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

In this prospective study, we analysed the changes in retinal vessel density (VD) using optical coherence tomography angiography (OCTA) in patients with commotio retinae up to 6 months after blunt ocular trauma. We analysed the VD in the superficial capillary plexus (SCP), deep capillary plexus (DCP), radial peripapillary capillary (RPC) and the foveal avascular zone (FAZ) area at 48 h, and 1, 3 and 6 months after the trauma and compared results with those of healthy fellow eyes. We also evaluated the best-corrected visual acuity (BCVA) and the structural, spectral domain (SD)-OCT parameters: ganglion cell complex (GCC) and retinal nerve fibre layer (RNFL). A total of 18 eyes of 18 patients (8 males, 10 females, mean age 49.61 ± 9.2 years) and 18 healthy control eyes were evaluated. GCC and RNFL thicknesses showed a significant trend towards progressively lower values from 1 month and 3 months after the trauma, respectively, compared to healthy eyes (p < 0.005). The reduction in SD-OCT parameters reached a plateau at 6 months. Similar behaviour was found in the VD of the SCP and RPC that significantly decreased, starting from 1 and 3 months after the trauma, respectively (p < 0.001). At 6 months, the VD values were stable. The DCP presented an initial decrease of VD (p < 0.001), and after 1 month, the values statistically increased until the sixth month, reaching values similar to those of the control group. The FAZ area and BCVA did not show statistically significant changes during the follow-up. OCTA provided a detailed and quantitative analysis of early retinal vascular perfusion alterations after commotio retinae, demonstrating that the impairment of the retinal microvasculature and its progressive changes over time occurred even in the absence of compromised visual acuity.