Retinal microvasculature changes in optical coherence tomography – angiography after severe blunt ocular trauma

Abstract

Background: The pathophysiological origin of the retinal damage present in ocular contusion is not clearly established. It is not known whether it is initially neurodegeneration or vascular ischaemia that leads to retinal atrophy. Methods: The aim of this study was to evaluate the retinal microvasculature with optical coherence tomography (OCT) - angiography of the eyes affected by severe ocular contusion as compared to the contralateral non-traumatised eyes. The retinal vessel density of superficial (SVP) and deep vascular plexus (DVP), area of choriocapillaris flow voids and foveal avascular zone area were evaluated. The macular thickness in OCT in the acute and late stages of the trauma was also analysed. Results: A total of 48 patients were included and at both 72 hours and 55 days after severe ocular contusion, there were no significant differences between traumatised and non-traumatised eyes for the vascular density of the SVP, the DVP, the choriocapillaris and area of the foveal avascular zone. But we observed significant increase in macular thickness in traumatised eyes compared to non-traumatised eyes at the initial emergency visit and a decrease in traumatised eyes at follow-up examination. Conclusions: These results suggest that the micro-vascularisation of the retina and the choriocapillaris are not initially affected in severe ocular contusions. The damage to the retina after trauma is therefore probably neurodegenerative rather than vascular.