Evaluation of Ocular Hypoperfusion in Patients with Acromegaly by Using Optical Coherence Tomography Angiography

ABSTRACT

Purpose

This study aimed to evaluate the retinal blood vessel parameters and the foveal avascular zone (FAZ) area using optical coherence tomography angiography (OCTA) in patients with acromegaly in comparison with healthy controls.

Methods

A total of 45 patients with acromegaly and 45 healthy controls were included in this study. In all patients, the vessel density (VD) of the deep and superficial macular vascular networks and the foveal avascular zone (FAZ) were measured using OCTA. The correlation of insulin-like growth factor 1 (IGF-1) level and disease duration with deep macular VD and FAZ values was analyzed. All parameters were registered. Results were assessed and compared between the two groups.

Results

Deep macular plexus VD values were lower in patients with acromegaly compared to the control group. No significant differences in VD values in the superficial segment, except for that in the inferior parafovea (P = .01) were found between the two groups. Furthermore, patients with acromegaly showed enlargement in the superficial (P = .30) and deep FAZ areas (P < .001). IGF-1 level and disease duration showed a significant negative correlation with the deep whole image (R = −0.216, P = .041, R = −0.339, P = .001, respectively), deep parafovea (R = −0.271, P = .01; R = −0.372, P < .001, respectively), deep parafovea superior hemi (R = −0.342, P = .001; R = −0.350, P = .001, respectively), deep parafovea temporal (R = −0.224, P = .034; R = −0.234, P = .026, respectively), deep parafovea nasal (R = −0.320, P = .002; R = −0.361, P < .001, respectively), and deep parafovea superior VD values (R = −0.293, P = .005; R = −0.307, P = .003, respectively) and a significant positive correlation with the deep FAZ area values (R = 0.244, P = .02; R = 0.329, P = .002, respectively).

Conclusion

VD values in the deep macular capillary plexus were lower in patients with acromegaly, and the superficial and deep FAZ area enlarged. Patients with acromegaly may have an increased risk of developing ocular vascular complications. OCTA can be used to evaluate retinal blood VD in patients with acromegaly.

KEYWORDS:

• Acromegaly
• optical coherence tomography angiography
• vessel density
• foveal avascular zone
• ocular hypoperfusion

Disclosure statement

The authors declare that they have no conflict of interest.

Ethics approval

Ethics Committee of Dicle University Faculty of Medicine, Diyarbakır, Turkey (decision date: March 5, 2020, No. 96)