First Author: M.Diez Sotelo SPAIN
Co Author(s): M. Abraldes Lopez-Veiga M. Fernandez Rodriguez M. Rodriguez Cid M. Gil Martinez F. Gomez-Ulla De Irazazabal
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To describe the principal microvascular findings by using optical coherence tomography Angiography (OCT-A) in relation to changes in the macular capillaries, to study the foveal avascular zone (FAZ), and the detection of ischaemic areas in the superficial and deep capillary plexus in patients with Retinal Vein Occlusion (RVO), as it is the second most frequent cause of retinal vascular disease after diabetic retinopathy, resulting in vision loss and significant associated morbidity.
1. Instituto Oftalmológico Gómez-Ulla. Santiago de Compostela. Spain. 2. Ophthalmology Department. Hospital de Conxo. Xerencia de Xestión Integrada de Santiago de Compostela. Santiago de Compostela. Spain. 3. University of Santiago de Compostela. Santiago de Compostela. Spain. 4. RETICS OFTARED (RD12/0034). Institute of Health Carlos III. Madrid. Spain.
Twenty three eyes of 23 consecutive patients with a mean age of 65 years (range 43-87 years) diagnosed of RVO (6 eyes with central RVO, 17 eyes with branch RVO) were recruited for the study. Fundus and macular capillary network were evaluated by retinography, spectral-domain OCT and OCT-A (using Angioplex and/or Triton SS-OCT-Angio), focusing on superficial and deep capillary plexus. The macular angiography scan protocol covered a 3x3 mm or either 6x6 mm area centred on the fovea.
The main features observed by evaluating the superficial capillary plexus were perifoveal capillary arcade disruption and the presence of microvascular abnormalities, both in 20 eyes (86.9%). Capillary non-perfusion areas and FAZ enlargement were observed in 13 eyes (56.5%) and 10 eyes (43.5%), respectively. In contrast, the deep plexus mainly showed capillary non-perfusion areas in 19 eyes (82.6%), FAZ enlargement in 18 eyes (78.3%) and vascular congestion in 17 eyes (73.9%).
Although Fluorescein Angiography (FA) is the gold standard to explore the retinal vasculature and vascular abnormalities in the RVO, OCT-A allows to distinguish a greater number of macular capillaries. Our study showed the larger involvement of the deep capillary plexus compared to the superficial plexus in RVO. Unlike FA, OCT-A enables to see the difference between retinal layers and to evaluate the FAZ and the areas of capillary non-perfusion, as well as to identify the main microvasculature features in patients with RVO. Therefore, we assume that it can be a good non-invasive diagnostic and prognostic tool in RVO.