Abstract
PurposeOptical coherence tomography angiography (OCT-A) enables visualization of retinal microcirculation. As a potential influence of mydriatic eye drops on retinal vessel density (VD) was proposed, the purpose of the present study was to investigate an influence of 5% phenylephrine and 0.5% tropicamide on macula and peripapillary VD.Methods30 eyes of 30 healthy persons were measured by en face OCT-A (Spectralis OCT II, Heidelberg Engineering, Heidelberg). Scans of the macula (12 sectors, region of interest, ROI: 6.10 mm2) and peripapillary region (4 sectors, ROI: 2.67 mm2) were performed before (-) and 30 minutes after application of phenylephrine 5% and tropicamide 0.5% (+) eye drops (scan size was 8.41 mm2). Macula microcirculation was quantified in 3 retinal layers (superficial vascular plexus (SVP), deep capillary plexus (DCP), intermediate capillary plexus (ICP)). Data analysis was performed with the Erlangen-Angio-Tool.Results(I) Mean VD was 33.03±2.3 (SVP), 23.53±2.9 (ICP) and 25.48±4.2 (DCP) before and 33.12±2.4 (SVP), 23.74±2.9 (ICP) and 25.82±4.0 (DCP) with mydriasis respectively. (II) Sectorial analysis: 30.63±2.9–34.45±2.9 (-) and 31.04±2.9–34.34±2.7 (+) in SVP; 22.61±2.9–24.93±3.2 (-) and 22.75±2.5–25.20±3.0 (+) in ICP; 24.56±4.7–26.45±3.4 (-) and 25.00±4.1–27.07±3.5 (+) in DCP. (III) Peripapillary region showed a mean VD of 31.82±3.8 before and 31.59±4.3 after mydriasis. Sectorial analysis of VD yielded a range of 31.04±4.1–32.65±3.8 (-) and 30.98±4.4–31.89±4.1 (+). (IV) Macula and peripapillary VD were not different before and after mydriasis (p>0.05).ConclusionPharmacologic mydriasis did not influence retinal microcirculation in macula and peripapillary region enabling OCT-A scans with enhanced imaging process and scan quality.
Highlights
Optical coherence tomography angiography (OCT-A) is a new non-invasive imaging technique enabling visualization of retinal microcirculation in healthy and diseased.[1]
As a potential influence of mydriatic eye drops on retinal vessel density (VD) was proposed, the purpose of the present study was to investigate an influence of 5% phenylephrine and 0.5% tropicamide on macula and peripapillary VD
Little is known about a potential mydriatic effect on retinal microcirculation and these data were not consistent until now. [3,4,5,6,7] Previous data of Scanning laser Doppler flowmetry (SLDF) provided evidence that retinal capillary perfusion (RCF) seemed to be influenced by local application of 0.5% tropicamide in normal subjects.[3]
Summary
Optical coherence tomography angiography (OCT-A) is a new non-invasive imaging technique enabling visualization of retinal microcirculation in healthy and diseased.[1]. Only few clinical studies have investigated the influence of mydriatic eye drops on retinal vessel blood flow and vessel density (VD) with incongruent data. Retinal capillary perfusion (RCF) was seen to be significantly decreased after application of 0.5% tropicamide in healthy eyes, measured with scanning laser doppler flowmetry (SLDF).[3] After application of phenylephrine eye drops blood velocity in the optical nerve head was observed to be reduced in animal (monkeys, rabbits) and healthy human eyes.[4,5] Blood flow of the central retinal artery seemed not to be influenced by phenylephrine in humans.[4,5] Contrary, no differences in vascular reactivity of the major retinal arterioles haven been observed after local application of 1% tropicamide, 1% cyclopentolate and the combination of 0.8% tropicamide and 5% phenylephrine, respectively.[6] The only study up to now, offering OCT-A data, showed no reduction of macula and peripapillary VD after local application of 0.5% tropicamide. Combination of 0.5% tropicamide and 0.5% phenylephrine yielded a significantly reduced peripapillary, but not macular VD.[7]
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