Diagnostic value OF oct-angiography AND regional hemodynamic assesSment in patients with retinal vein occlusion

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Abstract

Introduction. Ischemic maculopathy is the main cause of irreversible vision loss due to retinal vein occlusion (RVO). Fluorescein angiography (FA), which is the “gold standard” for evaluating retinal capillary plexuses, does not allow for the visualization of separate intraretinal capillary networks. Optical coherence tomography angiography (OCT-angiography) enables the possible visualization of four capillary plexi and allows for the quantitative analysis of microcirculation to quantitatively estimate capillary network density and non-perfusion areas.

Aim. To investigate microcirculation changes using OCT-angiography data and to compare the changes with opthalmoplethysmography indices in patients with RVO.

Material and methods. The study included 12 patients with RVO. In all patients, a routine ophthalmic examination was performed, and ocular blood flow was estimated using FA, OCT-angiography, and ophthalmoplethysmography.

Results. Ischemia in the macular area was detected in four patients (25%) according to FA results, and in eight (67%) accor ding to OCT-angiography data. Compared with the unaffected eye, significant decrease in the density of both superficial and deep capillary plexuses as well as a decrease in “flow area” and enlargement of foveal avascular zone were observed. A significant close direct correlation was established between capillary density in the superficial capillary plexus (r > 0.8) and the deep capillary plexus (r > 0.7), choroidal thickness, and opthalmoplethysmography indices (r > 0.6).

Conclusion. Compared with FA, OCT-angiography is a more sensitive method to detect macular capillary perfusion. In cases with RVO, the combination of the above mentioned methods with ophthalmoplethysmography allows for the comprehensive evaluation of regional hemodynamics.

About the authors

Svetlana N. Tultseva

I.P. Pavlov First St Petersburg State Medical University

Author for correspondence.
Email: tulceva@yandex.ru

MD, doctor of medical science, professor. Department of Ophthalmology

Russian Federation, Saint Petersburg

Yury S. Astakhov

I.P. Pavlov First St Petersburg State Medical University

Email: astakhov73@mail.ru

MD, PhD, professor. Ophthalmology Department

Russian Federation, Saint Petersburg

Aleksey G. Rukhovets

I.P. Pavlov First St Petersburg State Medical University

Email: arukhovets@gmail.com

ophthalmologist. Department of Ophthalmology

Russian Federation, Saint Petersburg

Aleksandra I. Titarenko

I.P. Pavlov First St Petersburg State Medical University

Email: Aleksandra-titarenko@yandex.ru

resident. Ophthalmology Department

Russian Federation, Saint Petersburg

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Copyright (c) 2017 Tultseva S.N., Astakhov Y.S., Rukhovets A.G., Titarenko A.I.

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