Optical coherence tomography angiography features of retinal artery occlusion before and after intra-arterial thrombolysis

Medicine Advances Pub Date : 2023-03-31 DOI:10.1002/med4.14
Qiaowei Wu, Yongyi Niu, Daiyu Chen, Hongbin Lin, Mingkui Tan, Yijun Hu, Honghua Yu, Anyi Liang
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Abstract

Background

To evaluate the ability of optical coherence tomography angiography (OCTA) to quantitatively assess the effectiveness of intra-arterial thrombolysis (IAT) surgery for the treatment of retinal artery occlusion (RAO).

Methods

This was a prospective observational study. Patients diagnosed with RAO who received IAT were enrolled. All participants underwent comprehensive ophthalmologic examinations and OCTA scans. The best-corrected visual acuity (BCVA), vascular densities (VDs) of the superficial capillary plexus (SCP), deep capillary plexus (DCP), radial peripapillary capillaries, and central retinal thickness (CRT) were recorded. The above parameters were compared between RAO eyes and the fellow healthy eyes before and after IAT. Correlations between the BCVA and OCTA parameters in RAO eyes were calculated.

Results

Thirty-four eyes from 34 consecutive RAO patients with a mean age of 51.0 ± 12.9 years were enrolled. There was a considerable decrease of VDs in the SCP, DCP, and radial peripapillary capillaries in all RAO eyes (all p < 0.001). Compared with contralateral normal eyes, CRT was significantly increased in RAO eyes (p < 0.001). The SCP and DCP VDs were significantly improved after IAT surgery (p = 0.010 and 0.014, respectively). BCVA in logMAR unit was negatively correlated with the DCP VD (r = −0.664, p = 0.010) and positively correlated with CRT (r = 0.597, p = 0.024) after surgery, but not significantly correlated with VDs or CRT before surgery.

Conclusion

Macular and peripapillary VDs of the retina detected by OCTA were greatly decreased in RAO eyes and improved after IAT treatment. OCTA is capable of quantifying VDs in separate retinal layers non-invasively, conveniently, efficiently, and precisely.

Abstract Image

动脉内溶栓前后视网膜动脉闭塞的光学相干断层扫描血管造影特征
背景评价光学相干断层扫描血管造影术(OCTA)定量评估动脉内溶栓(IAT)手术治疗视网膜动脉闭塞(RAO)的有效性的能力。方法本研究为前瞻性观察研究。接受IAT的诊断为RAO的患者被纳入研究。所有参与者都接受了全面的眼科检查和OCTA扫描。记录最佳矫正视力(BCVA)、浅毛细血管丛(SCP)、深毛细血管丛(DCP)、径向乳头周围毛细血管的血管密度(VDs)和视网膜中央厚度(CRT)。将上述参数在IAT前后在RAO眼睛和其他健康眼睛之间进行比较。计算RAO眼BCVA和OCTA参数之间的相关性。结果34例RAO患者共34眼,平均年龄51.0±12.9岁。所有RAO眼的SCP、DCP和径向乳头周围毛细血管中的VDs均显著降低(均p<0.001)。与对侧正常眼相比,RAO眼中的CRT显著增加(p>0.001)。IAT手术后SCP和DCP VDs显著改善(分别为p=0.010和0.014)。logMAR单位的BCVA与术后DCP VD呈负相关(r=-0.664,p=0.010),与CRT呈正相关(r=0.597,p=0.024),但与术前VDs或CRT无显著相关性。结论OCTA检测RAO患者视网膜黄斑和乳头周围VDs明显降低,IAT治疗后视网膜黄斑和乳突周围VDs有所改善。OCTA能够无创、方便、高效、准确地量化独立视网膜层中的VDs。
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