New vessel growth from ischemic retinal vein occlusion (RVO) is a common cause of vitreous hemorrhage, but early detection of new vessels may be challenging and often requires the use of invasive tests. However, a recent study suggests widefield OCT-A may be a helpful and noninvasive approach to detect neovascularization in patients with this condition.

The retrospective, observational case series included 39 eyes diagnosed with ischemic RVO that underwent widefield swept-source OCT-A imaging. The researchers compared the results against standard clinical exams, when available, and ultra-widefield fluorescein angiography (UWF-FA).

On widefield OCT-A, neovascularization elsewhere was seen in 41% of eyes, and the findings were characterized as sea-fan-shaped and nodular-shaped based on their appearance and localization. Neovascularization elsewhere was identified in just four eyes during standard clinical exams, for a detection rate of about 10%. All were sea-fan-shaped.

In one case, a nodular type of neovascularization elsewhere was found on widefield OCT-A but not on UWF-FA. Additionally, neovascularization of the disc was detected in one eye.

Huemer J, Khalid H, Wagner SK, et al. Phenotyping of retinal neovascularization in ischemic retinal vein occlusion using wide field OCT angiography. Eye (Lond). November 20, 2020. [Epub ahead of print].