Fovea Plana on Optical Coherence Tomography Angiography: New perspectives

PURPOSE To report on the reliability of optical coherence tomography angiography (OCTA) to diagnose fovea plana. METHODS A retrospective, cross-sectional, case-control study included patients with foveal persistence of the inner retinal layers, confirmed by spectral domain OCT (SD-OCT), and superficial (SCP) and deep capillary plexus (DCP) foveal vascularization confirmed by OCTA. A healthy control group was selected. Best-corrected visual acuity (BCVA) was obtained.SD-OCT was used for measuring the outer nuclear layer thickness and OCTA determined the foveal avascular zone (FAZ), SCP and DCP vascular density (VD). RESULTS OCTA reliability, based on all parameters, reached 97%, while based only on SCP VD 91%. The plana group (n=57) differed significantly from the control group (n=28) in terms of FAZ, SCP and DCP foveal VD (p 30% or FAZ <0.1 mm had fovea plana. The BCVA of the plana group had no correlation with OCTA quantitative parameters (Pearson |r|<0.18, Spearman |r|<0.44). CONCLUSION OCTA has a high accuracy in diagnosing fovea plana, as its characteristics differ significantly from the normal population. The lack of correlation between BCVA and OCTA parameters implies that reduced BCVA is likely to result from co-existent diseases rather than from the foveal structure.