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

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Introduction. Ischemic maculopathy is the main cause of irreversible vision loss due to retinal vein occlusion (RVO). Fluorescent angiography (FA), being “golden standard” in evaluating retinal capillary plexus does not allow to visualize separately intraretinal capillary networks. Optical coherence tomography angiography (OCT-angiography) gives the possibility to visualize 4 capillary plexi and allows carrying out a quantitative analysis of microcirculation quantitatively estimating capillary network density and non-perfusion areas.

Aim: to investigate microcirculation changes using OCT-angiography data and to compare them to opthalmoplethysmography indices in patients with RVO. Material and methods: The study included 12 patients with retinal vein occlusion. In all patients, routine ophthalmic examination was carried out, and additionally ocular blood flow was estimated using FA, OCT-angiography and ophthalmoplethysmography.

Results: Ischemia in the macular area was detected in 4 patients (25%) according to FA results, and in 8 (67%) according to OCT-angiography data. In comparison with the unaffected eye, significant decrease in density of both superficial and deep capillary plexi, decrease in ‘flow area’ and enlargement of foveal avascular zone were observed. Significant close direct correlation was established between capillary density in the superficial capillary plexus (r > 0.8) and the deep one (r > 0.7), choroidal thickness, and opthalmoplethysmography indices (r > 0.6).

Conclusion: When compared to FA, OCT-angiography is a more sensitive method to detect macular capillary perfusion. In case of retinal veins occlusion the combination of the above mentioned methods with ophthalmoplethysmography allows to perform comprehensive evaluation of the regional hemodynamics.

Svetlana N Tultseva

Author for correspondence.
I.P. Pavlov First St Petersburg State Medical University
Russian Federation, Saint Petersburg, Russia

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

Yury S Astakhov

I.P. Pavlov First St Petersburg State Medical University
Russian Federation, Saint Petersburg, Russia

MD, PhD, professor. Ophthalmology Department

Aleksey G Rukhovets

I.P. Pavlov First St Petersburg State Medical University
Russian Federation, Saint Petersburg, Russia

ophthalmologist. Department of Ophthalmology

Aleksandra I Titarenko

I.P. Pavlov First St Petersburg State Medical University
Russian Federation, Aleksandra-titarenko@yandex.ru

resident. Ophthalmology Department

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