Optical coherence tomography-angiography vascular changes in macula following cataract surgery
DOI:
https://doi.org/10.18203/2320-6012.ijrms20264179Keywords:
Vessel density, Perfusion density, Optical coherence tomography angiography, Non-diabetics, Diabetics, Foveal avascular zoneAbstract
Background: The study was done to estimate vessel density (VD), perfusion density (PD) and Foveal avascular zone (FAZ) changes in macula after uncomplicated cataract surgery and to compare the same between diabetics and nondiabetics.
Methods: 63 patients who had undergone cataract surgery were included in study, 32 nondiabetics, 31 diabetics. After standard ophthalmic examination, Optical Coherence Tomography-Angiography scans were taken preoperatively & at 3 weeks, 6 weeks and 3 months of postoperative period.
Results: Vessel density and perfusion density values were higher and FAZ values were lower in non-diabetics when compared with diabetics in preoperative and postoperative period. Vessel density and perfusion density increased significantly in both groups at 3 weeks visit but there was no significant increase in following visits. FAZ perimeter and circularity index decreased significantly and FAZ area decreased insignificantly in both groups. The difference in rate of these changes between 2 groups was insignificant.
Conclusions: Similar changes were observed in other studies as well. These changes in our study could be a result of an increase in light exposure after cataract surgery. Although other studies suggest various reasons for this change in their study. Whether these changes are beneficial to macula or worsens DR cannot be concluded with the present study as it requires more studies with larger samples and longer follow-up.
References
GBD 2019 Blindness and Vision Impairment Collaborators, Vision Loss Expert Group of the Global Burden of Disease Study. Causes of blindness and vision impairment in 2020 and trends over 30 years and prevalence of avoidable blindness in relation to VISION 2020: the Right to Sight: an analysis for the Global Burden of Disease Study. Lancet Glob Health. 2021;9(2):144–60.
Moshirfar M, Milner D, Patel BC. Cataract Surgery. In: StatPearls. Treasure Island (FL): StatPearls Publishing. 2023. Available at: http://www.ncbi.nlm.nih.gov. Accessed on 21 March 2026.
Parthasarathi P, Stokkermans TJ. Tests for Potential Vision. In: StatPearls. Treasure Island (FL): StatPearls Publishing. 2024. Available at: http://www.ncbi.nlm.nih.gov/books. Accessed on 21 March 2026.
Kolb H. Simple Anatomy of the Retina. In: Kolb H, Fernandez E, Nelson R, editors. Webvision: the organization of the retina and visual system. Salt Lake City (UT): University of Utah Health Sciences Center. 2024. Available at: http://www.ncbi.nlm.nih.go. Accessed on 21 April 2026.
Baldascino A, Ripa M, Carlà MM, Caporossi T, Grieco G, Gambini G, et al. Optical Coherence Tomography Angiography to Estimate Early Retinal Blood Flow Changes after Uncomplicated Cataract Surgery. Vision. 2022;24;6(3):38.
AttaAllah HR, Mohamed AAM, Ali MA. Macular vessels density in diabetic retinopathy: quantitative assessment using optical coherence tomography angiography. Int Ophthalmol. 2019;39(8):1845–59.
Scarinci F, Jampol LM, Linsenmeier RA, Fawzi AA. Association of Diabetic Macular Nonperfusion With Outer Retinal Disruption on Optical Coherence Tomography. JAMA Ophthalmol. 2015;133(9):1036–44.
Jeng CJ, Hsieh YT, Yang CM, Yang CH, Lin CL, Wang IJ. Development of diabetic retinopathy after cataract surgery. PLoS ONE. 2018;13(8):202347.
Diabetic Retinopathy Clinical Research Network Authors/Writing Committee, Baker CW, Almukhtar T, Bressler NM, Glassman AR, Grover S, et al. Macular edema after cataract surgery in eyes without preoperative central-involved diabetic macular edema. JAMA Ophthalmol. 2013;131(7):870–9.
Liao SB, Ku WC. Progression of diabetic retinopathy after phacoemulsification in diabetic patients: a three-year analysis. Chang Gung Med J. 2003;26(11):829–34.
Stunf Pukl S, Vidović Valentinčič N, Urbančič M, Irman Grčar I, Grčar R, Pfeifer V, et al. Visual Acuity, Retinal Sensitivity and Macular Thickness Changes in Diabetic Patients without Diabetic Retinopathy after Cataract Surgery. J Diabetes Res. 2017;7:3459156.
Samara WA, Shahlaee A, Adam MK, Khan MA, Chiang A, Maguire JI, et al. Quantification of Diabetic Macular Ischemia Using Optical Coherence Tomography Angiography and Its Relationship with Visual Acuity. Ophthalmology. 2017;124(2):235–44.
Yang JY, Wang Q, Yan YN, Zhou WJ, Wang YX, Wu SL, et al. Microvascular retinal changes in pre-clinical diabetic retinopathy as detected by optical coherence tomographic angiography. Graefes Arch Clin Exp Ophthalmol Albrecht Von Graefes Arch Klin Exp Ophthalmol. 2020;258(3):513–20.
Kim K, Kim ES, Yu SY. Optical coherence tomography angiography analysis of foveal microvascular changes and inner retinal layer thinning in patients with diabetes. Br J Ophthalmol. 2018;102(9):1226–31.
Mastropasqua R, Toto L, Mastropasqua A, Aloia R, De Nicola C, Mattei PA, et al. Foveal avascular zone area and parafoveal vessel density measurements in different stages of diabetic retinopathy by optical coherence tomography angiography. Int J Ophthalmol. 2017;10(10):1545–51.
Križanović A, Bjeloš M, Bušić M, Elabjer BK, Rak B, Vukojević N. Macular perfusion analysed by optical coherence tomography angiography after uncomplicated phacoemulsification: benefits beyond restoring vision. BMC Ophthalmol. 2021;21:71.
Gawęcki M, Prądzyńska N, Karska-Basta I. Long-term variations in retinal parameters after uncomplicated cataract surgery. J Clin Med. 2022;11(12):3426.
Baldascino A, Carlà MM, Caporossi T, Gambini G, Ripa M, Grieco G, et al. Early OCT angiography variations in macular and peripapillary area after uncomplicated cataract surgery and correlation with intraoperative parameters. Photonics. 2023;10(1):53.
Zhao Z, Wen W, Jiang C, Lu Y. Changes in macular vasculature after uncomplicated phacoemulsification surgery: Optical coherence tomography angiography study. J Cataract Refract Surg. 2018;44(4):453–8.
Feng L, Azhati G, Li T, Liu F. Macular vascular density changes following cataract surgery in diabetic patients: an optical coherence tomography angiography study. J Ophthalmol. 2021;2:67.
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