Correlation Between Fundus Fluorescein Angiography (Ffa), Optical Coherence Tomography (Oct) And Visual Acuity In Eyes With Broken Foveal Avascular Zone (Faz)

Abstract

Purpose: To identify the correlation between the broken foveal avascular zone (FAZ) on fundus fluorescein angiography (FFA) with the outer retinal changes on the optical coherence tomography (OCT) and its relationship with visual acuity. Methods: The study included the patients with diabetic retinopathy, non-proliferative and proliferative, with broken FAZ on FFA, and were compared with the controls selected from the eyes without retinopathy and intact FAZ. The OCT scanning with enhanced depth imaging (EDI) through the area of broken FAZ was reviewed. Results: Thirty eyes (mean age 51+12.92 years) with broken FAZ were included-18 eyes showed broken inner segment- outer segment (IS-OS) on OCT (p=0.21). Mean diabetic age was 8.3+4.01 years. Eight eyes in the study group had >20/30 best-corrected visual acuity (p=0.26). Macular thickness and visual acuity did not have a linear correlation. The duration of diabetes had a significant correlation with broken IS-OS junction (p=0.004). The odds of poor vision with broken FAZ were 2.5 (95% CI 0.5-12.4). The positive predictive value (PPV) of disrupted IS-OS junction in broken FAZ was 47.37% (95% CI (range 30.98% to 64.18%) and the negative predictive value (NPV) of intact IS-OS junction in broken FAZ was 50% (95% CI range 29.12% to 70.88%). The combined PPV of poor vision (<20/40) and longer diabetic duration (>9 years) was 88.89% (range 51.75% to 99.72%) and the NPV was 100% (range 71.51% to 100%). Conclusion: Disrupted IS-OS junction could indicate an ischemic macula, but correlation with visual acuity is important.