OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY OF RETINAL VENOUS OCCLUSION

TLDR

The study aimed to noninvasively evaluate retinal microvasculature in patients with retinal venous occlusion using optical coherence tomography angiography (OCTA) and explore its clinical utility. In a prospective observational cohort, subjects underwent comprehensive ophthalmic examination, fluorescein angiography as needed, and OCTA on a prototype spectral‑domain system with 3 mm × 3 mm and 6 mm × 6 mm scans centered on the fovea, reconstructing superficial, middle, and deep retinal slabs via intensity‑contrast algorithms and visualizing en‑face images, with manual segmentation to confirm algorithm accuracy. OCTA successfully visualized nearly all clinically relevant features—including impaired perfusion, atrophy, vascular dilation, shunt vessels, and intraretinal edema—in 25 subjects, matching fluorescein angiography while often providing more detailed anatomic and flow information, and proving at least as effective as fluorescein angiography when combined with standard SD‑OCT for managing macular complications of retinal venous occlusion.

Abstract

To noninvasively evaluate the retinal microvasculature in human subjects with retinal venous occlusions using optical coherence tomography angiography and assess potential clinical applications.This was a prospective, observational study of adult human subjects with clinical and imaging findings demonstrating retinal venous occlusion. Subjects underwent complete ophthalmic examination and fluorescein angiography as appropriate for their standard of care. Optical coherence tomography angiography was performed on a prototype spectral domain-OCTA system in 3 mm × 3 mm and 6 mm × 6 mm regions centered on the fovea and parafoveal areas. Retinal vasculature was assessed within three horizontal slabs consisting of the superficial, middle, and deep retina. The vasculature within each slab was reconstructed using intensity contrast-based algorithms and visualized as en-face images. Optical coherence tomography angiograms were manually segmented to verify the accuracy of the automated segmentation algorithms.Optical coherence tomography angiography was able to demonstrate almost all of the clinically relevant findings in 25 subjects with acute and chronic retinal venous occlusion. These findings were consistent with clinical, anatomic, and fluorescein angiographic findings including areas of impaired vascular perfusion, retinal atrophy, vascular dilation, shunt vessels, and some forms of intraretinal edema.Optical coherence tomography angiography is an investigational method that generates high-resolution, noninvasive angiograms that qualitatively illustrate most of clinically relevant findings in retinal venous occlusion. Optical coherence tomography angiography corresponds well with fluorescein angiograms and in many cases provides more detailed anatomic and blood flow information. Optical coherence tomography angiography, in conjunction with standard spectral domain-OCT, is at least equally as effective as fluorescein angiography for evaluation and management of the macular complications of retinal venous occlusions.