UWFA detects more retinal capillary nonperfusion in temporal quadrant

Ultra-widefield angiography (UWFA) is able to identify more retinal capillary nonperfusion (RCNP) than conventional fundus fluorescein angiography, particularly in the temporal quadrant. Of note, large increases in RCNP over 100 weeks of follow-up seeme to be uncommon.

Researchers conducted a prospective, longitudinal multicentre cohort analysis of adults with central retinal vein occlusion, yielding a total of 153 eyes available for assessment. All patients received anti-vascular endothelial growth factor treatment and were assessed through UWFA at baseline and week 100. Outcomes included area, distribution, and change in total, peripheral, and posterior pole RCNP.

The mean RCNP at baseline was 34.3 disc areas (DA), and 7.8 percent (n=12) of eyes had ≥75 DA RCNP. An increased risk of neovascularization, defined as >10 DA RCNP, was much more frequently observed in the temporal vs nasal periphery (75.8 percent vs 10.5 percent).

After 100 weeks, mean RCNP rose slightly to 42.1 DA, with a median change of 3.3 DA from baseline. Such an increase was statistically significant (95 percent confidence interval [CI], 0.4–7.3; p<0.01).

Progression was also fairly uncommon. Of the 146 eyes at baseline with ≤10 DA in the posterior pole, 11.0 percent (n=16) progressed to >10 DA at week 100, with a median increase of 69.7 DA (95 percent CI, 27.2–85.4) from baseline. On the other hand, those who did not progress saw a median 0 DA increase in total RCNP (p<0.001). Two progressors developed neovascular glaucoma.

Binary logistic regression analysis found that a larger baseline total RCNP area significantly predicted the progression to >10 DA by week 100 (odds ratio per DA, 1.02, 95 percent CI, 1.00–1.04; p=0.04), as did a history of glaucoma (OR, 24.82, 95 percent CI, 4.16–147.99; p<0.001).