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      Optical coherence tomography angiography characteristics of acute retinal arterial occlusion

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          Abstract

          Background

          To characterize the vascular changes in eyes within the acute phase of retinal arterial occlusion (RAO) by optical coherence tomography angiography (OCT-A) imaging.

          Methods

          This was a retrospective, observational study. Nineteen patients with RAO (symptom onset within 7 days) and 19 age and sex-matched normal control individuals were included. A comprehensive ophthalmic examination and OCT-A examination were conducted for all the patients.

          Results

          The vessel density of the superficial capillary plexus (SCP), deep capillary plexus (DCP), and area with a width of 300 μm around the FAZ (FD-300) was significantly reduced in RAO patients compared with that in the fellow eyes and normal control eyes. The vessel density of the SCP of RAO fellow eyes was significantly lower than that of the normal control eyes (all P < 0.05). Though no difference was observed in the FAZ of RAO eyes compared with that of fellow eyes and normal control eyes, the acircularity index (AI) of the FAZ was significantly increased in RAO eyes ( P < 0.05). Central macular thickness (CMT) was correlated with best-corrected visual acuity in central retinal arterial occlusion (CRAO) patients ( r = 0.626, P = 0.024). In BRAO eyes, the vessel density of the RAO-affected hemifield was significantly reduced compared with that of the unaffected hemifield ( P < 0.05). Radial peripapillary plexus (RPC) vessel density was reduced, accompanied by retinal nerve fiber layer (RNFL) thinning in 3 available CRAO patients.

          Conclusions

          As a valuable noninvasive imaging tool, OCT-A provides deeper and more detailed vascular information that extends our understanding of the vasculature alterations in acute RAO.

          Electronic supplementary material

          The online version of this article (10.1186/s12886-019-1152-8) contains supplementary material, which is available to authorized users.

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          Most cited references10

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          Imaging Foveal Microvasculature: Optical Coherence Tomography Angiography Versus Adaptive Optics Scanning Light Ophthalmoscope Fluorescein Angiography

          Purpose To compare the use of optical coherence tomography angiography (OCTA) and adaptive optics scanning light ophthalmoscope fluorescein angiography (AOSLO FA) for characterizing the foveal microvasculature in healthy and vasculopathic eyes. Methods Four healthy controls and 11 vasculopathic patients (4 diabetic retinopathy, 4 retinal vein occlusion, and 3 sickle cell retinopathy) were imaged with OCTA and AOSLO FA. Foveal perfusion maps were semiautomatically skeletonized for quantitative analysis, which included foveal avascular zone (FAZ) metrics (area, perimeter, acircularity index) and vessel density in three concentric annular regions of interest. On each set of OCTA and AOSLO FA images, matching vessel segments were used for lumen diameter measurement. Qualitative image comparisons were performed by visual identification of microaneurysms, vessel loops, leakage, and vessel segments. Results Adaptive optics scanning light ophthalmoscope FA and OCTA showed no statistically significant differences in FAZ perimeter, acircularity index, and vessel densities. Foveal avascular zone area, however, showed a small but statistically significant difference of 1.8% (P = 0.004). Lumen diameter was significantly larger on OCTA (mean difference 5.7 μm, P < 0.001). Microaneurysms, fine structure of vessel loops, leakage, and some vessel segments were visible on AOSLO FA but not OCTA, while blood vessels obscured by leakage were visible only on OCTA. Conclusions Optical coherence tomography angiography is comparable to AOSLO FA at imaging the foveal microvasculature except for differences in FAZ area, lumen diameter, and some qualitative features. These results, together with its ease of use, short acquisition time, and avoidance of potentially phototoxic blue light, support OCTA as a tool for monitoring ocular pathology and detecting early disease.
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            Correlation between the radial peripapillary capillaries and the retinal nerve fibre layer in the normal human retina.

            This study aims to provide evidence of the importance of radial peripapillary capillaries (RPCs) by quantitative study of the relationship between the RPCs and retinal nerve fibre layer (RNFL) in normal human donor eyes. The retinal microvasculature in eleven normal human donor eyes was perfused, fixed and labelled after cannulation of the central retinal artery. The retinas were dissected and whole-mounted for confocal microscopy. Six study regions were taken radially from the edge of the optic disc. RPCs from the optic disc edge to a radial distance up to 2.5 mm were imaged and their diameters, inter-capillary distance and volume occupation measured. These were correlated with the study region as well as thickness of the RNFL. It was found that the pooled average diameter of the RPCs in the first 2.5 mm from the optic disk was 8.9 μm. Significant differences in capillary diameter were present in the six regions, with larger diameter RPCs in the superior, inferior and nasal regions, and significantly smaller diameter in the temporal region. RPCs in the arcuate fibre regions extend the furthest from the optic disc, maintained a close inter-capillary distance for a longer distance than other regions, and have the highest RPCs volume occupancy. The RPCs volume was generally correlated with RNFL thickness. In conclusion, a close correlation between RNFL and RPCs presence has been demonstrated which is supportive of their functional reliance/co-dependence. The significantly smaller temporal RPCs may be a result of the greater presence of RPCs in the two bordering arcuate fibre regions and therefore a richer availability of nutrients diffusing from these two regions.
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              OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY IN RETINAL ARTERY OCCLUSION.

              To describe the retinal microvasculature of the eyes with nonarteritic retinal artery occlusion (RAO) based on optical coherence tomography angiography.
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                Author and article information

                Contributors
                1410657@tongji.edu.cn
                liuxiaoqiang@hotmail.com
                13817185959@163.com
                jingxu_tju@163.com
                +8621 6630 7527 , fwang7527@163.com
                Journal
                BMC Ophthalmol
                BMC Ophthalmol
                BMC Ophthalmology
                BioMed Central (London )
                1471-2415
                10 July 2019
                10 July 2019
                2019
                : 19
                : 147
                Affiliations
                ISNI 0000000123704535, GRID grid.24516.34, Department of Ophthalmology, Shanghai Tenth People’s Hospital, , Tongji University School of Medicine, ; Shanghai, 200072 China
                Author information
                http://orcid.org/0000-0002-3723-8210
                Article
                1152
                10.1186/s12886-019-1152-8
                6621973
                31291918
                cd00d299-f1b3-47c2-a5ba-f98b8aa2dec8
                © The Author(s). 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 19 March 2019
                : 24 June 2019
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100001809, National Natural Science Foundation of China;
                Award ID: 81770939
                Award ID: 81800836
                Award Recipient :
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2019

                Ophthalmology & Optometry
                optical coherence tomography angiography,retinal arterial occlusion,vessel density,acircularity index,foveal avascular zone

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