J Korean Ophthalmol Soc.  2017 Jul;58(7):818-827. 10.3341/jkos.2017.58.7.818.

Efficacy of Optical Coherence Tomography Angiography in Measuring the Foveal Avascular Zone Area in Patients with Branch Retinal Vein Occlusion

• Lee S
• Min JK
• Woo JM

• KMID: 2387156
• DOI: http://doi.org/10.3341/jkos.2017.58.7.818

Abstract

PURPOSE
To evaluate the efficacy of optical coherence tomography angiography (OCTA) by measuring the foveal avascular zone (FAZ) area in patients with branch retinal vein occlusion (BRVO).
METHODS
Thirty four eyes of 34 patients with BRVO were retrospectively reviewed. The area of the FAZ was calculated using fluorescein angiography (FAG) and OCTA. The FAZ area was divided into two groups according to the presence of macular edema, which was determined based on the central foveal thickness (300 µm), and then the measured areas were compared.
RESULTS
Pearson's correlation analysis revealed a significant positive correlation between FAG and the superficial capillary plexus (SCP) in OCTA with or without macular edema (r = 0.845, p = 0.001). However, there was not a significant correlation between FAG and the deep capillary plexus (DCP) in OCTA (r = 0.001, p = 0.996). In addition, the FAZ area measured by FAG and OCTA in the SCP showed a significant agreement between the two methods (intraclass correlation coefficient [ICC] = 0.916, p = 0.001). However, there was no significant relation found for the FAZ area between FAG and OCTA in the DCP (ICC = 0.001, p = 0.501).
CONCLUSIONS
In the patients with BRVO, OCTA can be used to measure the FAZ areas in both the SCP and DCP, beyond measurement of the FAZ area at the two-dimensional cross section used during FAG. The FAZ area in the SCP via OCTA showed a statistically significant correlation with the FAZ area determined by FAG, but there was no such correlation in the DCP. That said, the FAZ area in the DCP was positively correlated with a decrease in visual acuity among the patients, which may be an indicator of visual prognosis.

Keyword

Branch retinal vein occlusion (BRVO); Fluorescein angiography (FAG); Foveal avascular zone (FAZ); Macular edema (ME); Optical coherence tomography angiography (OCTA)

MeSH Terms

Angiography*
Capillaries
Fluorescein Angiography
Humans
Macular Edema
Prognosis
Retinal Vein Occlusion*
Retinal Vein*
Retinaldehyde*
Retrospective Studies
Tomography, Optical Coherence*
Visual Acuity
Retinaldehyde

Figure

• 

  Figure 1. Branch retinal vein occlusion without macular edema. Color fundus photo (A), Fluorescein angiography (FAG; B), Zoom on the fovea in FAG (C), optical coherence tomography angiography (OCTA) in the superficial capillary plexus showed quite nor-mal and well demarcated foveal capillary arcade (D). OCTA in the deep capillary plexus showed dilatation of deep inferior macular capillaries with hyper signal although there was not significant magnified nonperfused area in fovea (E). Optical coherence tomog-raphy showed there was no intraretinal cystic lesion (F).

• 

  Figure 2. Macular edema related to a branch retinal vein occlusion. Color fundus photo (A), Fluorescein angiography (FAG; B), Zoom on the fovea in FAG (C), optical coherence tomography angiography (OCTA) in the superficial capillary plexus showed pret-ty well demarcated foveal capillary arcade although there was disruption of the capillary network superiorly (D). However, OCTA in the deep capillary plexus (DCP) showed central black cysts, disorganization of the deep superior macula and magnified non-perfused area (E). Optical coherence tomography showed multiple intraretinal cysts where the corresponding OCTA in the DCP (F).

• 

  Figure 3. Relationship of foveal avascular zone area measured between fluorescein angiography (FAG) and optical coherence to-mography angiography (OCTA). Pearson’s correlation analysis showed significant positive correlation between FAG and superficial capillary plexus (SCP) in OCTA with or without macular edema (ME) (A: FAG vs. SCP in OCTA, r = 0.845, p = 0.001; B: FAG vs. SCP in OCTA without ME, r = 0.804, p = 0.001; C: FAG vs. SCP in OCTA with ME, r = 0.906, p = 0.001). But, there was not significant correlation between FAG and deep capillary plexus (DCP) in OCTA (D: FAG vs. DCP in OCTA, r = 0.001, p = 0.996; E: FAG vs. DCP in OCTA without ME, r = 0.246, p = 0.359; F: FAG vs. DCP in OCTA with ME, r = 0.106, p = 0.674).

• 

  Figure 4. Relationship of best corrected visual acuity (BCVA; logMAR) and deep capillary plexus (DCP) in optical coherence tomography angiography (OCTA). Pearson's correlation analysis showed significant positive correlation between logMAR and DCP in OCTA (r = 0.724 p = 0.001). logMAR = logarithm of the minimum angle of resolution.

Reference

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