2022 Annual Meeting and Alumni Reunion
Category : Clinical Research Candidate : Yifan Lu Poster #: C10
Quantitative Wide-field Swept-source Optical Coherence Tomography Angiography and Visual Outcomes in RAO
Yifan Lu , Ying Cui , Ying Zhu , Edward S . Lu , Rebecca Zeng , Rohan Bajaj , Raviv Katz , Rongrong Le , Jay C . Wang , John B . Miller
Purpose : Retinal artery occlusion ( RAO ) is an ophthalmic emergency that can lead to poor visual outcome and is associated with an increased risk of cerebral stroke and cardiovascular events . Fluorescein angiography ( FA ) is the traditional diagnostic tool for RAO ; however , wide-field swept-source optical coherence tomography angiography ( WF SS-OCTA ), as a nascent imaging technology , is able to provide quick and non-invasive angiographic information with a wide field of view . In this study , we looked for associations between OCT-A vascular metrics and visual acuity in patients with prior diagnosis of RAO .
Methods : Patients with diagnoses of central retinal artery occlusion ( CRAO ) or branched retinal artery occlusion ( BRAO ) were included . A 6mm x 6mm Angio and a 15mm x 15mm AngioPlex Montage OCT-A image were obtained for both eyes in each patient using the Zeiss Plex Elite 9000 WF SS-OCTA device . Each 6mm x 6mm image was divided into nine Early Treatment Diabetic Retinopathy Study ( ETDRS ) subfields . The average measurement of the central foveal subfield , inner ring , and outer ring was calculated for each parameter . Non-perfusion area ( NPA ) was manually measured using 15mm x 15mm Montage images . A linear regression model was utilized to identify a correlation between the imaging metrics and visual acuity . A P-value less than 0.05 was considered to be statistically significant .
Results : Twenty-five subjects were included in the study . For RAO eyes , there was a statistically significant negative correlation between vision and retinal thickness as well as superficial capillary plexus vessel density ( SCP VD ). A negative correlation was found between vision and deep capillary plexus vessel density ( DCP VD ) without statistical significance . There was a positive correlation between vision and choroidal thickness as well as choroidal volume without statistical significance . No statistically significant correlation was found between vision and the above metrics in contralateral eyes . For NPA measurements , no significant correlation was found between vision and NPA .
Conclusions : This is the first study to investigate the utility of WF SS-OCTA in RAO and to demonstrate correlations between various retinal vascular imaging metrics and visual outcomes . Further investigations should explore the associations between these imaging findings and cardiovascular risk as RAO patients are at elevated risk for symptomatic stroke . The results of this study provide a basis to understand the structural changes involved in visual outcomes in RAO . Furthermore , they may help guide management of RAO and prevention of cerebral stroke and cardiovascular accidents in patients with RAO .