Retinal Vascular Features in Ocular Blunt Trauma by Optical Coherence Tomography Angiography

Optical coherence tomography angiography imaging in peripheral commotio retinae: A case report

Purpose

We present a case of traumatic commotio retinae (CR), in which blood flow was evaluated using optical coherence tomography angiography (OCTA).

Observations

An 18-year-old Japanese man presented with traumatic retinal detachment and CR in his left eye, which had been hit by a handball. Fundus examination revealed peripheral retinal tear extending from the 1 to 3 o'clock position with retinal detachment, and CR near the area of tear. Fluorescein angiography (FA) confirmed an ischemic area near the retinal tear area at the CR. The patient underwent successful scleral buckling and cryopexy. Sequential OCTA imaging was performed and we were able to determine perfusion in the CR area, with maintained blood flow.

Conclusions and importance

In blunt eye trauma, peripheral commotio retinae can be assessed non-invasively over time using OCTA. OCTA is a useful method for evaluating peripheral retinal whitened areas.

Investigation of Retinal Vascular Parameters and Choroidal Vascular Index in Patients Developing Hyphema After Unilateral Blunt Trauma

BACKGROUND

To evaluate retinal and choroidal vascular changes in cases with hyphema after blunt ocular trauma that did not cause globe rupture or any retinal pathology.

METHODS

This cross-sectional study included 29 patients who developed hyphema after unilateral blunt ocular trauma (BOT). The other healthy eyes of the same patients were evaluated as the control group. Optical coherence tomography-angiography (OCT-A) was used for imaging. In addition, choroidal parameters were compared by calculating the choroidal vascular index (CVI) and using choroidal thickness measurements by two independent researchers.

RESULTS

Superior and deep flow values were significantly decreased in the traumatic hyphema group compared to the control group (p<0.05). Parafoveal deep vascular density (parafoveal dVD) values were decreased in traumatized eyes compared to control eyes (p=0.000). Vascular density values were similar other than that. In addition, there was a significant decrease in optic disc blood flow (ODF) and optic nerve head density (ONHD) values compared to the control group (p<0.05). In addition, no significant difference was observed between the groups in terms of mean CVI values (p>0.05).

CONCLUSION

Non-invasive diagnostic tools such as OCTA and EDI-OCT can be used to detect and monitor early changes in retinal and choroidal microvascular flow in cases of traumatic hyphema.

Optical Coherence Tomography Angiography Imaging of Foveal Atrophy Secondary to Commotio Retinae in a Pediatric Patient

Optical coherence tomography-angiography (OCTA) is a fast, reliable, and non-invasive technique for the diagnosis and follow-up of patients with commotio retinae (CR). Severity of the damage to the retinal and choroidal microvasculature in OCTA imaging and the visual prognosis are directly related to the severity of trauma. There are a few published reports on OCTA in CR that shows alterations of the retinal or superficial choroidal vessels and choriocapillary plexus. OCTA imaging seems to be predictive for visual prognosis. Herein, we present a 6-year-old boy, who had blunt trauma to the right eye with a stick during outdoor playing with visual acuity reduction to 0.1 following resolution of the Berlin's edema. In our case, OCTA revealed damage to the outer layers of the retinae and choriocapillaris and resulting in permanent vision loss. OCTA is a non-invasive, rapid, and safe imaging technique that qualitatively and quantitatively analyzes blood flow from the superficial capillary plexus to the choriocapillaris, which can be predictive in the visual prognosis.

Analyses of Foveal Avascular Zone in Patients with General Blunt Ocular Trauma Using Optical Coherence Tomography Angiography

PURPOSE

To investigate the effect of blunt ocular trauma (BOT) on foveal circulation, and in particular the foveal avascular zone (FAZ), using optical coherence tomography angiography (OCTA).

METHODS

This retrospective study consisted of 96 eyes (48 traumatized eyes and 48 nontraumatized eyes) from 48 subjects with BOT. We analyzed the FAZ area of deep capillary plexus (DCP) and superficial capillary plexus (SCP) immediately after BOT and at 2 weeks after BOT. We also evaluated the FAZ area of DCP and SCP in patients with and without blowout fracture (BOF).

RESULTS

There were no significant differences in FAZ area between traumatized and nontraumatized eyes at DCP and SCP in the initial test. In traumatized eyes, the FAZ area at SCP was significantly reduced on follow-up when compared to initial test (p = 0.01). In case of eyes with BOF, there was no significant differences in FAZ area between traumatized and nontraumatized eyes at DCP and SCP on initial test. No significant difference of FAZ area was found on follow-up relative to the initial test, whether in the DCP or SCP. In case of eyes without BOF, there was no significant differences of FAZ area between traumatized and nontraumatized eyes at DCP and SCP in initial test. Also, no significant difference of FAZ area at DCP was found on follow-up test compared to initial test. However, the FAZ area at SCP was significantly reduced in follow-up test compared with that in the initial test (p = 0.04).

CONCLUSIONS

Temporary microvascular ischemia occurs in the SCP of patients after BOT. Patients should be warned of transient ischemic changes that may occur after trauma. OCTA can provide useful information regarding the subacute changes in the FAZ at SCP after BOT, even without evident findings of structural damage on fundus examination.

The Role of Optical Coherence Tomography Angiography in Optic Nerve Head Edema: A Narrative Review

Optic nerve head (ONH) edema is a clinical manifestation of many ocular and systemic disorders. Ocular and central nervous system imaging has been used to differentiate the underlying cause of ONH edema and monitor the disease course. ONH vessel abnormalities are among the earliest signs of impaired axonal transportation. Optical coherence tomography angiography (OCTA) is a noninvasive method for imaging ONH and peripapillary vessels and has been used extensively for studying vascular changes in ONH disorders, including ONH edema. In this narrative review, we describe OCTA findings of the most common causes of ONH edema and its differential diagnoses including ONH drusen.

Effect of blunt ocular trauma on retinal microvasculature: An optical coherence tomography angiography study

BACKGROUND

To evaluate the retinal vascular changes and foveal avascular zone area in patients with unilateral blunt ocular trauma using optical coherence tomography angiography.

METHODS

This retrospective study consisted of 50 traumatized and 50 contralateral sound eyes of the patients with blunt ocular trauma. The foveal avascular zone area, choriocapillaris flow area, foveal, parafoveal, and perifoveal vessel densities in both superficial capillary plexus and deep capillary plexus and central macular thickness were evaluated.

RESULTS

There were no significant differences between traumatized and sound eyes in the foveal avascular zone area (p:0.36), choriocapillaris flow area (p:0.43), central macular thickness (p:0.67), and in vessel densities of superficial capillary plexus over all regions (p > 0.05 for all). However, the vessel densities of deep capillary plexus were significantly lower in traumatized eyes (p < 0.05 for all).

CONCLUSION

Optical coherence tomography angiography demonstrated a significant decrease in retinal deep capillary plexus vessel density of the eyes effected by blunt ocular trauma, even with no evident findings on fundus examination or structural spectral domain-optical coherence tomography changes.