Results : Lowest intra-individual ABI was significantly associated with VD both in the superficial and deep retinal layers (Pearson coefficient of correlation r = 0.42 and 0.25, respectively, p < 0.001 and p = 0.01) and higher Fontaine stage was significantly associated with lower VD (VD in Fontaine stage 1 = 0.284 ± 0.026 and VD in Fontaine stage 4 = 0.246 ± 0.030, p = 0.01). Excluding patient with media calcification VD was significantly lower in PAD compared to healthy controls (0.286 ± 0.024 and 0.270 ± 0.036, respectively, p = 0.02). There was significantly more non-perfused choriocapillaris area in eyes with PAD compared to healthy controls (43.9 ± 4.3% and 41.0 ± 5.2%, respectively, p = 0.01).

Conclusions : In this first study of retinal and choriocapillaris perfusion in patients with PAD we found both retinal and choroidal microcapillary perfusion to be significantly reduced in PAD. Further longitudinal studies on the relationship between retinal/choriocapillaris perfusion and PAD progression are needed.

This is a 2020 ARVO Annual Meeting abstract.