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Updated: Mar 25, 2026
Retinal Vascular Reactivity as Assessed by Optical Coherence Tomography Angiography
Published on: March 26, 2020
Geometric Decomposition of OCT Angiography in RVO: Unmasking Congestive Versus Compensatory Phenotypes and Deep
Jinlian Zhan1, Dijie Qiao1, Gangan Sun1
1State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China.
Retinal vein occlusion (RVO) involves inefficient compensation in fellow eyes and congestive failure in affected eyes, detectable through advanced morphologic decomposition. This method reveals early changes and the progressive synchronization of retinal and choroidal degeneration in RVO.
Area of Science:
- Ophthalmology
- Vascular Biology
- Medical Imaging
Background:
- Retinal vein occlusion (RVO) is a significant cause of vision loss.
- Conventional analysis of vessel density (VD) may not fully capture the complex microvascular remodeling in RVO.
Purpose of the Study:
- To characterize microvascular remodeling in RVO by differentiating
- congestion
- from
- compensation
- using morphologic decomposition.
- To evaluate the translaminar retina-choroid coupling in RVO.
Main Methods:
- Swept-source optical coherence tomography angiography was used in 226 eyes (88 RVO-affected, 88 fellow, 50 controls).
- Vessel density (VD) was decomposed into vessel length density (VLD) and vessel diameter index (VDI).
- Linear mixed-effects models were employed to analyze intereye correlations.
Main Results:
- Fellow eyes showed "inefficient compensation" (increased VLD, decreased VDI) in the deep capillary plexus (DCP).
- Affected eyes exhibited "congestive failure" (decreased VLD, increased VDI) in the DCP.
- DCP ischemia correlated with macular edema severity (TRT). A disease gradient was observed in retina-choroid coupling, worsening with disease severity.
Conclusions:
- RVO is a bilateral disorder with subclinical changes in fellow eyes.
- Morphologic decomposition offers superior biomarkers for early detection and monitoring of RVO.
- Progressive synchronization of retinal and choroidal degeneration indicates a collapse of neurovascular autoregulation in RVO.
