Comparative analysis of optical coherence tomography angiography findings before and after flow-diverting stent treatment covering the ophthalmic artery origin in the management of paraclinoid aneurysms.

PURPOSE

Flow-diverter stents (FDSs) are being increasingly used for endovascular treatment of paraclinoid aneurysms. However, their impact on ophthalmic artery (OA) flow and retinal microvasculature remains unclear. Using optical coherence tomography angiography (OCTA), we evaluated the microvascular changes after FDS placement on the OA.

METHODS

This retrospective study included 38 patients with paraclinoid aneurysms who had an FDS placed on the OA origin. OCTA imaging was performed preoperatively, on postoperative day 1, and at the 6th month. The superficial and deep capillary plexus (SCP, DCP) densities in the treated and untreated fellow eyes were determined and compared with a control group of 31 healthy individuals who underwent single-session OCTA. OA status and stent-related changes were assessed at the 6th month follow-up with digital subtraction angiography (DSA).

RESULTS

A significant reduction in SCP and DCP densities was observed in the stent-treated eyes over time, particularly in the central, superior, temporal, and inferior regions (p < 0.05), while untreated fellow eyes and controls showed no significant changes.

CONCLUSION

FDS placement covering the OA orifice leads to measurable retinal microvascular changes that are detectable by OCTA, demonstrating the value of the latter as a useful non-invasive tool for this purpose.