Quantitative measurement of vascular density and flow using optical coherence tomography angiography (OCTA) in patients with central retinal vein occlusion: Can OCTA help in distinguishing ischemic from non-ischemic type?
Tóm tắt
To evaluate microvascular changes and quantitative parameters in patients with central retinal vein occlusion (CRVO) by using optical coherence tomography angiography (OCTA) and finding difference between presumably ischemic and non ischemic CRVO. Patients with CRVO (31) and healthy control (20) were enrolled in this observational case control study. The OCTA was done for each patient and control subject. In macular area 2 images were taken for each eye (3 × 3 mm and 8 × 8 mm). The images were analyzed at three capillary plexuses (superficial and deep retinal capillary layers and choriocapillaris layer). Thirty-one patients with CRVO (mean age 60.00 ± 13.72 years) and 20 healthy age/gender matched subjects (mean age 54.10 ± 12.33 years) were enrolled in this study (p = 0.095). The mean visual acuity of patients was 0.47 ± 0.54 LogMAR. Eyes with CRVO as compared with fellow eyes and control group showed significant reduction of flow in superficial (1.171 ± 0.262 vs. 1.362 ± 0.285 vs. 1.453 ± 0.105) and deep capillary plexus (1.042 ± 0.402 vs. 1.331 ± 0.315 vs. 1.526 ± 0.123) and choriocapillaris (1.206 ± 0.543 vs. 1.841 ± 0.308 vs. 1.966 ± 0.05) and vascular density in superficial (45.92 ± 4.2 vs. 50.99 ± 4.35 vs. 52.85 ± 2.99) and deep (48.03 ± 4.71 vs. 55.86 ± 3.81 vs. 58.2 ± 2.65) capillary plexuses. Some parameters (flow of both retinal capillary plexuses and parafoveal vascular density in deep plexus) showed significantly reduction in fellow eyes than control group. The parameters including flow [superficial (1.014 ± 0.264 vs. 1.279 ± 0.19) and deep (0.873 ± 0.442 vs. 1.152 ± 0.32) capillary plexuses and choriocapillaris (0.79 ± 0.327 vs. 1.424 ± 0.51)] and vascular density [superficial (44.24 ± 2.13 vs. 46.58 ± 4.13) and deep (45.28 ± 3.5 vs. 49.32 ± 3.94) capillary plexuses] were lower significantly in ischemic type than non ischemic CRVO. The most damaged parameter was flow in deep capillary plexus. The model with smallest Akaike information criterion and Bayesian information criterion was chosen as the best model. For easier calculation, we also calculated the reduced model. By choosing the threshold of 12.6, the formula [3.9 × F1S + 0.8 × F3S] can diagnose the presumably ischemic CRVO from non ischemic type with AUC of 0.84, sensitivity of 100% and specificity of 69%. (F1S: flow in the central 1 mm-radius-circle of superficial plexus and F3S: flow in the central 3 mm-radius-circle of superficial plexus). In CRVO patients, the OCTA can accurately evaluate changes in microvascular structures. It may help in differentiation ischemic CRVO from non-ischemic CRVO.
Tài liệu tham khảo
Glanville J, Patterson J, McCool R, Ferreira A, Gairy K, Pearce I. Efficacy and safety of widely used treatments for macular oedema secondary to retinal vein occlusion: a systematic review. BMC Ophthalmol. 2014;14:7.
Casselholm de Salles M, Kvanta A, Amren U, Epstein D. Optical coherence tomography angiography in central retinal vein occlusion: correlation between the foveal avascular zone and visual acuity. Invest Ophthalmol Vis Sci. 2016;57:OCT242–6.
Fingler J, Zawadzki RJ, Werner JS, Schwartz D, Fraser SE. Volumetric microvascular imaging of human retina using optical coherence tomography with a novel motion contrast technique. Opt Express. 2009;17:22190–200.
Jia Y, Tan O, Tokayer J, et al. Split-spectrum amplitudedecorrelation angiography with optical coherence tomography. Opt Express. 2012;20:4710–25.
Mastropasqua R, Toto L, Antonio LD, Borrelli E, Senatore A, Nicola MD, Martino GD, Ciancaglini D, Carpineto P. Optical coherence tomography angiography microvascular findings in macular edema due to central and branch retinal vein occlusions. Sci Rep. 2017;7:40763.
Adhi M, Bonini Filho MA, Louzada RN, et al. Retinal capillary network and foveal avascular zone in eyes with vein occlusion and fellow eyes analyzed with optical coherence tomography angiography. Invest Ophthalmol Vis Sci. 2016;57:OCT486–94.
Seknazi D, Coscas F, Sellam A, Rouimi F, Coscas G, Souied E, Glacet-Bernard A. Optical coherence tomography angiography in retinal vein occlusion correlations between macular vascular density, visual acuity, and peripheral nonperfusion area on fluorescein angiography. Retina. 2017;0:1–9.
Coscas F, Glacet-Bernard A, Miere A, Caillaux V, Uzzan J, Lupidi M, Coscas G, Souied EH. Optical coherence tomography angiography in retinal vein occlusion: evaluation of superficial and deep capillary plexa. Am J Ophthalmol. 2016;161:160–71.
Kashani AH, Lee SY, Moshfeghi A, Durbin MK, Puliafito CA. Optical coherence tomography angiography of retinal venous occlusion. Retina. 2015;35:2323–31.
Martinet V, Guigui B, Glacet-Bernard A, et al. Macular edema in central retinal vein occlusion: correlation between optical coherence tomography, angiography and visual acuity. Int Ophthalmol. 2012;32(4):369–77.
Lee EK, Han JM, Hyon JY, Yu HG. Changes in choroidal thickness after intravitreal dexamethasone implant injection in retinal vein occlusion. Br J Ophthalmol. 2015;99:1543–9.
Fang K, et al. Subfoveal choroidal thickness in retinal vein occlusion. Ophthalmology. 2013;120:2749–50.
McIntosh RL, Rogers SL, Lim L, et al. Natural history of central retinal vein occlusion: an evidence-based systematic review. Ophthalmology. 2010;117:1113–23.
Kim MJ, Woo SJ, Park KH, Kim TW. Retinal nerve fiber layer thickness is decreased in the fellow eyes of patients with unilateral retinal vein occlusion. Ophthalmology. 2011;118:706–10.
Wakabayashi T, Sato T, Hara-Ueno CH, Fukushima Y, Sayanagi K, Shiraki N, Sawa M, Ikuno Y, Sakaguchi H, Nishida K. Retinal microvasculature and visual acuity in eyes with branch retinal vein occlusion: imaging analysis by optical coherence tomography angiography. Invest Ophthalmol Vis Sci. 2017;58:2087–94.
Paques M, et al. Structural and hemodynamic analysis of the mouse retinal microcirculation. Invest Ophthalmol Vis Sci. 2003;44:4960–7.
Chex X, Rahimy E, Sergott RC, et al. Spectrum of retinal vascular diseases associated with paracentral acute middle maculopathy. Am J Ophthalmol. 2015;160:26–34.
Samara WA, Shahlaee A, Sridhar J, Khan MA, Ho AC, Hsu J. Quantitative optical coherence tomography angiography features and visual function in eyes with branch retinal vein occlusion. Am J Ophthalmol. 2016;166:76–83.