Capillary microvascular parameters on OCTA correlate with visual acuity in epiretinal membranes
Investigators evaluated macular microvascular parameters using optical coherence tomography angiography in 117 patients with idiopathic epiretinal membranes. They found that capillary metrics, including fractal dimension, vessel density, and average vessel diameter, significantly correlated with best-corrected visual acuity, while large vessel parameters showed no independent association. Fractal dimension demonstrated the strongest predictive value for poor vision, achieving an area under the curve of 0.775 when combined with age and signal strength index. These findings suggest that capillary-specific OCTA parameters may serve as useful imaging biomarkers for visual impairment in epiretinal membranes, warranting further validation for clinical diagnostic workflows.
The original study
Prediction of visual acuity by macular distortion measured with optical coherence tomography angiography in epiretinal membranes.
- Authors
- Cheng CY, Hsiao CC, Hsieh YT
- Journal
- Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie
- Type
- Journal Article
- PMID
- 42853279
Original abstract
PURPOSE: To quantify macular distortion in epiretinal membranes (ERMs) using optical coherence tomography angiography (OCTA) and analyze the correlations between visual acuity and OCTA parameters. METHODS: A cross-sectional retrospective observational study of 117 eyes from 117 patients with idiopathic ERMs who underwent OCTA. Full-layered retinal vasculature images from 3 × 3-mm² en face OCTA were analyzed. Microvascular parameters, including vessel tortuosity (VT), fractal dimension (FD), vessel density (VD), skeleton density (SD), and average vessel diameter (AVD), were measured after image processing to separate capillaries and large vessels. Linear regression models were used to assess the correlations with best-corrected visual acuity (BCVA), and receiver operating characteristic (ROC) curves were used to assess incremental discrimination for poor vision (BCVA of 20/50 or less). RESULTS: Lower VT, FD, VD, and SD and greater AVDs in capillaries were significantly correlated with poorer BCVA (p = 0.014 for VT; p < 0.0001 for FD, VD, SD, and AVD), even after adjusting for age, signal strength index (SSI) and central subfield thickness (CST). No significant correlations were found between large vessel parameters and BCVA after adjustment. Thirty eyes (28.2%) were categorized as poor vision; among the capillary parameters, FD had the highest area under the ROC curve (0.775) for BCVA of 20/50 or worse when combined with age, SSI and CST. CONCLUSIONS: OCTA parameters of capillaries significantly correlated with visual acuity in ERMs, with FD being the most informative biomarker. Large vessels are not independently associated with BCVA. Such distinct roles of capillaries and large vessels in ERM-related vision impairment warrant further validation for possible clinical utility.