Examination of Age-Related Retinal Vascular Changes in the Macula Using Optical Coherence Tomography Angiography of the Eyes After Cataract Surgery

Abstract

Purpose

Optical coherence tomography angiography (OCTA) allows noninvasive observation of the retinal vasculature, and image analysis can be used to calculate the retinal vessel density and foveal avascular zone (FAZ) area. A previous study showed that macular vessel density and the signal strength index (SSI) of OCTA images increased significantly after cataract surgery. However, the effect of aging on OCTA analysis remains unclear. This study aimed to investigate age-related changes in macular vascularization while excluding the effects of cataracts.

Patients and Methods

OCTA imaging of the macula was performed in adult patients who had undergone cataract surgery between February 2018 and May 2019 and in young healthy participants between April 2017 and April 2018.

Results

The median (quartiles) age of the overall study population was 59.0 (27.0, 69.0) years, and no severe refractive error was observed (axial length: 24.2 ± 1.3 [mean ± SD] mm; spherical equivalent: 0.75 [−2.25, 0.00] diopter). When we investigated the relationship between macular vessel density and age after excluding the effects of cataracts, we found that the macular vessel density showed age-related changes even in the absence of the effects of the SSI. However, the FAZ area was not affected by age.

Conclusion

Macular vessel density decreased with age, even when the effects of cataracts were excluded. The effects of age and cataracts should be considered when designing studies and interpreting OCTA findings of the retinal vasculature.

Keywords:

• optical coherence tomography angiography
• macular vessel density
• foveal avascular zone
• aging
• cataract surgery

Abbreviations

OCTA, Optical coherence tomography angiography; FAZ, Foveal avascular zone; SSI, Signal strength index; AL, Axial length; cpRNFL, Circumpapillary retinal nerve fiber layer; mGCL-IPL, Macular ganglion cell layer–inner plexiform layer; mIPL-OPL, Macular inner plexiform layer–outer plexiform layer; SS, Swept-source; SRL, Superficial retinal layer; DRL, Deep retinal layer; KSM, Kanno-Saitama Macro; mVD, Macular vessel density.

Data Sharing Statement

All data generated or analyzed during this study are included in this article. Further inquiries can be directed to the corresponding author.

Ethics Approval and Informed Consent

This study was approved by the ethics committee of Saitama Medical University. Written informed consent was obtained for publication of this article and the accompanying images from the patients.

Acknowledgments

The authors thank Editage for the English language review.

Disclosure

The authors declare no conflicts of interest.

Additional information

Funding

This study was not supported by any funding.