Abstract
Background/objectives
Abnormal retinal neovascularization caused by ischemic retinal vein occlusion (RVO) is a frequent cause of visually significant vitreous hemorrhage. The early detection of new vessels may be challenging and often requires the use of invasive tests such as fundus fluorescein angiography (FA). We demonstrate the use of wide-field optical coherence tomography angiography (WF-OCTA) in the detection and characterization of neovascularization secondary to ischemic RVO.
Subjects/methods
We conducted a retrospective observational case series of patients diagnosed with ischemic RVO between August 2018 and March 2019, who underwent WF-SS-OCTA imaging (PLEX Elite 9000, Carl Zeiss Meditec). We performed real-life montage imaging, covering the involved area and compared the findings of WF-SS-OCTA to standard clinical examination and when available, ultrawide-field fluorescein angiography (UWF-FA, Optos 200TX).
Results
In the included 39 eyes with ischemic RVO, neovascularization elsewhere (NVE) was encountered in 16 of 39 eyes (41%) on WF-OCTA and were characterized as sea-fan type vessels and nodular type vessels, based on their appearance and localization. NVE was identified in 4/39 eyes on standard clinical examination, equating to a detection rate of 10.3%. All were of a sea-fan morphology. In one case, NVE found on WF-OCTA was not observed on UWF-FA, which was a nodular type. Neovascularization of the disc (NVD) was detected in one eye.
Conclusions
WF-OCTA may become a useful noninvasive tool in the detection of neovascularization in patients with ischemic RVO. Furthermore, the characterization of different morphologies of neovascularization detected by WF-OCTA could be of clinical relevance
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Acknowledgements
Presented at: the 19th EURETINA 2019 Congress, Paris, France, September 5-8, 2019. Acknowledgments to the NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK, for supporting the research.
Funding
HK is supported by a scholarship from Egyptian mission sector, Ministry of Higher Education, Egypt. RR has received speaker fees from Carl Zeiss Meditec AG. PAK has received speaker fees from Heidelberg Engineering, Topcon, Carl Zeiss Meditec AG, Haag-Streit, Allergan, Novartis, and Bayer. He has served on advisory boards for Novartis and Bayer and has been an external consultant for DeepMind and Optos. PAK is supported by a United Kingdom (UK) National Institute for Health Research (NIHR) Clinician Scientist Award (NIHR-CS--2014-12-023). Other authors have no financial disclosures. The sponsor had no rule in the design or conduct of this research.
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Huemer, J., Khalid, H., Wagner, S.K. et al. Phenotyping of retinal neovascularization in ischemic retinal vein occlusion using wide field OCT angiography. Eye 35, 2812–2819 (2021). https://doi.org/10.1038/s41433-020-01317-9
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DOI: https://doi.org/10.1038/s41433-020-01317-9
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