scholarly journals Macular Perfusion Analysed by Optical Coherence Tomography Angiography after Uncomplicated Phacoemulsification: Benefits beyond Restoring Vision

Author(s):  
Ana Križanović ◽  
Mirjana Bjeloš ◽  
Mladen Bušić ◽  
Biljana Kuzmanović Elabjer ◽  
Benedict Rak ◽  
...  

Abstract Background: The purpose of the study is to investigate the changes of macular perfusion by OCT-angiography (OCT-A) after uncomplicated phacoemulsification.Methods: OCT-A was performed before cataract surgery, 1 week, 1 month, and 3 months after surgery recording superficial vascular complex (SVC), nerve fiber layer vascular plexus (NFLVP) superior vascular plexus (SVP), deep vascular complex (DVC), intermediate capillary plexus (ICP) and deep capillary plexus (DCP), as well as large choroidal blood vessels and choriocapillaris (CC) were recorded. Explant area (EA), vessels area (VA), vessels percentage area (VPA), total number of junctions (TNJ), junctions density (JD), total vessels length (TVL), average vessels length (AVL), total number of end points (TNEP), mean E lacunarity (MEL), and foveal avascular zone (FAZ) area throughout all layers were analysed.Results: Significant changes of vascular parameters in 55 eyes of 55 patients mostly reached plateau one week after surgery and remained stable up to three months after surgery, occurring in all retinal layers but not in choroid and choriocapillaris. Changes of FAZ area ensued across all retinal layers within one month after surgery. The greatest increase in VPA (22.79%), TVL (16.71%), AVL (166.71%) and JD (29.49%) was in SVC causing the largest FAZ surface decrease (-25.54%) in SVC likewise. On the contrary, the greatest change of MEL (-53.41%) appeared in DVC.Conclusions: This is the first OCT-A study demonstrating that perfusion alterations observed in macula after phacoemulsification are response to functional hyperaemia prompted by augmented visual stimulation. Phacoemulsification in elderly population proved as advantageous feature in addition to restoring visual acuity.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ana Križanović ◽  
Mirjana Bjeloš ◽  
Mladen Bušić ◽  
Biljana Kuzmanović Elabjer ◽  
Benedict Rak ◽  
...  

Abstract Background The purpose of the study is to investigate the changes of macular perfusion by OCT-angiography (OCT-A) after uncomplicated phacoemulsification. Methods OCT-A was performed before cataract surgery, 1 week, 1 month, and 3 months after surgery recording superficial vascular complex (SVC), nerve fiber layer vascular plexus (NFLVP), superficial vascular plexus (SVP), deep vascular complex (DVC), intermediate capillary plexus (ICP) and deep capillary plexus (DCP), as well as large choroidal blood vessels and choriocapillaris (CC). Explant area (EA), vessels area (VA), vessels percentage area (VPA), total number of junctions (TNJ), junctions density (JD), total vessels length (TVL), average vessels length (AVL), total number of end points (TNEP), and mean lacunarity (ML) throughout all layers were analysed. Results Significant changes of vascular parameters in 55 eyes of 55 patients mostly reached plateau one week after surgery and remained stable up to 3 m after surgery, occurring in all retinal layers but not in choroid and CC. The greatest increase in VPA (22.79%), TVL (16.71%), AVL (166.71%) and JD (29.49%) was in SVC. On the contrary, the greatest change of ML (− 53.41%) appeared in DVC. Conclusions This is the first OCT-A study demonstrating perfusion alterations in macula after phacoemulsification due to functional hyperaemia. We presume the effect is evoked by increased light intensity stimulation of retina after cataract removal. Accordingly, phacoemulsification in elderly population could have advantageous feature in addition to restoring visual acuity.


2021 ◽  
Vol 6 (6-1) ◽  
pp. 122-127
Author(s):  
A. N. Stulova ◽  
N. S. Semenova ◽  
A. V. Zheleznyakova ◽  
V. S. Akopyan ◽  
D. V. Lipatov

Background. Optical coherence tomography angiography (OCT-A) is a promising tool for the detection of microvascular impairment at the preclinical stage of diabetic retinopathy (DR). Evaluation of dynamic OCT-A changes and their association with systemic factors can help to reveal early biomarkers of DR progression.Aim: to evaluate time-related OCT-A changes and their association with systemic factors in type 1 diabetes mellitus (DM1) patients with no apparent DRMaterials and methods. 38 DM1 patients with no apparent DR and 39 healthy volunteers were included in the study. All participants underwent 7-fi eld fundus photography, OCT and OCT-A. We analyzed OCT-A parameters (foveal avascular zone (FAZ) area (mm2), acircularity index (AI), vessel density (VD), skeletonized density (SD)) as well as the results of blood and urea tests.Results. After one year of observation, AI was significantly higher (р = 0.005) and VD0–300 was signifi cantly lower in superfi cial vascular plexus (SVP, p < 0.0001) and deep capillary plexus (DCP, р = 0.032) in DM1 patients. We have also registered a positive correlation between AI and triglycerides (TG) level (r = 0.627, p = 0.007) as well as a negative correlation between ketones and VD (SVP VD0–300: r = –0.695, p = 0.030; intermediate capillary plexus (ICP, VD0–300: r = –0.551, p = 0.041; DCP, VD0–300: r = –0.704, p = 0.003; SVP, VD300–600: r = –0.853, p = 0.001).Conclusions. After one year of observation, we have registered an increase in AI level and a decline in VD in SVP and DCP which can be the earliest signs of DR progression. A signifi cant correlation between these parameters and systemic factors indicates their role as potential DR biomarkers.


Biomedicines ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 247
Author(s):  
Jorge González-Zamora ◽  
Valentina Bilbao-Malavé ◽  
Elsa Gándara ◽  
Anna Casablanca-Piñera ◽  
Claudia Boquera-Ventosa ◽  
...  

The purpose of this study was to evaluate the presence of retinal and microvascular alterations in COVID-19 patients with bilateral pneumonia due to SARS-COV-2 that required hospital admission and compare this with a cohort of age- and sex-matched controls. COVID-19 bilateral pneumonia patients underwent retinal imaging 14 days after hospital discharge with structural optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) measurements. Vessel density (VD) and foveal avascular zone (FAZ) area were evaluated in the superficial, deep capillary plexus (SCP, DCP), and choriocapillaris (CC). After exclusion criteria, only one eye per patient was selected, and 50 eyes (25 patients and 25 controls) were included in the analysis. COVID-19 patients presented significantly thinner ganglion cell layer (GCL) (p = 0.003) and thicker retinal nerve fiber layer (RNFL) compared to controls (p = 0.048), and this RNFL thickening was greater in COVID-19 cases with cotton wool spots (CWS), when compared with patients without CWS (p = 0.032). In both SCP and DCP, COVID-19 patients presented lower VD in the foveal region (p < 0.001) and a greater FAZ area than controls (p = 0.007). These findings suggest that thrombotic and inflammatory phenomena could be happening in the retina of COVID-19 patients. Further research is warranted to analyze the longitudinal evolution of these changes over time as well as their correlation with disease severity.


2021 ◽  
Vol 14 (5) ◽  
pp. e240208
Author(s):  
Hana A Mansour ◽  
Sami Uwaydat ◽  
Muhamad H Yunis ◽  
Ahmad M Mansour

Optical coherence tomography angiography imaging in two patients with oculocutaneous albinism, one with severe nystagmus, showed persistence of both the superficial and the deep retinal capillary plexus adding another vascular feature to the foveal hypoplasia.


2019 ◽  
Vol 30 (6) ◽  
pp. 1418-1423 ◽  
Author(s):  
Claudio Furino ◽  
Grazia Montrone ◽  
Maria Vittoria Cicinelli ◽  
Stefania Balestra ◽  
Maria Oliva Grassi ◽  
...  

Purpose: To investigate a subset of diabetic patients without diabetic retinopathy with optical coherence tomography angiography, assessing the differences in macular perfusion between diseased eyes and healthy controls. Methods: Monocentric cross-sectional study, including 86 eyes from 43 diabetic patients with no clinical signs of diabetic retinopathy and 78 eyes from 39 controls. Patients underwent 3.0 × 3.0 mm and 4.5 × 4.5 mm swept-source optical coherence tomography angiography. Vessel density (%), foveal avascular zone area (mm2), and avascular density (%) were provided for the superficial capillary plexus and the deep capillary plexus. Results: The foveal avascular zone area at the superficial capillary plexus was larger in the study group compared to controls, irrespective of the area of the slab considered. A meaningful difference was found in the vessel density at the deep capillary plexus of the 3.0 × 3.0 mm slab (p = 0.03). Almost all the variables considered in the study showed a significant within-subject effect. Age significantly correlated with vessel density of superficial capillary plexus on 4.5 × 4.5 mm in both control and diabetic eyes. Conclusion: Diabetic patients with subclinical diabetic retinopathy feature a larger foveal avascular zone at the superficial capillary plexus compared with controls, as well as relative reduction of the vessel density at the deep capillary plexus. These findings might serve as the basis for screening between normal and diabetic subjects.


Author(s):  
Pasha Anvari ◽  
Amin Najafi ◽  
Reza Mirshahi ◽  
Mahsa Sardarinia ◽  
Maryam Ashrafkhorasani ◽  
...  

Purpose: To compare the area of the foveal avascular zone (FAZ) in the superficial and deep retinal layers using two different spectral-domain optical coherence tomography angiography (OCTA) devices. Methods: A cross-sectional comparative study was conducted to obtain macular OCTA images from healthy subjects using Optovue RTVue XR Avanti (Optovue, Inc, Fremont, CA) and Spectralis HRA+OCTA (Heidelberg Engineering, Heidelberg, Germany). Two independent trained graders measured the FAZ area using automated slab segmentation. The FAZ area in the superficial and deep retinal layers were compared. Results: Twenty-three eyes of 23 subjects were included. The graders agreement was excellent (>0.86) for all measurements. The mean FAZ area was significantly larger at the superficial retinal layer as compared to the deep retinal layer on both devices (0.31 ± 0.08 mm2 vs 0.26 ± 0.08 mm2 in Optovue and 0.55 ± 0.16 mm2 vs 0.36 ± 0.13 mm2 in Spectralis, both P < 0.001). The mean FAZ area was significantly greater in the superficial and deep retinal layers using Spectralis as compared to Optovue measurements (P < 0.001 for both comparisons). Conclusion: In contrast to previous reports, the FAZ area was larger in the superficial retina as compared to deep retinal layers using updated software versions. Measurements from different devices cannot be used interchangeably.


Author(s):  
T. Hamann ◽  
M. R. J. Wiest ◽  
M. Brinkmann ◽  
M. Toro ◽  
K. Fasler ◽  
...  

Abstract Purpose To investigate a possible microvascular component of poppers maculopathy (PMP) using optical coherence tomography angiography (OCTA). Methods Twelve patients suffering from poppers maculopathy were included. Health records, optical coherence tomography (OCT), and OCTA data was gathered and compared to a healthy control group (HC). PMP lesion type was determined by manifestation in OCT. OCTA-based evaluation of retinal vascular plexus and choriocapillaris (CC) was executed. Vessel density (VD) and vessel length density (VLD) in superficial and deep capillary plexus (SCP, DCP), as well as flow deficits (FD), within the foveal avascular zone (FAZ) in CC were assessed. Results Median age of PMP patients was 40 (min 24; max 64) years, all male. Eleven patients presented with ellipsoid zone-type lesions; one patient showed a vitelliform-type lesion. No qualitative microvascular changes between PMP patients and HC were identified. Quantitative values for VD and VLD of SCP and DCP did not differ in between the two groups. The analysis of FDs in CC showed no deviation from PMP patients to HC. Conclusions No vascular anomalies in qualitative and quantitative analysis in OCTA were detected in PMP patients. The constitution of the CC within FAZ of PMP patients does not differ from HC when assessed as FD.


2020 ◽  
Author(s):  
Hongjing Zhu ◽  
Weiwei Zhang ◽  
Qinghuai Liu

Abstract Aim: To describe the changes of optical coherence tomography angiography (OCTA) characteristics in severe non-proliferative Diabetic Retinopathy(S-NPDR) eyes. And study the effect of Panretinal photocoagulation(PRP) on these characteristics.Methods: This is a prospective study including 31 eyes from 18 consecutive patients with S-NPDR and 31 eyes of healthy subjects. We measured macular vascular density (VD) and foveal avascular zone(FAZ) area by an OCTA device. All patients with S-NPDR underwent PRP treatment. In S-NPDR eyes, the VD and foveal avascular zone(FAZ) area were assessed at 1 week before PRP, 1 month, 3 months and 6 months following PRP.Results: Compared with the normal control group ,in superficial retinal capillary plexus (SCP), macular VD decreased in S-NPDR group expect foveal VD. In foveal ,p=0.7;In parafoveal and perifoveal, p<0.001. In deep retinal capillary plexus (DCP), macular VD was also lower in S-NPDR group. In foveal, p=0.01.In parafoveal and perifoveal, p<0.001. And FAZ area expanded in S-NPDR eyes(p=0.05). In S-NPDR eyes , at 3 months after PRP, foveal VD in DCP increased significantly(p=0.04). At 6 months after PRP, foveal VD increased both in SCP and DCP (P=0.01,P=0.008,respectively). At 6 months after PRP,FAZ area decreased (p=0.04).Conclusions : Patients with S-NPDR have retinal microcirculation disorder, and PRP can partially improve the macular microcirculation. VD and FAZ can be used as sensitive indicators for follow-up observation of diabetic retinopathy.


2020 ◽  
Vol 30 (3) ◽  
pp. 600-607
Author(s):  
Elif Güler Kazancı ◽  
Muhammet Furkan Korkmaz ◽  
Mehmet Erol Can

Purpose: The purpose was to evaluate retinal vascular parameters by optical coherence tomography angiography in β-thalassemia major patients. Methods: Thirty-three patients with β-thalassemia major (study group) and 29 healthy children (control group) were enrolled in the study. All subjects underwent a complete ocular examination. The mean foveal avascular zone, non-flow area, foveal avascular zone perimeter, acircularity index of foveal avascular zone, foveal density, the superficial capillary plexus, and deep capillary plexus were scanned using 6 × 6 mm optical coherence tomography angiography scans centered on the macula. Superficial capillary plexus and deep capillary plexus were also scanned centered on the optic disk. We collected data on histories of patients, and hemoglobin and ferritin were also studied from both groups. Results: The mean age was 13.85 ± 4.69 years (range: 4–21 years) in β-thalassemia major group and 12.59 ± 3.66 years (range: 6–18 years) in the control group. The mean foveal avascular zone value was 0.265 ± 0.11 mm2 in the study group and 0.296 ± 0.12 mm2 in the control group. The mean non-flow area value was 0.468 ± 0.12 mm2 in the study group and 0.479 ± 0.14 mm2 in the control group ( p > 0.05). Differences in the mean values for foveal density and acircularity index were statistically significant between the study group and control group ( p < 0.05, p = 0.026, and p = 0.026, respectively). Superficial capillary plexus and deep capillary plexus were not a significant difference between the study and control groups in 6 × 6 mm scans on macula and 4.5 × 4.5 mm scans on optic disk area ( p > 0.05). Acircularity index was negatively correlated ( r = −0.292, p = 0.026), and foveal density was positively correlated with hemoglobin ( r = 0.292, p = 0.026). Conclusion: By using optical coherence tomography angiography, we detected foveal microvascular changes in young β-thalassemia patients before significant ocular anomalies development.


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