Purpose: To investigate the relationship between best-corrected visual acuity (BCVA) and the foveal avascular zone (FAZ) in patients with central retinal vein occlusion (CRVO) evaluated with optical coherence angiography (OCT-A).
Methods: The study was a prospective consecutive case series including 24 patients with CRVO. All patients received either aflibercept or ranibizumab intravitreal injections prior to analysis. Best-corrected visual acuity and FAZ were evaluated in eyes without macular edema. The FAZ areas were evaluated with OCT-A in both the superficial and deep capillary plexus layers by using 3 × 3-mm images of the macula. Disruption of the ellipsoid zone (EZ) was also analyzed.
Results: The mean superficial FAZ area measured 0.76 mm2 (95% confidence interval [CI] 0.50-1.13). The mean deep FAZ area measured 1.12 mm2 (95% CI 0.77-1.47). In a multivariable analysis a negative correlation was found between the BCVA and the superficial FAZ area (r = -0.54, P = 0.03). The correlation between the BCVA and deep FAZ area did not meet statistical significance (r = -0.43, P = 0.09). In a multivariable analysis, disruption of the ellipsoid zone was significantly correlated to a larger superficial FAZ area (r = 0.68, P = <0.001) and poor visual acuity (r = 0.75, P < 0.001).
Conclusions: Optical coherence tomography-A is a novel technique that allows segmented evaluation of the FAZ in patients with CRVO providing additional prognostic information. The FAZ areas were enlarged both in the superficial and the deep capillary networks. A significant correlation was found between BCVA and the FAZ area in CRVO patients without macular edema (ClinicalTrials.gov, number NCT02274259).