Japanese Journal of Ophthalmology

, Volume 62, Issue 3, pp 274–279 | Cite as

Extended field imaging using swept-source optical coherence tomography angiography in retinal vein occlusion

  • Shinji Kakihara
  • Takao Hirano
  • Yasuhiro Iesato
  • Akira Imai
  • Yuichi Toriyama
  • Toshinori Murata
Clinical Investigation



To evaluate the degree of ischemia in eyes with retinal vein occlusion (RVO) using swept-source optical coherence tomography angiography (SS-OCTA) with the extended field imaging (EFI) technique, which extends the area encompassed by SS-OCTA by scanning through trial frames fitted with a +20-diopter lens.

Study Design

Retrospective observational study.


Twenty-three consecutive eyes of 22 patients with RVO underwent 12 × 12 mm SS-OCTA imaging both with and without EFI for determination of extension rate. Two graders blinded to the clinical data evaluated the degree of retinal ischemia in paired EFI-SS-OCTA and fluorescein angiography (FA) images, and the concordance rates between the grades were statistically examined.


One EFI-SS-OCTA image was not successfully obtained due to motion artifacts caused by the patient’s poor central vision, while SS-OCTA images without EFI were captured in all 23 eyes. The average extension rate of EFI-SS-OCTA over SS-OCTA was 1.39 ± 0.06 and the average scanning area was enlarged by 76.4%. Two graders evaluated the degree of retinal ischemia by measuring nonperfusion areas as the sum of disc areas/diameters. Although their assessments of the EFI-SS-OCTA images were in complete agreement (Cohen’s Unweighted Kappa coefficient = 1.00), concordance using FA images was only moderate (Cohen’s Unweighted Kappa coefficient = 0.60).


EFI-SS-OCTA noninvasively produces wider field images of retinal vasculature with one capture and provides resolution sufficient to accurately evaluate retinal capillary nonperfusion in RVO.


Retinal vein occlusion Optical coherence tomography Optical coherence tomography angiography Capillary nonperfusion Fluorescein angiography 



The authors thank Yoshitaka Takano, a certified orthoptist at Shinshu University hospital, for collecting data and other paramedical staff in our team for helping to make this study possible.


Supported by JSPS KAKENHI Grant Number JP 16K11283.

Conflicts of interest

S. Kakihara, None; T. Hirano, Lecture fees (Bayer, Novartis, Santen, Zeiss); Y. Iesato, Lecture fees (Bayer, Novartis, Santen); A. Imai, None; Y. Toriyama, Lecture fees (Bayer, Nidek, Novartis); T. Murata, Lecture fees (Bayer, Novartis, Santen, Zeiss).

Supplementary material

10384_2018_590_MOESM1_ESM.pdf (20 kb)
Supplementary material 1 (PDF 20 kb)
10384_2018_590_MOESM2_ESM.pdf (26 kb)
Supplementary material 2 (PDF 25 kb)


  1. 1.
    Cugati S, Wang JJ, Rochtchina E, Mitchell P. Ten-year incidence of retinal vein occlusion in an older population: the Blue Mountains Eye Study. Arch Ophthalmol. 2006;124:726–32.CrossRefPubMedGoogle Scholar
  2. 2.
    Noma H, Funatsu H, Harino S, Nagaoka T, Mimura T, Hori S. Influence of macular microcirculation and retinal thickness on visual acuity in patients with branch retinal vein occlusion and macular edema. Jpn J Ophthalmol. 2010;54:430–4.CrossRefPubMedGoogle Scholar
  3. 3.
    Murakami T, Tsujikawa A, Miyamoto K, Sakamoto A, Ota M, Ogino K, et al. Relationship between perifoveal capillaries and pathomorphology in macular oedema associated with branch retinal vein occlusion. Eye (Lond). 2012;26:771–80.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Iesato Y, Imai A, Hirano T, Toriyama Y, Murata T. Effect of leaking capillaries and microaneurysms in the perifoveal capillary network on resolution of macular edema by anti-vascular endothelial growth factor treatment. Jpn J Ophthalmol. 2016;60:86–94.CrossRefPubMedGoogle Scholar
  5. 5.
    Braithwaite T, Nanji AA, Greenberg PB. Anti-vascular endothelial growth factor for macular edema secondary to central retinal vein occlusion. Cochrane Database Syst Rev. 2010. Scholar
  6. 6.
    Brown DM, Campochiaro PA, Singh RP, Li Z, Gray S, Saroj N, et al. Ranibizumab for macular edema following central retinal vein occlusion: six-month primary end point results of a phase III study. Ophthalmology. 2010;117(1124–33):e1.Google Scholar
  7. 7.
    Campochiaro PA, Brown DM, Awh CC, Lee SY, Gray S, Saroj N, et al. Sustained benefits from ranibizumab for macular edema following central retinal vein occlusion: twelve-month outcomes of a phase III study. Ophthalmology. 2011;118:2041–9.CrossRefPubMedGoogle Scholar
  8. 8.
    Prasad AGSR, Apte RS. Intravitreal pharmacotherapy: applications in retinal disease. Compr Ophthalmol Update. 2007;8:259.PubMedGoogle Scholar
  9. 9.
    Wroblewski JJ, Wells JA 3rd, Adamis AP, Buggage RR, Cunningham ET Jr, Goldbaum M, et al. Pegaptanib sodium for macular edema secondary to central retinal vein occlusion. Arch Ophthalmol. 2009;127:374–80.CrossRefPubMedGoogle Scholar
  10. 10.
    Brown DM, Heier JS, Clark WL, Boyer DS, Vitti R, Berliner AJ, et al. Intravitreal aflibercept injection for macular edema secondary to central retinal vein occlusion: 1-year results from the phase 3 COPERNICUS study. Am J Ophthalmol. 2013;155(429–37):e7.Google Scholar
  11. 11.
    Group BVOS. Argon laser scatter photocoagulation for prevention of neovascularization and vitreous hemorrhage in branch vein occlusion. A randomized clinical trial. Arch Ophthalmol. 1986;104:34–41.CrossRefGoogle Scholar
  12. 12.
    Group TCVOS. A randomized clinical trial of early panretinal photocoagulation for ischemic central vein occlusion The Central Vein Occlusion Study Group N report. Ophthalmol. 1995;102:1434–44.CrossRefGoogle Scholar
  13. 13.
    Gass JD. A fluorescein angiographic study of macular dysfunction secondary to retinal vascular disease. VI. X-ray irradiation, carotid artery occlusion, collagen vascular disease, and vitritis. Arch Ophthalmol. 1968;80:606–17.CrossRefPubMedGoogle Scholar
  14. 14.
    Iijima H. Reduced light sensitivity due to impaired retinal perfusion in branch retinal vein occlusion. Jpn J Ophthalmol. 2017. Scholar
  15. 15.
    Kwiterovich KA, Maguire MG, Murphy RP, Schachat AP, Bressler NM, Bressler SB, et al. Frequency of adverse systemic reactions after fluorescein angiography. Results of a prospective study. Ophthalmology. 1991;98:1139–42.CrossRefPubMedGoogle Scholar
  16. 16.
    Ishibazawa A, Nagaoka T, Takahashi A, Omae T, Tani T, Sogawa K, et al. Optical coherence tomography angiography in diabetic retinopathy: a prospective pilot study. Am J Ophthalmol. 2015;160(35–44):e1.Google Scholar
  17. 17.
    Abri Aghdam K, Reznicek L, Soltan Sanjari M, Framme C, Bajor A, Klingenstein A, et al. Peripheral retinal non-perfusion and treatment response in branch retinal vein occlusion. Int J Ophthalmol. 2016;9:858–62.PubMedPubMedCentralGoogle Scholar
  18. 18.
    Uji A, Yoshimura N. Application of extended field imaging to optical coherence tomography. Ophthalmology. 2015;122:1272–4.CrossRefPubMedGoogle Scholar
  19. 19.
    Kimura M, Nozaki M, Yoshida M, Ogura Y. Wide-field optical coherence tomography angiography using extended field imaging technique to evaluate the nonperfusion area in retinal vein occlusion. Clin Ophthalmol. 2016;10:1291–5.CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Patz A. Argon laser photocoagulation for macular edema in branch vein occlusion. Am J Ophthalmol. 1984;98:374–5.CrossRefPubMedGoogle Scholar
  21. 21.
    Group TCVOS. Natural history and clinical management of central retinal vein occlusion. Arch Ophthalmol. 1997;115:486–91.CrossRefGoogle Scholar

Copyright information

© Japanese Ophthalmological Society 2018

Authors and Affiliations

  • Shinji Kakihara
    • 1
  • Takao Hirano
    • 1
  • Yasuhiro Iesato
    • 1
  • Akira Imai
    • 1
  • Yuichi Toriyama
    • 1
  • Toshinori Murata
    • 1
  1. 1.Department of OphthalmologyShinshu University School of MedicineMatsumotoJapan

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