Plexus-Specific Retinal Capillary Blood Flow Analysis Using Erythrocyte Mediated Angiography and Optical Coherence Tomography Angiography.

ABSTRACT

Purpose: The purpose of this study was to identify and measure plexus-specific absolute retinal capillary blood flow velocity and acceleration in vivo in both nonhuman primates (NHPs) and humans using erythrocyte mediated angiography (EMA) and optical coherence tomography angiography (OCTA). Methods: EMA and OCTA scans centered on the fovea were obtained in 2 NHPs and 11 human subjects. Scans were also obtained in NHP eyes while IOP was experimentally elevated. Erythrocyte velocity and acceleration in retinal arteries, capillaries, and veins were measured and capillaries were categorized based on location within the superficial vascular (SVP), intermediate capillary (ICP), or deep capillary plexus (DCP). Generalized linear mixed models were used to estimate the effects of intraocular pressure (IOP) on capillary blood flow. Results: Capillary erythrocyte velocity at baseline IOP was 0.64 ± 0.29 mm/s in NHPs (range of 0.14 to 1.85 mm/s) and 1.55 ± 0.65 mm/s in humans (range of 0.46 to 4.50 mm/s). Mean erythrocyte velocity in the SVP, ICP, and DCP in NHPs was 0.69 ± 0.29 mm/s, 0.53 ± 0.22 mm/s, and 0.63 ± 0.27 mm/s, respectively (P = 0.14 for NHP-1 and P = 0.28 for NHP-2). Mean erythrocyte velocity in the human subjects did not differ significantly among SVP, ICP, and DCP (1.46 ± 0.59 mm/s, 1.58 ± 0.55 mm/s, and 1.59 ± 0.79 mm/s, P = 0.36). In NHPs, every 1 mm Hg increase in IOP was associated with a 0.13 mm/s reduction in arterial velocity, 0.10 mm/s reduction in venous velocity, and 0.01 mm/s reduction in capillary velocity (P < 0.001) when accounting for differences in mean arterial pressure (MAP). Conclusions: Blood flow by direct visualization of individual erythrocytes can be quantified within capillary plexuses. Capillary velocity decreased with experimental IOP elevation.