Optical Coherence Tomography Angiography in Central Retinal Vein Occlusion: Macular Changes and Their Correlation with Peripheral Nonperfusion at Ultra-Widefield Fluorescein Angiography

Abstract

<b><i>Introduction:</i></b> The aim of this study was to investigate the correlation between ischemic index (ISI) measured on ultra-widefield (UWF) fluorescein angiography (FA) images and macular parameters obtained by optical coherence tomography angiography (OCT-A) in eyes affected by central retinal vein occlusion (CRVO). <b><i>Methods:</i></b> Retrospective study of data from 12 eyes affected by treatment-naïve CRVO. All patients underwent a comprehensive ocular examination including structural OCT, OCT-A, and UWF FA. Variables analyzed included best corrected visual acuity (BCVA) measured with the ETDRS chart; foveal avascular zone (FAZ) area at full-thickness OCT-A angiogram; perfusion density (PD) in the superficial (SCP) and deep capillary plexus (DCP); ISI; and central macular thickness (CMT). <b><i>Results:</i></b> ISI showed a significant positive correlation with FAZ area (<i>r</i> = 0.63, <i>p</i> = 0.019) and a significant negative correlation with PD in the SCP (<i>r</i> = −0.62, <i>p</i> = 0.022), PD in the DCP (<i>r</i> = −0.66, <i>p</i> = 0.011), and BCVA (<i>r</i> = −0.75, <i>p</i> = 0.002). FAZ area also negatively correlated to PD in the SCP (<i>r</i> = −0.75, <i>p</i> = 0.002) and DCP (<i>r</i> = −0.64, <i>p</i> = 0.016). BCVA positively correlated to PD in the SCP (<i>r</i> = 0.67, <i>p</i> = 0.009) and DCP (<i>r</i> = 0.68, <i>p</i> = 0.008), while a negative correlation was found with FAZ area (<i>r</i> = −0.65, <i>p</i> = 0.013) and CMT (<i>r</i> = −0.70, <i>p</i> = 0.006). <b><i>Discussion/Conclusion:</i></b> OCT-A macular parameters (namely, FAZ area and PD of SCP and DCP) significantly correlated with ISI, a quantitative way to assess peripheral retinal nonperfusion on UWF FA. Macular OCT-A analysis may help in assessing the need for additional UWF FA testing in eyes affected by CRVO.