Wide-Field Swept-Source Optical Coherence Tomography Angiography (WF SS-OCTA) Vascular Metrics Reveal a Larger Effect Size on Contrast Sensitivity than Visual Acuity in Retinal Vein Occlusion

Abstract

Purpose : WF SS-OCTA is a non-invasive option for assessing the retinal microvasculature in eyes with retinal vein occlusion (RVO). We sought to evaluate the relationship between WF SS-OCTA and contrast sensitivity (CS), compared to visual acuity (VA), in eyes with RVO.

Methods : This cross-sectional study included 64 eyes of 37 patients with RVO that were tested with the Quantitative CS Function (qCSF) test (Adaptive Sensory Technology) on the same day as imaging with WF SS-OCTA (PLEX® Elite 9000, Carl Zeiss Meditec). Outcomes included Snellen’s VA reported as LogMAR and response to different contrast levels. The microvasculature measurements analyzed included vessel density (VD) and vessel skeletonized density (VSD) in the superficial (SCP) and deep (DCP) capillary plexus, and whole retina (WR), and foveal avascular zone (FAZ) parameters on 3, 6, and 12 mmxmm images. Mixed effects multivariable regression models controlling for age and lens status were performed. Standardized beta coefficients were calculated by refitting the standardized data.

Results : Regression results revealed that both VA and CS were significantly associated with the OCTA vascular metrics on all three angiogram dimensions. Among the 3 mmxmm images, the largest standardized beta coefficients were between CS at 1 cpd and VD and VSD in the DCP (β = 0.54, β = 0.52, p < 0.001), and between VA and FAZ perimeter and circularity (β = 0.50, β = 0.50, p < 0.001). On 6 mmxmm images, the largest standardized beta coefficients were between VA and VSD in the SCP and WR (β = -0.52, β = -0.51, p = 0.001), and between AULCSF and VSD in the SCP (β = 0.49, p = 0.001). On 12 mmxmm images, VA was significantly associated with VD in the SCP (β = -0.34, p = 0.036) and WR (β = -0.36, p = 0.025), but was not significantly associated with VSD. On the other hand, multiple CS metrics revealed significant associations with both VD and VSD on 12 mmxmm images. The largest effect size was between CS at 3 cpd and VD in the WR (β = 0.50, p = 0.002) (Table1).

Conclusions : Our results indicate that CS is associated with the microvasculature changes of RVO. Given the strong associations of CS with patient reported visual outcomes, the routine evaluation of CS combined with WF SS-OCTA may be supported in the clinical management of RVO.

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