Study of Retinal Microvasculature Changes in Patients after Blunt Ocular Trauma by Using Optical Coherence Tomography Angiography

Abstract

Abstract Purpose To assess structural and vascular changes of the macula and optic nerve in patients with unilateral blunt trauma in comparison to the contralateral sound eye by using optical coherence tomography angiography (OCTA). Methods This prospective study was carried out on 50 traumatized eyes and 50 contralateral sound eyes of patients who were subjected to blunt trauma within 7 days of injury. We evaluated best-corrected visual acuity (BCVA), intraocular pressure (IOP), retinal vessel density (VD) of superficial capillary plexus (SCP), deep capillary plexus (DCP), radial peripapillary capillary (RPC) and the foveal avascular zone (FAZ) by OCTA. We also assessed the structural spectral domain (SD)-OCT parameters including central macular thickness (CMT), ganglion cell complex (GCC) and retinal nerve fiber layer (RNFL) thickness. Results The BCVA was statistically significantly better in controls (0.16 ± 0.24 LogMAR) than traumatized eyes (0.28 ± 0.31 LogMAR) (p = 0.015). There was no statistically significant difference between the traumatized and control eyes regarding the means of SCP, DCP, outer retinal slab and RPC, FAZ area, CMT, IOP, GCC thickness and RNFL average thickness (p 0.05). In the commottio retinae group, the SCP and outer retinal slab VD were significantly lower in some parafoveal quadrants (p`0.05) than the non-commottio retinae group, while IOP, DCP and RPC vessel density, FAZ area, CMT, GCC and RNFL average thickness didn’t show any statistically significant difference between the two groups (p > 0.05). Conclusion Blunt trauma did not induce vascular or structural changes in the macula and optic nerve. Only patients with commottio retinae showed a decrease in vascular densities in some parafoveal areas as compared to those without commottio retinae despite no changes in macular structural anatomy as measured by SD- OCT. This finding suggest that OCTA can detect subtle changes that may influence functional prognosis.