Papillary Vessel Density Changes After Intravitreal Anti-VEGF Injections in Hypertensive Patients with Central Retinal Vein Occlusion: An Angio-OCT Study

Abstract

Purpose: To investigate papillary microvascular changes in patients affected by macular edema due to Central Retinal Vein Occlusions (CRVO) after anti-Vascular Endothelial Growth Factor (VEGF) therapy. Methods: Prospective analysis of papillary and peripapillary vessel density (VD) changes in 18 eyes of 18 hypertensive patients affected by CRVO before and after the loading-phase of intravitreal Ranibizumab (IVR) injections. Data were quantitatively measured by optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) before as well as 1 month and 4 months after injections. The correlation between post-treatment best-corrected visual acuity (BCVA) and changes in the retinal microvasculature evaluated by OCTA was assessed. Results: 18 eyes of 18 consecutive patients with a known history of arterial hypertension and affected by an acute CRVO episode were enrolled. Central macular thickness (CMT) was significantly reduced after IVR injections (p < 0.001), while mean BCVA improved from 0.70 ± 0.26 logarithm of the minimal angle of resolution (logMAR) units at baseline to 0.25 ± 0.18 logMAR units after 4 months (p < 0.001). VD inside disc and peripapillary significantly increased (p < 0.001 and p = 0.01, respectively) after treatment. Conclusions: OCTA showed VD increase in the papillary area in patients affected by CRVO after anti-VEGF therapy. This area could represent a new region of interest to study microvasculature changes concomitant with severe macular edema.

Repeatability of measuring the vessel density in patients with retinal vein occlusion: An optical coherence tomography angiography study

“…Interestingly, recent study by Nicolai et al suggest the application of OCTA on peripapillary area to evaluate microvascular changes when the CRVO is complicated with macular edema. According to their study, peripapillary metrics can be more reliable data when the macular metrics are unreliable due to macular edema [20].…”

Longitudinal Changes on Optical Coherence Tomography Angiography in Retinal Vein Occlusion

“…We did not analyze factors associated with recurrence of ME during follow-up [ 20 ] and are unable to predict whether eyes with worse macular perfusion parameters are more prone to ME. Moreover, we did not analyze the peripapillary area, which may have led to different results, as a prospective study including 18 CRVO patients found increased peripapillary VD after anti-VEGF therapy [ 47 ]. We also did not consider healthy eyes as controls but we used the fellow eyes.…”

Vascular density of optic nerve head in diabetic retinopathy using optical coherence tomography angiography

“…Nicola et al reported less W-disc and PP area VD in central retinal vein occlusion (CRVO) than normal fellow eyes, which are significantly increased after treatment [ 34 ]. Another study showed that mean RNFL thickness and W-RPC VD were significantly lower in the non-arteritic anterior ischemic optic neuropathy (NAION) group compared to normal group [ 35 ].…”