Chong Chen,Kayla Nicole Nodecker,Rajiv M Sastry,Leiyu Wang,Xinyi Ding,Ying Zhu,Francesco Romano,Filippos Vingopoulos,Robbert Roel Struyven,Ioanna Ploumi,Selin S Gumustop,Shivesh Himanshu Shah,Sarah Lillian Wagner,Nimesh A Patel,Leo A Kim,David M Wu,Demetrios Vavvas,Deeba Husain,Joan W Miller,John B Miller
{"title":"视网膜动脉闭塞与视力预后相关的微血管变化和成像生物标志物的纵向评价。","authors":"Chong Chen,Kayla Nicole Nodecker,Rajiv M Sastry,Leiyu Wang,Xinyi Ding,Ying Zhu,Francesco Romano,Filippos Vingopoulos,Robbert Roel Struyven,Ioanna Ploumi,Selin S Gumustop,Shivesh Himanshu Shah,Sarah Lillian Wagner,Nimesh A Patel,Leo A Kim,David M Wu,Demetrios Vavvas,Deeba Husain,Joan W Miller,John B Miller","doi":"10.1016/j.ajo.2025.09.031","DOIUrl":null,"url":null,"abstract":"PURPOSE\r\nTo longitudinally assess changes in macular thickness and microvascular metrics in retinal artery occlusion (RAO) patients, and to identify imaging biomarkers associated with visual prognosis.\r\n\r\nDESIGN\r\nRetrospective cohort study.\r\n\r\nPARTICIPANTS\r\n56 RAO patients (57 eyes) and 27 controls (30 eyes).\r\n\r\nMETHODS\r\nComprehensive ophthalmic evaluations were performed, including macular OCT and 6 × 6 mm swept-source OCT angiography (SS-OCTA). Retinal thickness, macular ischemic area, ischemia-fovea distance, vessel skeletonized density (VSD), vessel density (VD), and foveal avascular zone (FAZ) area were quantified. Receiver operating characteristic (ROC) and linear regression analyses assessed imaging biomarkers correlated with visual outcomes.\r\n\r\nMAIN OUTCOME MEASURES\r\nLongitudinal changes in retinal structure and microvasculature, and their associations with final visual acuity (VA).\r\n\r\nRESULTS\r\nAmong 57 RAO eyes (28 BRAO) with a median follow-up of 83.0 (35.5, 172.0) weeks, retinal thickness significantly decreased over time (p < 0.05), while macular ischemic area expanded from 64.97% to 73.58% (p = 0.002). In a subset of 24 RAO eyes with longitudinal SS-OCTA scans, eyes with a baseline ischemic area ≤ 1/3 of the scan area showed increased VSD and VD in both plexuses over time (p < 0.05). FAZ area was significantly larger in CRAO compared to BRAO (p = 0.0001), although no statistically significant change in FAZ area was observed over time (p = 0.341), a numerical increase was noted in CRAO cases. Better baseline VA, greater ischemic distance to fovea, smaller initial ischemic area, higher VSD and VD in SCP, and smaller FAZ area were associated with better final VA (all p < 0.05, AUC: 0.80-0.89). Multivariable linear regression identified baseline ischemic area and FAZ area as independent predictors of final VA (p = 0.003, 0.008).\r\n\r\nCONCLUSIONS\r\nMultimodal quantification demonstrates the progressive ischemia in RAO and potential reperfusion in eyes with limited involvement. Ischemic area and FAZ area are key imaging biomarkers for visual prognosis.","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"1 1","pages":""},"PeriodicalIF":4.2000,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Longitudinal Evaluation of Microvascular Changes and Imaging Biomarkers Associated with Visual Prognosis in Retinal Artery Occlusion.\",\"authors\":\"Chong Chen,Kayla Nicole Nodecker,Rajiv M Sastry,Leiyu Wang,Xinyi Ding,Ying Zhu,Francesco Romano,Filippos Vingopoulos,Robbert Roel Struyven,Ioanna Ploumi,Selin S Gumustop,Shivesh Himanshu Shah,Sarah Lillian Wagner,Nimesh A Patel,Leo A Kim,David M Wu,Demetrios Vavvas,Deeba Husain,Joan W Miller,John B Miller\",\"doi\":\"10.1016/j.ajo.2025.09.031\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"PURPOSE\\r\\nTo longitudinally assess changes in macular thickness and microvascular metrics in retinal artery occlusion (RAO) patients, and to identify imaging biomarkers associated with visual prognosis.\\r\\n\\r\\nDESIGN\\r\\nRetrospective cohort study.\\r\\n\\r\\nPARTICIPANTS\\r\\n56 RAO patients (57 eyes) and 27 controls (30 eyes).\\r\\n\\r\\nMETHODS\\r\\nComprehensive ophthalmic evaluations were performed, including macular OCT and 6 × 6 mm swept-source OCT angiography (SS-OCTA). Retinal thickness, macular ischemic area, ischemia-fovea distance, vessel skeletonized density (VSD), vessel density (VD), and foveal avascular zone (FAZ) area were quantified. Receiver operating characteristic (ROC) and linear regression analyses assessed imaging biomarkers correlated with visual outcomes.\\r\\n\\r\\nMAIN OUTCOME MEASURES\\r\\nLongitudinal changes in retinal structure and microvasculature, and their associations with final visual acuity (VA).\\r\\n\\r\\nRESULTS\\r\\nAmong 57 RAO eyes (28 BRAO) with a median follow-up of 83.0 (35.5, 172.0) weeks, retinal thickness significantly decreased over time (p < 0.05), while macular ischemic area expanded from 64.97% to 73.58% (p = 0.002). In a subset of 24 RAO eyes with longitudinal SS-OCTA scans, eyes with a baseline ischemic area ≤ 1/3 of the scan area showed increased VSD and VD in both plexuses over time (p < 0.05). FAZ area was significantly larger in CRAO compared to BRAO (p = 0.0001), although no statistically significant change in FAZ area was observed over time (p = 0.341), a numerical increase was noted in CRAO cases. Better baseline VA, greater ischemic distance to fovea, smaller initial ischemic area, higher VSD and VD in SCP, and smaller FAZ area were associated with better final VA (all p < 0.05, AUC: 0.80-0.89). Multivariable linear regression identified baseline ischemic area and FAZ area as independent predictors of final VA (p = 0.003, 0.008).\\r\\n\\r\\nCONCLUSIONS\\r\\nMultimodal quantification demonstrates the progressive ischemia in RAO and potential reperfusion in eyes with limited involvement. 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Longitudinal Evaluation of Microvascular Changes and Imaging Biomarkers Associated with Visual Prognosis in Retinal Artery Occlusion.
PURPOSE
To longitudinally assess changes in macular thickness and microvascular metrics in retinal artery occlusion (RAO) patients, and to identify imaging biomarkers associated with visual prognosis.
DESIGN
Retrospective cohort study.
PARTICIPANTS
56 RAO patients (57 eyes) and 27 controls (30 eyes).
METHODS
Comprehensive ophthalmic evaluations were performed, including macular OCT and 6 × 6 mm swept-source OCT angiography (SS-OCTA). Retinal thickness, macular ischemic area, ischemia-fovea distance, vessel skeletonized density (VSD), vessel density (VD), and foveal avascular zone (FAZ) area were quantified. Receiver operating characteristic (ROC) and linear regression analyses assessed imaging biomarkers correlated with visual outcomes.
MAIN OUTCOME MEASURES
Longitudinal changes in retinal structure and microvasculature, and their associations with final visual acuity (VA).
RESULTS
Among 57 RAO eyes (28 BRAO) with a median follow-up of 83.0 (35.5, 172.0) weeks, retinal thickness significantly decreased over time (p < 0.05), while macular ischemic area expanded from 64.97% to 73.58% (p = 0.002). In a subset of 24 RAO eyes with longitudinal SS-OCTA scans, eyes with a baseline ischemic area ≤ 1/3 of the scan area showed increased VSD and VD in both plexuses over time (p < 0.05). FAZ area was significantly larger in CRAO compared to BRAO (p = 0.0001), although no statistically significant change in FAZ area was observed over time (p = 0.341), a numerical increase was noted in CRAO cases. Better baseline VA, greater ischemic distance to fovea, smaller initial ischemic area, higher VSD and VD in SCP, and smaller FAZ area were associated with better final VA (all p < 0.05, AUC: 0.80-0.89). Multivariable linear regression identified baseline ischemic area and FAZ area as independent predictors of final VA (p = 0.003, 0.008).
CONCLUSIONS
Multimodal quantification demonstrates the progressive ischemia in RAO and potential reperfusion in eyes with limited involvement. Ischemic area and FAZ area are key imaging biomarkers for visual prognosis.
期刊介绍:
The American Journal of Ophthalmology is a peer-reviewed, scientific publication that welcomes the submission of original, previously unpublished manuscripts directed to ophthalmologists and visual science specialists describing clinical investigations, clinical observations, and clinically relevant laboratory investigations. Published monthly since 1884, the full text of the American Journal of Ophthalmology and supplementary material are also presented online at www.AJO.com and on ScienceDirect.
The American Journal of Ophthalmology publishes Full-Length Articles, Perspectives, Editorials, Correspondences, Books Reports and Announcements. Brief Reports and Case Reports are no longer published. We recommend submitting Brief Reports and Case Reports to our companion publication, the American Journal of Ophthalmology Case Reports.
Manuscripts are accepted with the understanding that they have not been and will not be published elsewhere substantially in any format, and that there are no ethical problems with the content or data collection. Authors may be requested to produce the data upon which the manuscript is based and to answer expeditiously any questions about the manuscript or its authors.