Retinal Vascular Alterations in Eyes with Nonperfused Retinal Vein Occlusion detected on single-capture 65°-widefield OCT-Angiography

Abstract

Purpose : A recent innovation in OCT-Angiography (OCTA), the wide-field OCTA (WF-OCTA), provides images of patients with retinal vascular disease allowing precise assessment of retinal non perfusion (RNP) at a high resolution and a wide field of view. This cross-sectional study examines the retinal vascular changes in patients with RNP due to retinal vein occlusion (RVO).

Methods : Consecutive patients with RNP due to RVO were examined using single-capture 65°-WF-OCTA (A-scan rate: 1.7MHz;) at the Department of Ophthalmology, Medical University of Vienna and ultra-widefield color fundus (UW-CF) imaging (Zeiss Clarus 700). RNP and central capillary loss were assessed on 65°-WF-OCTA images and retinal vascular alterations including ghost vessels, hard exudates, cotton wool spots, tortuous vessels, collateral vessels and neovascularization were evaluated on the UW-CF images.

Results : We included 26 eyes of 26 patients (male n=13, 50.0%; right eyes n=17, 65.4%). Median patient age was 61.5 years (Quartiles 58-73 years) and median duration of disease (from first symptoms until acquisition of images) was 15 months (Quartiles 2.5-24 months) with a median number of intravitreal Anti-VEGF injections of 7 (Quartiles 2-12). The mean best corrected visual acuity (decimal) was 0.64±0.32, and mean nonperfusion area was 50.7mm²±40.1mm². 24 (92.3%) patients showed tortuous vessels, equally many presented with capillary loss, while 2 patients had signs of neovascular changes (7.7%). Ghost vessels were found in 11 patients (42.3%), 22 patients showed hard exudates (84.6%), 11 patients presented with cotton wool spots (42.3%) and 17 patients had collateral vessels (65.4%). No vitreous hemorrhage was documented.

Conclusions : All patients with RNP due to RVO presented retinal vascular alterations. Most commonly, tortuous vessels and capillary loss were found. Only 2 patients showed signs of neovascularization.

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

 

Single-Capture WF-OCTA en face image of 48-year-old male with RNP due to RVO.