Changes of Macular Vasculature After Uncomplicated Phacoemulsification Surgery Using Optical Coherence Tomography Angiography

Study Overview
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Brief Summary
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To record the vascular changes that may be present in the macular after uncomplicated phacoemulsification surgery by using OCTA, a comparative study between healthy and diabetic patients

Detailed Description
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A prospective study of 30 patients with senile or complicated cataract scheduled to do phacoemulsification surgery in Tanta University Hospital Two groups will be divided: Group (1): Cataract will no diabetic retinopathy Group (2): Cataract associated with diabetic retinopathy. All patients will be subject to Full ophthalmologic examination before the surgery. Imaging will include OCTA. OCTA will be performed using cirrus OCT (Zeiss, Inc., USA). High-quality 6 x 6 mm OCTA macular scans and 3 × 3-mm papillary scan with strong signal-noise ratio with adequate centration on the fovea and optic nerve head respectively will be selected. Segmentation will be used to evaluate superﬁcial and deep capillary retinal plexus projections in addition to the choriocapillaries. If errors in segmentation were detected, manual correction would be performed. The superﬁcial retinal capillary plexus (SCP) will be delineated with an inner boundary at the internal limiting membrane (ILM) and an outer boundary 10 µm inside the inner plexiform layer (IPL). The deep retinal capillary plexus (DCP) will be segmented with an inner boundary 10 µm inside the IPL and an outer boundary at 10 µm beneath the outer plexiform layer (OPL). The vessel density metric from enface OCT angiogram will be used as an indicator of macular retinal and papillary perfusion. Vessel density (VD) analysis computes the percentage of area occupied by OCTA detected vasculature in a measured area. Choriocapillaries flow voids will be computed to assess choriocapillaries circulation. The measurements of the OCTA, axial length, intraocular pressure will be obtained before the phacoemulsification surgery. Optical coherence tomography and IOP measurements will also be obtained 1 week after surgery.

Official Title
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Changes of Macular Vasculature After Uncomplicated Phacoemulsification Surgery Using Optical Coherence Tomography Angiography

Conditions
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Diabetic Retinopathy

Intervention / Treatment
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* Other: Phacoemulsification for cataract


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: - Presence of a nuclear, cortical cataract or complicated cataract due to diabetic mellitus Intraocular pressure (IOP) of 21 mm Hg or lower Axial length (AL) between 20.0 mm and 25.0 mm. Exclusion Criteria: Eyes with an AL longer than 25.0 mm or shorter than 20.0 mm, IOP higher than 21 mm Hg, History of ocular trauma or intraocular surgery, or any abnormal intraocular findings Poor OCT-A images because of severe cataracts or unstable fixation Any signs of intraoperative or postoperative complications

Ages Eligible for Study
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Minimum Age: 30 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Group(1): Cataract with no diabetic retinopathy<br> | Other: Phacoemulsification for cataract<br>* Phacoemulsification for removal of cataract<br>|
| Group (2): Cataract associated with diabetic retinopathy<br> | Other: Phacoemulsification for cataract<br>* Phacoemulsification for removal of cataract<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| To record the vascular changes that may be present in the macular after uncomplicated phacoemulsification surgery by using OCTA |  | 1 week after surgery |