Morphologic and Functional Retinal Vessel Changes in Branch Retinal Vein Occlusion: An Optical Coherence Tomography Angiography Study

Am J Ophthalmol. 2017 Oct;182:168-179. doi: 10.1016/j.ajo.2017.08.004. Epub 2017 Aug 31.

Abstract

Purpose: The present study aimed to investigate the morphology of the retinal vasculature in eyes with branch retinal vein occlusion (BRVO) using optical coherence tomography (OCT) angiography.

Design: Observational case series.

Methods: Fluorescein angiography (FA) and OCT angiography were used to examine macular area and the retinal vasculature at the affected arteriovenous (AV) crossing in 46 patients with BRVO.

Results: FA revealed that the affected AV crossing pattern involved arterial overcrossing in 23 eyes (50.0%) and venous overcrossing in 11 eyes (23.9%). However, FA failed to detect the crossing pattern in 10 eyes (21.7%). OCT angiography was significantly more effective for identification of the AV crossing pattern than FA (44 eyes; 95.7%; P = .013). The number of eyes with venous overcrossing detected via OCT angiography (20 eyes, 43.5%) was also higher than that detected via FA (P = .047). OCT angiography revealed that venous narrowing (25.5 ± 21.1 μm) was significantly greater in instances of venous overcrossing than in those of arterial overcrossing (46.4 ± 23.7 μm, P = .005). Macular nonperfusion areas (NPAs) were larger in eyes with venous overcrossing than in those with arterial overcrossing (P = .011 for superficial plexus, P = .049 for deep plexus). The peripheral NPA was significantly larger in eyes with venous overcrossing (65.1 ± 35.3 disc area [DA]) than in those with arterial overcrossing (17.2 ± 24.1 DA; P < .001).

Conclusions: Our findings suggest that BRVO characterized by venous overcrossing may be more prevalent than previously reported, and that there is a significant association between NPA size and AV crossing pattern.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Computed Tomography Angiography
  • Female
  • Fluorescein Angiography
  • Humans
  • Male
  • Middle Aged
  • Regional Blood Flow
  • Retinal Artery / physiopathology*
  • Retinal Vein / physiopathology*
  • Retinal Vein Occlusion / diagnosis*
  • Retinal Vein Occlusion / physiopathology*
  • Retrospective Studies
  • Tomography, Optical Coherence*
  • Visual Acuity