Direct and crossover effects of Phenylephrine and Cyclopentolate on foveal avascular zone and vessel density of macular capillary plexuses: an optical coherence tomography angiography study

Abstract

Purpose: To determine the influence of phenylephrine and cyclopentolate on foveal avascular zone (FAZ) and vessel density of macular capillary plexus measurements via optical coherence tomography angiography (OCTA). Materials and Methods: The participants were separated into 2 groups according to the administration of drops. One drop of phenylephrine 2.5% was administered on one eye of each subject in the phenylephrine group (n=30) and one drop of cyclopentolate 1% in the cyclopentolate group (n=30). FAZ parameters and vessel density values of both superficial (SCP) and deep capillary plexuses (DCP) were calculated via OCTA priorly and at 45 min following the drop administration in both eyes. Vessel density, acircularity index of FAZ, FAZ area, perimeter of FAZ and foveal density-300 were evaluated via OCTA. Results: The vessel density values of fovea in SCP and DCP was 18.51±7.14% and 36.05±8.76% and significantly decreased to 16.16±6.26% and 33.29±9.47% respectively after drop instillation in dilated eyes in phenylephrine group (p=0.041 and p=0.032). Likewise, the vessel density values in SCP and DCP were 21.56±7.74% and 39.27±8.76% and significantly decreased to 18.89±7.32% and 35.36±5.75% respectively, after drop instillation in dilated eyes in cyclopentolate group (p=0.035 and p=0.028). However, there was no significant difference between before and after instillation of drops in terms of foveal density-300 value via FAZ assessment tool in both dilated and nondilated contralateral eyes in both groups (p>0.05 for all). Conclusions: Mydriasis with phenylephrine and/ or cyclopentolate did not affect the foveal density-300 values while analyzing the perfusion of macula. Vessel density in foveal region should be evaluated via FAZ evaluation software of the OCTA.

The influence of topical cyclopentolate instillation on peripapillary and macular microvasculature measured by optical coherence tomography angiography in healthy individuals

“…In our study, different from their study, we found no change on either macular or peripapillary microvasculature by using cyclopentolate 1%. Göker et al 5 determined the influence of phenylephrine and cyclopentolate on FAZ and vessel density of macular capillary plexus measurements via OCT-A. The vessel density values in SCP and DCP were found to be significantly decreased after drop instillation in both phenylephrine and cyclopentolate groups in their study.…”

“…A novel, noninvasive imaging technology, optical coherence tomography angiography (OCT-A) has recently been used in many ophthalmology clinics. 1 2 3 5 It has been evaluated in different ocular and systemic diseases to visualize retinal microvasculature in different layers as well as optic nerve head blood flow. Many studies have investigated factors influencing OCT-A findings such as motion artifacts and image quality, 6 7 age and gender, 8 spherical equivalent and axial length, 9 systemic diseases, 10 and how to apply and assess OCT-A most adequately.…”

“… 4 Both sympathomimetics and parasympatholytics have vasoconstricting effects, and they may affect the measurements of OCT-A parameters. 5 There are several studies on the influence of topical mydriatics such as tropicamide 1% and phenylephrine hydrochloride 2.5% on quantitative OCT-A parameters. 1 2 3 Direct and crossover effects of phenylephrine and cyclopentolate on foveal avascular zone (FAZ) and vessel density of macular capillary plexuses via OCT-A were reported very recently.…”

“… 1 2 3 Direct and crossover effects of phenylephrine and cyclopentolate on foveal avascular zone (FAZ) and vessel density of macular capillary plexuses via OCT-A were reported very recently. 5 However, in this context, there is no study about the effect of cyclopentolate 1% on OCT-A peripapillary microvasculature. Therefore, we aimed to evaluate the effect of topical cyclopentolate 1% on both peripapillary capillary and macular microvasculature measurements with OCT-A in healthy volunteers.…”

Retinal vessel tortuosity as a prognostic marker for disease severity in Fabry disease

“…Influencing factors on vessel density measurements by OCT-A as sex, age, exercise, intraocular pressure, blood pressure [ 30 ] or application of mydriatic eye drops [ 31 ] even among healthy eyes as well the size of angiocube and interrater reliability [ 32 ] were described and may have had an impact on the discrepancies in the different studies. Retinal vessel density, measured by OCT-A, seems to be an inhomogeneous parameter in FD.…”