Quantitative Wide-Field Swept-Source Optical Coherence Tomography Angiography and Visual Outcomes in RAO

Abstract

Purpose

Retinal artery occlusion (RAO) is an ophthalmic emergency that can lead to poor visual outcomes and is associated with an increased risk of stroke and cardiovascular events. Wide-field swept-source OCT-A (WF SS-OCTA) can provide quick and non-invasive angiographic information with a wide field of view. Here, we looked for associations between OCT-A vascular imaging metrics and vision in RAO patients.

Methods

Patients with diagnoses of central (CRAO) or branched retinal artery occlusion (BRAO) were included. 6mm × 6mm Angio and 15mm × 15mm AngioPlex Montage OCT-A images were obtained for both eyes in each patient using Zeiss Plex Elite 9000 WF SS-OCTA device. Each 6mm × 6mm image was divided into nine Early Treatment Diabetic Retinopathy Study (ETDRS) subfields. Non-perfusion area (NPA) was manually measured using 15mm × 15mm images. A linear regression model was utilized to identify correlation between imaging metrics and vision. P-values less than 0.05 were considered as statistically significant.

Results

Twenty-five subjects were included. For RAO eyes, there was a statistically significant inverse correlation between retinal thickness as well as superficial capillary plexus (SCP) vessel density (VD) and vision. An inverse correlation was found between deep capillary plexus (DCP) VD and vision without statistical significance. There was a positive correlation between choroidal thickness as well as choroidal volume and vision without statistical significance. No significant correlation was found between the metrics and vision in contralateral eyes. For NPA and vision, no significant correlation was identified.

Conclusion

This is the first study to investigate the utility of WF SS-OCTA in RAO and to demonstrate correlations between retinal vascular imaging metrics and visual outcomes. The results of this study provide a basis to understand the structural changes involved in vision in RAO and may guide management of RAO and prevention of cerebral stroke and cardiovascular accidents.

Keywords:

• WF SS-OCTA
• RAO
• BRAO
• CRAO
• ETDRS
• ARI network

Acknowledgments

The abstract of this paper was presented at the ARVO Annual Meeting 2022 as a poster presentation with interim findings. The poster’s abstract was published in “ARVO Annual Meeting Abstract” in IOVS, June 2022, Vol.63, 2925 – F0078.

Disclosure

J.B.M. is a consultant for Alcon, Allergan, Carl Zeiss, Sunovion, Topcon, and Genentech. J.C.Wang reports personal fees from Zeiss and Genentech, outside the submitted work. J.W.M reports personal fees and royalties paid to Mass Eye and Ear and distributed according to institutional policy from Valeant Pharmaceuticals; personal fees from, Scientific Advisory Board to; stock options from; licensed Patent (not yet commercialized) to ONL Therapeutics; personal fees, Board of Directors of and Stock Options from Aptinyx, Inc.; personal fees for consultancy from Sunovion, personal fees from and Scientific Advisory Board for KalVista Pharmaceuticals, personal fees for consultancy from Heidelberg Engineering, equity in company related to vaccine development from Ciendias Bio, grants from Lowy Medical Research Institute for Mactel Study (no PI salary), outside the submitted work; In addition, J.W.M has patents US 7,811,832, US 5,798,349; US 6,225,303; US 6,610,679; CA 2,185,644; CA 2,536,069 licensed to ONL Therapeutics. The authors report no other conflicts of interest in this work.

Additional information

Funding

Lions International Fund (Grant 530125 and 530869). The funding organization had no role in design or conduct of this research.