Retinal Hemodynamics Seen on Optical Coherence Tomography Angiography Before and After Treatment of Retinal Vein Occlusion

Suzuki, N.; Hirano, Yoshio; Tomiyasu, Taneto; Esaki, Yuya; Uemura, Akiyoshi; Yasukawa, Tsutomu; Yoshida, Masahito; Ogura, Yuichiro

doi:10.1167/iovs-16-20648

Cited by 68 publications

(73 citation statements)

References 27 publications

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“…Although we did not find any case of complete reperfusion after anti-VEGF therapy within the area of coexisting edema and nonperfusion, the retinal perfusion may be improved with resolution of the edema in some cases. Suzuki et al 28 have reported decreased nonperfusion after anti-VEGF therapy in patients with RVO. de Carlo et al 39 also have reported the reappearance of retinal microvasculature after anti-VEGF treatment in the areas previously shown to have flow voids due to intraretinal fluid in diabetic macular edema (DME).…”

Section: Discussionmentioning

confidence: 98%

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Changes in Retinal Microvasculature and Visual Acuity After Antivascular Endothelial Growth Factor Therapy in Retinal Vein Occlusion

Winegarner

Wakabayashi

Fukushima

et al. 2018

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. To investigate the changes in the retinal microvasculature during the course of anti-VEGF therapy in eyes with macular edema due to retinal vein occlusion (RVO) and their association with visual outcomes.METHODS. The vessel density (VD) and foveal avascular zone (FAZ) area in the superficial capillary plexus (SCP) and deep capillary plexus (DCP) were quantitatively measured by optical coherence tomography angiography (OCTA) in 48 consecutive eyes with RVO before and 1, 3, 6, 9, and 12 months after anti-VEGF therapy. Anti-VEGF therapy was performed either with ranibizumab or aflibercept following a pro re nata (PRN) regimen. The correlation between post-treatment best-corrected visual acuity (BCVA) and changes in the retinal microvasculature evaluated by OCTA were assessed.RESULTS. The BCVA improved significantly at 12 months (P < 0.001). Better BCVA at 12 months was significantly associated with a better VD in the SCP and DCP both at baseline (R 2 ¼ 0.524, P < 0.001 and R 2 ¼ 0.457, P < 0.001, respectively) and at 12 months (R 2 ¼ 0.521, P < 0.001 and R 2 ¼ 0.662, P < 0.001, respectively). Overall, both VD and FAZ did not change significantly during the 12 months. However, the progression of nonperfusion was observed in the SCP in 6 (13%) eyes and in the DCP in 10 (21%) eyes. The number of macular edema recurrence was significantly associated with a decrease in the VD (P ¼ 0.006 [SCP] and P < 0.001 [DCP]) and less visual gain (P ¼ 0.02) after treatment.CONCLUSIONS. Anti-VEGF therapy maintains retinal perfusion in most patients with RVO. Preserving retinal perfusion is crucial for better visual outcomes.

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Section: Discussionmentioning

confidence: 98%

“…To date, several studies have reported the macular VD and FAZ before and after anti-VEGF therapy. [28][29][30] However, the results are conflicting because of the short follow-up periods and a limited number of patients studied. In addition, the possible associations between changes in the retinal VD and visual outcomes have not been reported.…”

mentioning

confidence: 99%

Changes in Retinal Microvasculature and Visual Acuity After Antivascular Endothelial Growth Factor Therapy in Retinal Vein Occlusion

Winegarner

Wakabayashi

Fukushima

et al. 2018

Invest. Ophthalmol. Vis. Sci.

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“…The innovative data provided by OCTA was the involvement of DCP [1, 17, 18]. On standard fluorescein angiography, it is impossible to identify the exact location of capillary leakage, and the DCP is not directly visible.…”

Section: Discussionmentioning

confidence: 99%

“…On standard fluorescein angiography, it is impossible to identify the exact location of capillary leakage, and the DCP is not directly visible. With the advent of OCTA, it was possible to visualize the presence of cysts, the non-perfusion areas, the dilation of macular capillaries, and the disruption of perifoveal arcade at the level of SCP and DCP [1, 5, 17]. The reduction of VD in DCP was correlated with a degree of peripheral ischemia, evaluated by means of fluorescein angiography [18].…”

Section: Discussionmentioning

confidence: 99%

Microvascular Retinal and Choroidal Changes in Retinal Vein Occlusion Analyzed by Two Different Optical Coherence Tomography Angiography Devices

et al. 2019

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Purpose: To investigate retinal and choroidal microvascular changes and structural choroidal involvement in retinal vein occlusion (RVO). Methods: Retrospective analysis of treatment-naïve macular edema secondary to RVO, studied by optical coherence tomography (OCT) and OCT angiography (OCTA), before and after the loading phase of intravitreal injections of ranibizumab (IVR-LP). OCTA was performed using two different devices: AngioVue RTVue XR Avanti (spectral-domain OCTA) and Zeiss PLEX® Elite 9000 (swept-source OCTA). Results: 30 eyes of 30 consecutive patients (17 branch and 13 central RVO) were included. Central macular thickness and subfoveal choroidal thickness (SCT) were significantly reduced after IVR-LP (p < 0.001 and p = 0.046, respectively). 23 eyes were eligible for OCTA analysis. Baseline vessel density (VD) in deep capillary plexus (DCP) was significantly reduced in RVO eyes compared with fellow eyes (p = 0.03 and p = 0.002 for PLEX® Elite and AngioVue, respectively). After IVR-LP, no significant VD changes in any vascular layer was found. PLEX® Elite VD analysis showed significant differences in DCP between ischemic versus non-ischemic eyes (p = 0.011). Conclusion: OCTA suggests a retinal vascular impairment of DCP but no involvement of choroid in RVO eyes. A greater baseline SCT could be due to a choroidal exudation. OCTA imaged with PLEX® Elite allowed to differentiate ischemic and non-ischemic patients at baseline.

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“…Выделены зоны снижения плотности капиллярной сети (овал), которые не визуализировались при проведении флюоресцентной ангиографии, и расширение ава-скулярной зоны (стрелка) Более выраженные микроциркуляторные из-менения характерны для ОЦВС, что ассоциирует-ся с более высокими концентрациями эндотели-ального сосудистого фактора роста (VEGF) [4,5]. N. Suzuki et al [25] определили, что терапия ин-гибиторами ангиогенеза уменьшает площадь зон отсутствия капиллярной перфузии, а количество интравитреальных инъекций по данным ОКТ-ангиографии прямо пропорционально улучшению гемодинамики.…”

Section: Discussionunclassified

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

Тульцева

Николаевна²,

Astakhov

et al. 2017

Ophthalmology Reports

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 Введение. Ишемическая макулопатия -основная причина необратимого снижения зрения при окклюзии вен сетчатки (ОВС). «Золотым стандартом» оценки ретинальной сосудистой сети яв-ляется флюоресцентная ангиография (ФАГ), однако она не позволяет раздельно визуализировать интраретинальные сосудистые сплетения. Оптическая когерентная томография-ангиография (ОКТ-ангиография) даёт возможность визуализировать четыре капиллярных сплетения и позволяет про-водить количественный анализ микроциркуляции с расчётом плотности капиллярной сети и зон отсутствия капиллярной перфузии. Цель: изучить у больных с ОВС особенности изменения микро-циркуляции по данным ОКТ-ангиографии и сопоставить их с показателями офтальмоплетизмогра-фии. Материалы и методы. В исследование включено 12 пациентов с окклюзией вен сетчатки. Всем пациентам проводилось стандартное офтальмологическое обследование с дополнительной оценкой регионарной гемодинамики с помощью ФАГ, ОКТ-ангиографии и офтальмоплетизмографии. Результаты. У больных с ОВС по данным ФАГ ишемия в центральной зоне выявлена у 4 паци-ентов (25 %), а по данным ангиографии ОКТ -у 8 (67 %). При сравнении с непоражённым гла-зом выявлено значимое снижение плотности капилляров в поверхностном и глубоком капиллярных сплетениях, уменьшение зоны перфузии хориокапилляров и расширение фовеолярной аваскулярной зоны в глубоком капиллярном сплетении. Получена значимая тесная прямая связь между плотно-стью капилляров в поверхностном (r > 0,8) и глубоком (r > 0,7) капиллярных сплетениях сетчатки, толщиной хориоидеи и показателями офтальмоплетизмографии (r > 0,6). Выводы. ОКТ-ангиография является более чувствительным методом диагностики макулярной капиллярной перфузии по срав-нению с флюоресцентной ангиографией. Сочетание обсуждаемых методов с выполнением офтальмо-плетизмографии позволяет провести комплексную оценку регионарной гемодинамики при окклюзии вен сетчатки.  Ключевые слова: окклюзии вен сетчатки; глазной кровоток; ишемия сетчатки; капиллярная пер-фузия; ОКТ-ангиография; офтальмоплетизмография.

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Retinal Hemodynamics Seen on Optical Coherence Tomography Angiography Before and After Treatment of Retinal Vein Occlusion

Cited by 68 publications

References 27 publications

Changes in Retinal Microvasculature and Visual Acuity After Antivascular Endothelial Growth Factor Therapy in Retinal Vein Occlusion

Changes in Retinal Microvasculature and Visual Acuity After Antivascular Endothelial Growth Factor Therapy in Retinal Vein Occlusion

Microvascular Retinal and Choroidal Changes in Retinal Vein Occlusion Analyzed by Two Different Optical Coherence Tomography Angiography Devices

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

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