Longitudinal evaluation of optic nerve head perfusion after phacoemulsification using OCT angiography

Area of Science:

• Ophthalmology
• Microcirculation Research
• Medical Imaging

Background:

• Posterior segment microcirculation may be affected by cataract surgery, but its impact on optic nerve head (ONH) perfusion is not fully understood.
• Optical coherence tomography angiography (OCTA) offers a noninvasive method to evaluate ONH microvasculature and detect subtle postoperative changes.

Purpose of the Study:

• To investigate the effect of uncomplicated phacoemulsification cataract surgery on ONH perfusion using OCTA.
• To assess changes in radial peripapillary capillary (RPC) vessel density and ONH tomographic parameters post-surgery.

Main Methods:

• Prospective cohort study of 76 eyes from 38 patients undergoing cataract surgery.
• ONH OCTA imaging performed preoperatively and at 1 week, 1 month, and 3 months postoperatively.
• Analysis of RPC vessel density and ONH tomographic parameters, with fellow eyes as controls.

Main Results:

• Significant increase in whole-image RPC vessel density observed postoperatively (p < 0.01).
• Most RPC parameters remained stable, with a notable change in the superior peripapillary sector.
• No significant changes in ONH tomographic parameters, including cup-to-disc ratio and RNFL thickness.

Conclusions:

• Uncomplicated cataract surgery leads to increased global ONH microvascular perfusion detectable by OCTA.
• No concurrent structural alterations in the ONH were observed post-surgery.
• Postoperative ONH OCTA scans are essential for establishing new baselines for longitudinal assessment.