| Objective: To observe the vascular characteristics and changes after treatment,and to explore the prognostic and assessment for parameters of optical coherence tomography angiography(OCTA)in the retinal vein occlusion(RVO)with OCTA.Methods:(1)32 nonischemic CRVO patients(32 eyes)and 32 ishchemic CRVO patients(32 eyes)were randomly selected among 45-60 years old,and the density of retinal vessel in the 3mm diameter range of macular area between healthy eyes and sick eyes were compared by OCTA.(2)For the 32 nonischemic CRVO patients(32eyes)whose diagnosis were confirmed by ophthalmic clinical examination,their healthy eyes and sick eyes were examined by OCT angiography.The density of blood vessels in surface and deeper retina and retinal thickness in the macular area3 mm diameter range of retina were acquired respectively,and analyze the correlation of blood vessels in the surface and retinal edema in the macular;discuss the relation of the density change of blood vessels in surface and deep retina in the macular and disease progression for the nonischemic CRVO eyes.(3)24 patients(24 eyes)with macular edema secondary to RVO confirmed by ophthalmic clinical examination received intravitreal injection of afibercept.Before and after the treatment 1 week,1month,best corrected visual acuity(BCVA),intraocular pressure,slit lamp microscope,optical coherence tomography angiography(3x3mm scanning range model)were observed.The changes in BCVA,central macular thickness(CMT),vascular density of superficial capillary plexus(SCP),deep capillary plexus(DCP),and the area,perimeter and the roundness index in foveal avascular zone(FAZ)were analyzed before and after the treatment.(4)We analyzed the aboved-mentioned data of(3)further,explore correlation of the baseline BCVA and SCP,DCP vascular density;and the correlation of Final visual acuity value(FVG)and SCP,DCP vascular density,Deep-Superficial Flow Ratio(DSFR)and blood flow FAZ area,perimeter,non-circular index.Results:(1)(1)The mean density of retinal vessel in the whole range of nonischemic CRVO eyes was 44.73±3.24%,and of healthy eyes was 51.24±2.45%,and there was significant difference between two types(P <0.05).(2)The mean density of retinal vessel in the whole range of ischemic CRVO eyes was 39.46±2.51%,and of healthy eyes was 51.06±2.45%,and there was significant difference between two types(P<0.05).(3)There was significant difference for the density of retinal vessel both in the whole range and each region between nonischemic and ishchemic CRVO patients(P <0.05).(2)(1)The average density of blood vessels in the whole range for 32 patients(32 eyes)with nonischemic CRVO was(44.73 ±3.24)%,and the average density of blood vessels for healthy eyes was(51.24 ±2.45)%,and there was difference for the density of blood vessels both whole range and each region(P<0.05).(2)It show a negative relation between the average density of blood vessels and the thickness of retina(retinal edema).Y=-0.462x+55.047,R2=0.842.(3)For different disease progression:1 week,1 month,2 months,the average density(%)of blood vessels on the surface of the macular for the nonischemic CRVO eyes were:(47.47 ± 2.90)%,(42.37 ± 2.74)%,(38.54 ± 3.90)%,and the average density of deeper blood vessels in the macular were:(42.87 ± 2.15)%,(39.49 ±2.34)%,(38.32 ± 3.02)%,then the average density of blood vessels on the surface decreased with the disease progression,while the density of deeper blood vessels had significantly reduced at the beginning of the course of disease.(3)(1)Intravitreal injection of afibercept for 1 month and 3months,BCVA improved with the difference were statistically significant(P<0.05).(2)The treatment for 1 week and 1 month,CMT decreased with the difference were statistically significant(P<0.001).(3)There were no statistical difference for the vascular density of SCP,DCP before and after treatment 1 month,3months.(4)There was statistical difference for FD-300 before and after treatment 1 month,3months.(5)The area and perimeter of FAZ after treatment increased obviously,and the roundness index of FAZ decreased than before with the difference were statistically significant.(4)(1)It was positive correlation for the baseline BCVA and superficial vascular density(P < 0.05),and there wasn’t obvious correlation for the baseline BCVA with deep vascular density;(2)There were no correlation for the SCP,DCP vascular density before the treatment with final vision gain(FVG),but there was obvious positive correlation with DSFR and FVG(r= 0.518,P= 0.01).(3)There were no correlation for FAZ area,perimeter and non-circular index and the FVG.Conclusion:(1)The density of blood vessels in the macular for the nonischemic CRVO eyes was less than it for healthy eyes;(2)It show a negative relation between the average density of blood vessels and the macular edema;meanwhile,the decrease of the density in deeper retina may be earlier the blood vessels on the surface.(3)For macular edema secondary to RVO,eyesight improved and edema absorbed obviously with the intravitreal injection of aflibercept in short-term clinical observation.At the same time,FAZ becomed regular and rounded after treatment,but the vascular density in macular changed slightly.(4)Superficial capillary perfusion is influential to eyesight for RVO-ME with eyes;It may be a significant parameter for DSFR to predict the effect for RVO-ME. |
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