Evaluation of macular and optic disc radial peripapillary vessel density with optical coherence tomography angiography in iron deficiency anemia

PurposeTo investigate effect of iron deficiency anemia (IDA) on macular and radial peripapillary capillary (RPC) vascular changes by optical coherence tomography angiography (OCTA).MethodsThirty-three patients with IDA and 33 healthy controls were enrolled in the study. Foveal avascular zone (FAZ) area, macular superficial capillary plexus (SCP) and deep capillary plexus (DCP) vessel density and RPC vessel density were evaluated by the AngioVue Imaging System. Hemoglobin (Hb), hematocrit (Hct), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), red cell distribution width (RDW), serum iron, total iron-binding capacity (TIBC), serum ferritin and transferrin saturation values were also recorded.ResultsThere were no statistically significant differences between the two groups in terms of FAZ area and FAZ perimeter while foveal density (FD) was significantly decreased in the IDA group. Compared to control group, IDA group revealed significantly decreased macular vessel density in all macular regions except fovea in both SCP and DCP. RPC vessel density was significantly decreased in whole image, peripapillary and superior-hemifield area wihout RNFL thinning. Hemoglobin level was positively correlated with SCP whole and RPC whole vessel density and serum iron level was also positively correlated with SCP whole vessel density.ConclusionMacular and optic disc vessel density were reduced in IDA patients. OCTA may be useful in detecting retinal ischemia before clinically visible signs of retinopathy associated with IDA appear.     

Normative data assessment of age-related changes in macular and optic nerve head vessel density using optical coherence tomography angiography

ObjectiveTo investigate macular and optic nerve head vessel density in healthy individuals using optical coherence tomography angiography (OCTA), and determine their relationship with age.MethodThis retrospective study included 153 eyes of 153 individuals aged between 20 and 80 years, who had no systemic diseases, optic disk, or retinal pathologies. The retinal (6 × 6 mm) and optic disk (4.5 × 4.5 mm) OCTA images were evaluated for superficial capillary plexus (SCP), deep capillary plexus (DCP) and radial peripapillary capillary plexus (RPCP) vessel density, foveal avascular zone (FAZ) area, and choriocapillaris flow area and compared among 5 age groups.ResultsThe SCP vessel density was significantly associated with age for the whole image (P = 0.001), parafovea (P = 0.038), and perifovea (P/ce:italic>= 0.001). The DCP vessel density significantly varied with age in the whole image (P = 0.004), parafovea (P = 0.001), and perifovea (P = 0.002). The SCP and DCP vessel densities were significantly lower in the older age groups, and more prominently so after 50 years of age. The FAZ area increased with age; however, this finding was not statistically significant (P = 0.660). The choriocapillaris flow area decreased with age (P = 0.002). The RPCP vessel density in the inside disk significantly decreased with age (P = 0.038).ConclusionAge should be taken into consideration when using OCTA in the diagnosis and follow-up of retinal and optic nerve diseases. It is believed that the results here in can be used as a reference baseline for future studies.     

The role of optical coherence tomography angiography in reticular pseudodrusen

BackgroundTo investigate the changes in retinal and choriocapillaris vessel density (VD) in patients effected by early age-related macular degeneration (AMD) and reticular pseudodrusen (RPD), using Optical Coherence Tomography Angiography (OCTA).MethodsA total of seventy-eight eyes of 78 patients (43 male, 35 female, mean age 72.61 ± 5.15) with non-neovascular AMD (38 eyes with early AMD and 40 eyes with RPD) was recruited in this observational prospective study. Forty eyes of 40 healthy subjects represented the control group. The VD was measured in superficial capillary plexus (SCP), deep capillary plexus (DCP) and choriocapillaris in different macular regions.ResultsThere were no significant differences in VD of the SCP and DCP among the controls and the two study groups (p > 0.05). The VD of the choriocapillaris revealed a statistically significant reduction in early AMD and RPD groups respect to controls (p < 0.001). Furthermore, the patients with RPD showed a significantly decreased VD respect to patients with early AMD in different macular regions (p < 0.001).ConclusionsThe quantitative analysis of retinal and choriocapillaris blood flow by OCTA provided useful information regarding the vascular changes in non-neovascular AMD patients suggesting that the choriocapillaris loss is mainly involved in the pathogenesis of RPD.     

Association between macular and papillary vessel density by optical coherence tomography angiography in a large healthy population

PurposeTo provide a normative data set of the relationship between macular and papillary vessel density (VD) using swept-source optical coherence tomography angiography (SS-OCTA) in a large healthy population.MethodsCross-sectional study conducted on 346 right eyes of healthy subjects. Macular and papillary SS-OCTA VD measurements of the retinal superficial capillary plexus (SCP), deep capillary plexus (DCP), and choriocapillaris (CC) in the central area and the four quadrants were obtained. Correlations between macular and papillary VD among different quadrants were assessed.ResultsThe mean participant age was 37.7 ± 19.8 years (range 5–83); 59% were women. No correlation was detected neither for the global SCP (R = 0.050; P = 0.040), DCP (R = -0.056; P = 0.038) nor CC (R = 0.102; P < 0.001) between macular and papillary VD. In a subanalysis, there was also no correlation in any of the quadrants studied (R ≤ 0.180; P < 0.001). In a subgroup of 45 left eyes, there was no correlation in the different plexus and layers studied between macular and papillary vasculature. No differences in SCP, DCP and CC were found according to gender, age or axial length in the relationship between macular and papillary VD.ConclusionThere is no association between macular and papillary VD neither in the SCP, DCP or CC in any of the regions studied. Hence, macular and optic nerve head vascularization should be investigated separately to identify which structure is more relevant in each disease.     

Macular optical coherence tomography angiography analysis in diabetes mellitus patients with a history of Covid-19

PurposeThere is evidence of decreased vessel density in optical coherence tomography angiography (OCTA) after Covid-19. We aimed to investigate whether the outcome of retinal vasculopathy would be worse if patients with diabetes mellitus (DM) were infected with coronavirus using OCTA to assess retinal vessels.MethodsOne eye of each subject was included in the study. Diabetic patients without retinopathy and non-diabetic controls were divided into four groups according to their Covid-19 history: group 1=DM(-)Covid-19(-); group 2=DM(+)Covid-19(-); group 3=DM(-)Covid-19(+); and group 4=DM(+)Covid-19(+). All Covid-19 patients were not hospitalised. Macular OCTA scans were performed in a 6 × 6 mm area.ResultsDiabetes had no effect on the area of the foveal avascular zone (FAZ), but Covid-19 caused an increase in FAZ area. Diabetes and Covid-19 had an effect on both the superficial capillary plexus (SCP) and the deep capillary plexus (DCP) in the fovea. Eta squared (ƞ2) is a measure of effect size. The effect size of Covid-19 (ƞ2=0.180) was found to be greater than that of diabetes (ƞ2=0.158) on the SCP, whereas the effect size of diabetes (ƞ2=0.159) was found to be greater than that of Covid-19 (ƞ2=0.091) on the DCP.ConclusionsThe percentage of vessel density was lower in the fovea and the FAZ area was enlarged in the diabetic patients who recovered from Covid-19. In diabetic patients Covid-19 may lead to deterioration of vascular metrics.     

Optical coherence tomography angiography findings in transfusion-dependent beta-thalassemia patients with and without splenectomy

BackgroundOcular involvement is common in transfusion-dependent beta-thalassemia (TDβ-T) patients. We aimed to investigate the effect of splenectomy on optical coherence tomography angiography (OCTA) findings in TDβ-T patients.MethodsThe study is a prospective cross-sectional study. A total of 45 eyes of 23 patients with splenectomy (34.04±8.83 years), 18 eyes of 9 patients without splenectomy (27.44±5.43 years), and 54 eyes of 27 controls (33.22±6.44 years) were included. Vessel density in superficial capillary plexus, deep capillary plexus and radial peripapillary capillary, foveal avascular zone, choriocapillaris flow area, choroidal and retinal thickness detected by OCTA were evaluated. p < 0.05 was considered significant.ResultsVessel density of superficial capillary plexus and deep capillary plexus were similar in patients with and without splenectomy, and controls. Choriocapillaris flow area was significantly decreased in patients with splenectomy than that in those without splenectomy and controls (2.02±0.12 vs. 2.17±0.1 and 2.14±0.12; p < 0.001). Choroidal thickness was significantly lower in patients without splenectomy than in patients with splenectomy and controls (260.05±61.02 vs. 305.11±42.13 and 298.89±29.14, p = 0.008). Parafoveal and perifoveal thickness of the full retina and outer retina were significantly lower in patients without splenectomy than in patients with splenectomy and controls (301.06±10.0, 279.78±10.28 vs. 311.04±14.89, 290.87±13.67 and 316.63±13.57, 289.56±9.31, p < 0.001 and p = 0.002; 174.72±7.81, 167.17±6.21 vs. 182.87±8.81, 173.60±7.09 and 185.11±9.26, 173.96±6.79, p = 0.001 and p < 0.001, respectively).ConclusionsOCTA findings can provide information about the microvascular effects of splenectomy on the retina of patients with TDβ-T.     

Comparison of microvascular parameters and diagnostic ability of optical coherence tomography angiography between eyes with primary angle closure glaucoma and primary open angle glaucoma

BackgroundTo investigate and compare the peripapillary and macular microvascular parameters between eyes with primary angle closure glaucoma (PACG) and primary open-angle glaucoma (POAG) using optical coherence tomography angiography (OCTA).MethodsSeventy-nine eyes of 43 patients with primary angle closure glaucoma (PACG), 78 eyes of 43 patients with primary open-angle glaucoma (POAG), 64 eyes of 35 patients with primary angle closure (PAC), and 73 eyes of 40 control subjects underwent imaging with OCTA. Perfusion density (PD) and vessel density (VD) for the macular area, and PD and flux index (FI) for the peripapillary area were calculated automatically. The area under receiver operator characteristic curves (AUC) were constructed to distinguish PACG and POAG eyes from healthy control eyes.ResultsThe peripapillary FI in all quadrants and PD and VD of the macular outer circle in superior and inferior quadrants were significantly lower in PACG and POAG eyes than in control eyes. The peripapillary FI in the inferior quadrant was significantly lower in the POAG group than in the PACG group (0.348 ± 0.06 vs. 0.369 ± 0.06, p = 0.04). The remaining OCTA parameters in the peripapillary and macular area did not show a significant difference between the POAG and PACG groups. Eyes with PAC presented significantly lower PD and VD than healthy control eyes at the superior and inferior quadrant of the macular outer circle, while retinal nerve fiber layer and ganglion cell inner complex thickness were not significantly different from than control eyes. The best diagnostic parameter was peripapillary FI in both PACG (AUC: 0.922) and POAG (AUC: 0.938) eyes.ConclusionsWe found significantly lower peripapillary FI in the inferior quadrant in POAG eyes compared to the PACG eyes, which may indicate the different underlying pathogenesis between POAG and PACG. The PAC eyes had lower macular PD and VD than normal eyes. This suggests that retinal vascular impairment may develop earlier than structural damage in PAC eyes.     

Choriocapillary regional characteristics in idiopathic macular holes using optical coherence tomography angiography

Purpose: To evaluate the characteristics of vascular density (VD) of the retinal capillary plexuses in idiopathic macular hole (IMH), the fellow eye, and healthy control eyes by optical coherence tomography angiography (OCTA).Methods: A retrospective cases series study involving 20 unilateral eyes (20 patients) with IMH, the unaffected fellow eyes (n = 20) and 20 health controls, with age- and sex-matched, was conducted in Shanxi Eye Hospital from January 2019 to December 2021. VD of the retinal capillary plexuses measurements were obtained by OCTA.Results: Four quadrants of superficial capillary plexuses (SCP) in IMH eyes were not significant compared with that in the unaffected fellow eyes (all P > 0.05). The four quadrants of deep capillary plexuses (DCP) in IMH eyes were lower than that in the unaffected fellow eyes (all P < 0.05). Different regions retinal thickness in the IMH eyes was higher than that in the unaffected fellow eyes (all P < 0.05). a significant negative correlation between deep vessel density and retinal thickness in different quadrants among IMH eyes (all P < 0.05). Additionally, the correlation between the vascular density of SCP and retinal thickness was significant in macular fovea area (= 0.519, P = 0.019). <0.001.Conclusions: The morphology of retina and choroid in idiopathic macular hole is different from that in fellow eye. The thickness of choroid in the fovea area of the unaffected eye also showed a decreasing trend. Taken together, the mechanism of macular hole may be further understood, that is, the decrease of choroid thickness may occur before the macular hole formation. It was verified again that the choroidal blood flow area in macular fovea of IMH patients was significantly lower than that in fellow eyes and healthy eyes.     

Associations between body mass index and choroidal thickness,superficial and deep retinal vascular indices,and foveal avascular zone measured by OCTA

AimThe present study explores the effects of Body Mass Index (BMI) on choroidal thickness, the deep and superficial retinal capillary plexuses, and the foveal avascular zone (FAZ).MethodsThe subjects in this prospective study were divided into five groups based on their calculated BMI. Choroidal thickness, superficial and deep retinal capillary plexuses, and FAZ were measured using enhance depth imaging (EDI) and optical coherence tomography angiography (OCTA). The groups were then compared and correlations with BMI were evaluated.ResultsThe study included 210 eyes of 105 subjects. The comparison of the BMI groups revealed a significant decrease in the mean choroidal thicknesses in the obese groups (p = 0.001), and a significant negative correlation between BMI and mean choroidal thickness (p = 0.02). The results of the analysis of the mean superficial and deep retinal capillary plexuses did not differ between the groups (p = 0.089, p = 0.808 respectively), while the deep FAZ measurements revealed a significant decrease in the obese groups (p = 0.003).ConclusionChoroidal thickness and deep FAZ are significantly negatively correlated with BMI, suggesting potential choroidal and retinal microvascular effects of obesity.     

Quantitative assessment of retinal vessel density and thickness changes in internal carotid artery stenosis patients using optical coherence tomography angiography

ObjectiveTo quantitatively assess the retinal features of patients with different degrees of internal carotid artery stenosis (ICAS), particularly mild ICAS patients, utilizing optical coherence tomography angiography (OCTA).MethodsThirty-two mild ICAS patients (mild ICAS group), 34 moderate to severe ICAS patients (nonmild ICAS group), and 40 controls were enrolled in this study. Retinal vessel density was quantitatively measured by OCTA, including radial peripapillary capillary vessel density (RPC-VD), superficial and deep capillary plexus vessel density (SCP/DCP-VD). Structural parameters were collected from optical coherence tomography (OCT), including retinal thickness and subfoveal choroidal thickness (SFCT). Furthermore, LASSO-penalized logistic regression was used to construct the diagnostic model based on retinal parameters. ROC curves and nomogram plots were used to assess the diagnostic ability of this model for ICAS.ResultsThe macular SCP-VD of mild ICAS patients was significantly lower than that of controls and lower than that of nonmild ICAS patients (all p < 0.05). However, there was no difference among the three groups in terms of DCP-VD (p > 0.05). RPC-VD could effectively discriminate between the mild ICAS group and the nonmild ICAS group (p = 0.005). For structural OCT, only the SFCT decreased as the ICAS degree increased (p < 0.05). Diagnostic scores based on retinal parameters showed a strong diagnostic capability for mild ICAS (AUC = 0.8656).ConclusionMild ICAS patients exhibited distinct retinal features compared to nonmild ICAS patients and control subjects. OCTA potentially represents a promising method for the early detection of ICAS patients and the noninvasive surveillance of haemodynamic changes in those patients.     

Evaluation of peripapillary - macular microvascularity and choroidal vascularity index after refractive surgery

BackgroundTo evaluate the microvascularity and choroidal vascularity index (CVI) using optical coherence tomography angiography (OCTA) and OCT following femtosecond laser-assisted in-situ keratomileusis (FS-LASIK) and small incision lenticule extraction (SMILE) procedures.MethodsPatients with myopia (<-6.0D sphere) or myopic astigmatism (<-4.0D astigmatism) were enroled. The percentage of vessel density and foveal avascular zone (FAZ) size, optic disc flux index and perfusion were noted and the CVI was calculated before and after surgery.ResultsTwenty-nine eyes of 16 patients in the FS-LASIK group and 30 eyes of 16 patients in the SMILE group were enroled. Macular vessel density, FAZ size, and optic disc flux index were significantly higher on postoperative 1st day compared to preoperative day (p = 0.001, p = 0.007, and p < 0.001, respectively). There was no significant difference in terms of macular and peripapillary CVI between postoperative 1st day and preoperative day (p > 0.05). All microvascular parameters were similar on postoperative 7th day and preoperative day (p > 0.05).ConclusionsIt was detected that there is a transient alteration in macular and peripapillary microvascularity after FS-LASIK/SMILE, whereas choroidal circularity is not significantly affected by these refractive surgeries.     

Comparison of peripapillary and macular vascular density in primary open-angle glaucoma,pseudoexfoliation glaucoma,and normal control eyes

PurposeTo compare the optical coherence tomography angiography (OCT-A) of the macula, and optic disc in primary open-angle glaucoma (POAG), pseudoexfoliation glaucoma (PXG), and normal eyes.MethodsIn this observational, cross-sectional study, Sixty–five eyes with POAG, 61 eyes of age, and mean deviation (MD) from standard automated perimetry matched PXG patients, and 45 normal control eyes underwent OCT-A using AngioVue, and optic disc-associated vessel density (VD), macular-associated VD, Foveal avascular zone (FAZ) area, FAZ perimeter (PERIM), and vessel density within a 300 μm wide region of the FAZ (FD) were compared between groups.ResultsPeripapillary OCT-A parameters were significantly different among normal, and glaucomatous eyes with the highest values in the control eyes, but none of the peripapillary OCT-A parameters except inside disc VD was statistically significantly different between the PXG eyes, and POAG eyes. Correlation analysis revealed significant correlation between mean retinal nerve fiber layer (RNFL) and peripapillary VD in control (r = 0.427, P = 0.006), PXG (r = 0.82, P<0.001), and POAG (r = 0.79, P<0.001) eyes.PXG eyes exhibited significantly lower superficial, and deep macular vessel densities in parafoveal and perifoveal regions compared with POAG eyes after adjustment (p<= 0.05). Overall, moderate /severe PXG eyes had lower superficial, and deep vessel densities in parafoveal and perifoveal regions compared to mild PXG.ConclusionPeripapillary VD (inside disc), and macular vessel densities (parafovea and perifovea) demonstrate a significant difference in age and glaucoma severity-matched POAG and PXG eyes. Moderate/advance glaucomatous eyes, exhibit significant damage to the superficial and deep macular vascular structures.     

Macular and peripapillary optical coherence tomography angiography metrics in thyroid-associated ophthalmopathy with chorioretinal folds

PurposeTo evaluate macular and radial peripapillary capillary (RPC) microvascular densities and the thickness of the retinal nerve fiber layer (RNFL) in thyroid-associated ophthalmopathy (TAO) with chorioretinal folds (CRFs) and the associations of these characteristics with visual function.MethodA cross-sectional study was performed at the Ophthalmology Department of the Sun Yat-sen Memorial Hospital from March 2018 to August 2021. All patients underwent ocular examination, ophthalmic function tests and optical coherence tomography angiography (OCTA). The microvascular densities in the macula and optic papilla in the TAO with CRFs or without CRFs. Correlation analyses were used to examine the association of microvascular density and visual function.ResultsTen TAO patients with CRFs (CRF group, 20 eyes) and 10 TAO patients without CRFs (NCRF group, 20 eyes) were recruited for the study. Visual function measurements, including best-corrected visual acuity (BCVA), were found to be worse in the CRF group (all p < 0.05). The macular whole-image vessel density in the superficial layer (SLR-mwiVD) was significantly decreased in the CRF group (p < 0.05). The RPC whole-image vessel density (RPC-wiVD) was significantly decreased in the CRF group (p < 0.05), particularly in the temporal subfields. The P100 amplitude of visual evoked potentials (VEPs) was positively associated with SLR-mwiVD and RPC-wiVD. The thickness of RNFL in the CRF group was obviously thicker than that in the NCRF group (p < 0.05).ConclusionsOur study showed decreased microvascular density of the macula and RPC and thicker RNFL in TAO patients with CRFs. CRFs with decreased microvascular density should be regard as an indicator of visually threatening conditions.     

Morphological changes in retinochoroidal microvasculature after caffeinated versus decaffeinated coffee consumption

BackgroundTo investigate changes in retinochoroidal microvascular morphology after caffeinated versus decaffeinated coffee consumption in age- and gender-matched healthy individuals using optical coherence tomography (OCT) and OCT angiography (OCTA).MethodsIn this prospective, randomized clinical study, a staff member in charge of record keeping randomly assigned 48 healthy volunteers to two groups: caffeinated coffee consumers (24 eyes) and decaffeinated coffee consumers (24 eyes). Participants' ages and genders were recorded before consumption, and a comprehensive ophthalmologic exam was performed, followed by OCT and OCTA analyses before, 30 min, one, six, and 24 h after blindly consuming either of the coffees.ResultsCaffeinated and decaffeinated coffee consumers had mean ages of 23.45 ± 0.92 and 22.73 ± 1.13, respectively (p = 0.407). The following parameters changed significantly in caffeinated coffee consumers 30 min and 1 h post-consumption (pre-consumption versus 30 min versus one hour post-consumption; p < 0.05): a) parafoveal superficial capillary plexus vessel density (%): 54.45 versus 51.8 versus 51.92, b) parafoveal deep capillary plexus vessel density (%): 55.16 versus 52.45 versus 52.83, c) outer retinal flow area (%): 8.87 ± 1.91 versus 8.03 ± 1.88 versus 8.11 ± 1.93, d) choriocapillaris flow area (mm²): 20.95 ± 0.98 versus 19.82 ± 1.20 a versus 19.62 ± 0.95, and e) sub-foveal choroidal thickness (µm): 295.06 ± 5.45 versus 277.08 ± 5.33 versus 260.71 ± 58.61. No significant differences in any OCT and OCTA parameters were found between consecutive measurements in decaffeinated coffee consumers (p > 0.05).ConclusionsCaffeinated coffee appears to transiently reduce parafoveal vessel density, capillary flow area, and sub-foveal choroidal thickness. Lack of these microvascular morphological changes in decaffeinated coffee suggests a potential caffeine-induced vasoconstrictive effect.     

Quantitative changes in peripapillary,macular, and choriocapillaris microvasculature of patients with non-ocular Behçet's disease and relationship with systemic vascular involvement,an optical coherence tomography angiography study

BackgroundTo evaluate the changes in the peripapillary, macular and choriocapillaris microvasculatures in the eyes of patients with Behçet's disease (BD) without ocular involvement by optical coherence tomography angiography (OCT-A) and to investigate the relationship with systemic vascular involvement (SVI).MethodsThe study included 56 eyes of 33 patients with non-ocular BD and 61 eyes of 33 healthy subjects. The macular microvascular (MMV) vessel densities (VDs), FAZ parameters, Choriocapillaris flow area (CCFA), radial peripapillary capillary (RPC) VDs and optic nerve head (ONH) analyses were performed with OCT-A. MMV, RPC, ONH, and CCFA measurements were compared between the non-ocular BD patients and healthy controls. Then, the patient group was divided into two subgroups according to the presence of SVI. MMV, RPC, and CCFA measurements of these subgroups were compared with the healthy controls.ResultsWhile deep capillary plexus VD and foveal density decreased in MMV analysis in the BD group compared to the control group, CCFA was not different. In the RPC and ONH analysis, the VDs of the inside-disc small vessels and the VDs of the inside-disc all vessels were decreased while the cup/disk area ratio and cup volume were increased in the BD group compared to the healthy controls. Furthermore, the VDs of the inside-disc vessels were reduced in patients without SVI compared to those with SVI and healthy controls.ConclusionsThe RPC network, ONH and MMV architecture analysis by OCT-A revealed changes in the MMV, RPC, and ONH structures in non-ocular BD patients. Moreover, the decrease in RPC VDs and MMV VDs in patients without SVI suggested that the patients with BD without SVI had subclinical ocular involvement even in the absence of clinical ocular findings.     

Investigation of changes in retinal vascular parameters and choroidal vascular index values during the early recovery period of COVID-19: The COVID-OCTA study

BackgroundCOVID-19 effects microvasculature in many tissues. This study investigated whether the choroidal structure is also affected.MethodsThis cross-sectional study included 80 patients with COVID-19 and the same number of age- and gender-matched healthy individuals. All participants' right eye measurements were examined. Optical coherence tomography angiography (OCTA) was used for imaging. Otherwise, two independent researchers used the Choroidal vascular index (CVI) for choroidal parameters calculation.ResultsSuperior and deep flow values were lower in the COVID-19 group than in the control group, and vascular density (VD) values were lower in all regions in this group. Except for the superior mean VD, there was no statistically significant difference (p = 0.003). However, the COVID-19 group had significantly lower subfoveal choroidal thickness (SFChT) measurements than the control group (p = 0.001). In addition, no significant difference was observed between the groups in evaluating mean CVI values (p>0.05).ConclusionNoninvasive diagnostic tools such as OCTA and EDI-OCT can be used to monitor early changes in diseases affecting microvessels, such as from COVID-19.     

Is it useful to do OCTA in coronary artery disease patients to improve SYNTAX-based cardiac revascularization decision?

BackgroundTo investigate retinal and optic disk microcirculation using optical coherence tomography angiography (OCTA) in order to predict related outcomes based on the SYNergy between PCI with TAXUS and Cardiac Surgery (SYNTAX) score (SS) system in coronary artery disease patients.Methods104 patients were grouped based on coronary angiography results: 32 chronic coronary syndrome (CCS) patients, 35 acute coronary syndrome (ACS) patients, and 37 healthy controls. The SS system determined atherosclerosis degree and lesion-related mortality risk, followed by scoring as SYNTAX I score (SS-I) and SYNTAX II score (SS-II). Patients were further subdivided into SS-I, SS-II percutaneous coronary intervention (PCI), and SS-II coronary artery by-pass grafting (CABG) groups. Following a thorough ophthalmological examination, an OCTA Angio Retina mode (6 × 6 mm) automatically quantified retinal and optic disk microcirculation.ResultsThe mean ages did not differ significantly among groups (p = 0.940). The outer retinal select area varied significantly among groups, with the highest values found in ACS patients (p = 0.040). Despite non-significant differences between SS-I patients and healthy controls, the former had lower capillary plexus vessel densities in all regions and in foveal vessel density 300 μm around foveal avascular zone (FD-300) (p>0.05). Vessel densities were lowest in SS-II PCI≥28.5 patients, particularly in whole (p = 0.034) and parafoveal (p = 0.009) superficial capillary plexus, and in FD-300 (p = 0.019). Vessel densities were lowest in SS-II CABG (p = 0.020), and perifoveal (p = 0.017) deep capillary plexus, and in FD-300 (p = 0.003). The outer retina flow area increased the most in SS-II CABG≥25.1 patients (p = 0.020).ConclusionsUsing OCTA, a non-invasive imaging technique, to assess retinal and optic disk microcirculation appears to have the potential to yield significant clinical results in the early diagnosis or prognosis of cardiovascular diseases.     

Optic nerve head vessel density in patients with pseudoexfoliation syndrome/glaucoma: A systematic review and meta-analysis

PurposeExfoliative material has been shown to accumulate in ocular and systemic tissues. We aimed to perform a systematic review and meta-analysis of the current literature evaluating optic nerve head vessel density (VD) using optical coherence tomography angiography (OCTA) in patients with XFS and XFG.MethodsStudies were retrieved from PubMed, Scopus, and Web of Science databases. Studies comparing patients with XFS and/or XFG patients to healthy controls, using the optic nerve head-centred 4.5 × 4.5 mm square OCTA scan protocol were included. Pooled results are presented as standardised mean differences with 95% confidence intervals (CI). Meta-regression analysis was performed between mean difference in circumpapillary VD between XFG and controls and mean pRNFL thickness in patients with XFG.ResultsFifteen studies with 1475 eyes were included in this review. Whole image VD and circumpapillary VD (cpVD) were significantly decreased in patients with XFS [−0.78(95% Cl: −1.08, −0.47); −0.55(95% Cl: −0.80, −0.30); respectively] and XFG [−1.85(95% CI: −2.33, −1.36); −1.84 (95% CI: −2.30, −1.39); respectively] compared to healthy controls. Furthermore, pRNFL thickness decreased in patients with XFS [−0.55(95% Cl: −0.72, −0.35)] and XFG [−1.78(95% Cl: −2.21, −1.36)] compared to healthy controls. Meta-regression showed that pRNFL thickness decreased with increasing mean cpVD difference in XFG patients compared to healthy controls.ConclusionsOCTA provides non-invasive, objective and reproducible assessment of peripapillary VD and is important for the detection of vasculopathy in patients with XFS or XFG. This study provides strong evidence for decreased cpVD in the eyes of patients with XFS and XFG.     

Retinal findings of COVID-19 patients using ocular coherence tomography angiography two to three months after infection: Ocular appearance recovered COVID-19 patient

PurposeThe aim of this study was to evaluate the ocular disorders in COVID-19 patients, two to three months after infection.MethodsIn this cross-sectional, historically controlled study, fifty-one COVID-19 patients were compared with thirty-seven age, and gender-matched healthy individuals. After complete ophthalmological examination, all participants underwent peripapillary and macular optical coherence tomography, and optical coherence tomography angiography (OCTA) measurements (OptoVue Inc, Freemont, CA, USA).ResultsThe time between the initial onset of symptoms, and ophthalmologic examination was 63.31±15.21 (40–95 days). Ophthalmic examination of all the recovered COVID-19 patients was within normal range. None of the peripapillary and macular OCTA parameters were significantly different between the two groups with pairwise comparisons, but after adjusting for age, gender, axial length, and signal strength index (SSI), recovered COVID-19 eyes showed a significant increase in peripapillary retinal nerve fiber (RNFL) thickness, superficial, and deep macular vessel densities in parafoveal and perifoveal regions compared with healthy control eyes (p<= 0.05). Inner retinal thickness overall is higher in recovered COVID-19 eyes compared to healthy eyes after adjustment.ConclusionPatients with moderate-intensity SARS-CoV-2 pneumonia had altered peripapillary and macular vessel density compared to healthy subjects. Further investigation is warranted to analyze the correlation of these changes with disease severity as well as evolution of these changes over time.