Changes in wider field swept-source OCT angiography vascular metrics with anti-vascular endothelial growth factor therapy in central retinal vein occlusion

Peyman Razavi; Grace Baldwin; Itika Garg; Luis Martinez Velazquez; Mauricio Garcia; Jenny Gan; Hanna Choi; Rebecca Zeng; Filippos Vingopoulos; Deeba Husain; Leo A Kim; Nimesh A Patel; John B Miller

doi:10.1007/s00417-024-06410-3

Changes in wider field swept-source OCT angiography vascular metrics with anti-vascular endothelial growth factor therapy in central retinal vein occlusion

Graefes Arch Clin Exp Ophthalmol. 2024 Feb 20. doi: 10.1007/s00417-024-06410-3. Online ahead of print.

Authors

Affiliations

¹ Harvard Retinal Imaging Lab, Boston, MA, USA.
² Retina Service, Massachusetts Eye and Ear, Boston, MA, USA.
³ Harvard Retinal Imaging Lab, Boston, MA, USA. John_Miller@meei.harvard.edu.
⁴ Retina Service, Massachusetts Eye and Ear, Boston, MA, USA. John_Miller@meei.harvard.edu.
⁵ Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Retinal Imaging Lab, Harvard Medical School, 243 Charles St., Boston, MA, 02114, USA. John_Miller@meei.harvard.edu.

PMID: 38376563
DOI: 10.1007/s00417-024-06410-3

Abstract

Purpose: To investigate the impact of anti-VEGF therapy on vascular metrics in eyes with macular edema secondary to central retinal vein occlusion (CRVO) using wider field swept-source OCT angiography (WF SS-OCTA).

Methods: We included 23 eyes with macular edema associated with non-ischemic CRVO from 22 patients treated with anti-VEGF therapy (median number of injections: 5 [2-9]). Changes in vessel density (VD), vessel skeletonized density (VSD), and foveal avascular zone (FAZ) parameters were measured using WF SS-OCTA. Visual acuity (VA) and central subfield thickness (CST) were also measured.

Results: Median CST decreased significantly from 369 µm (305-531) to 267 µm (243-300, p < 0.001). VD and VSD parameters in 12 × 12 mm images showed significant reductions. For instance, VSD in the whole retina decreased from a median of 13.37 (11.22-13.74) to 11.29 (9.36-12.97, p = 0.013). Additionally, a significant increase in FAZ circularity was found, suggesting improved microvascular integrity. Significant inverse correlations were found between the number of anti-VEGF injections and all VSD and VD parameters on the 12 × 12 mm images (p < 0.05). Notably, the reductions in VSD and VD on 12 × 12 mm angiograms in the deep capillary plexus (DCP) after each injection significantly correlated with increased logMAR VA (worse VA).

Conclusion: Anti-VEGF therapy in CRVO patients not only mitigates macular edema but also alters the overall microvascular morphology and functionality as revealed by WF SS-OCTA.

Keywords: Anti-VEGF; Central retinal vein occlusion (CRVO); Vascular metrics; Vessel density; Wide field OCTA.

Abstract

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