The Impact of Cataracts on the Measurement of Macular Choriocapillaris Flow Deficits using Swept-Source OCT Angiography

Abstract

Purpose : The impact of cataracts on the measurement of macular choriocapillaris flow deficits (CC FDs) was assessed by comparing the quantitative results before and after cataract surgery using an image quality algorithm developed for swept-source optical coherence tomography angiography (SS-OCTA) scans and a validated strategy for quantifying the CC FDs.

Methods : SS-OCTA image quality scores and CC FDs measurements within the fovea-centered 1mm, 3mm, and 5mm diameter circles were compared before and after cataract surgery. CC FDs changes in a modified Early Treatment Diabetic Retinopathy Study (ETDRS) grid were further investigated.

Results : Twenty-four eyes were studied. Overall image quality in all three circles was observed to improve significantly following the removal of cataracts (all p < 0.05). Although there was good repeatability in the measurements of CC FDs at both visits (intraclass correlation coefficients were over 0.95), significant decreases in CC FD measurements were observed after surgery within the 1mm circle (p < 0.001) and 3mm circle (p = 0.011), while no changes were observed within the 5mm circle (p = 0.509) or any of the quadrant sectors of the modified ETDRS grid (all p > 0.05).

Conclusions : The presence of cataracts resulted in worse image quality and increased CC FD measurements within the fovea-centered 1mm and 3mm circles, with the 1mm circle being impacted the most.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

 

Figure. Example of increased image quality and decreased choriocapillaris flow deficit measurements after cataract surgery.