Midperipheral Microvascular Defects and Their Associations With Vitreoretinal Abnormalities in Early-Stage Familial...

Area of Science:

• Ophthalmology
• Retinal Vascular Diseases
• Microcirculation Research

Background:

• Familial exudative vitreoretinopathy (FEVR) is a genetic disorder characterized by abnormal retinal vascular development.
• Early-stage FEVR can present with subtle changes in the peripheral retina that may precede significant vision loss.
• Understanding the microvascular and microstructural changes in early FEVR is crucial for timely diagnosis and management.

Purpose of the Study:

• To investigate microvascular growth defects in the temporal midperipheral retina in early-stage FEVR.
• To determine the correlation between these microvascular abnormalities and vitreoretinal microstructural abnormalities (VRMAs).

Main Methods:

• 127 patients with early-stage FEVR and 31 healthy controls underwent widefield optical coherence tomography angiography.
• Evaluated vessel density (VD), vessel diameter index (VDI), and vessel index (VI) in superficial (SCP) and deep (DCP) capillary plexuses.
• Measured optic disc to avascular area distance (Optic-AVA) to assess retinal vascular dysplasia.

Main Results:

• 61.42% of FEVR eyes exhibited temporal midperipheral microvascular abnormalities (MVAs), always associated with VRMAs.
• FEVR eyes showed reduced VD and VI, and increased SCP VDI compared to controls.
• Microvascular loss correlated with Optic-AVA reduction, preretinal vasculature (PRV), and VRMA presence.

Conclusions:

• Microvascular abnormalities in the temporal midperipheral retina are present in early FEVR.
• Microvascular loss in FEVR is associated with retinal vascular dysplasia, PRV, and VRMAs.
• These findings highlight the interplay between vascular and structural changes in early FEVR progression.