OCT angiography in polycythemia vera

Dear Editor, We studied the article titled “Evaluating the impact of polycythemia vera on retinal and optic nerve head microvascularity: An OCTA study” by Feyza CM et al.[1] We have some queries and suggestions for the authors. The authors have reported statistically significant thinner retinal parameters in patients with polycythemia vera (PV) compared to healthy controls. We would like to know the clinical significance of these findings. How do this study’s results change how an ophthalmologist or hematologist treats a case of PV? The authors mention that the retinal damage identified in their study is supported by the occurrence of various vascular issues such as artery and vein occlusions, sinus thrombosis, and ischemic optic neuropathies, as mentioned in the literature. Is there a cut-off value below which vision loss or a thrombotic event can be predicted? The decrease in various retinal parameters may be statistically significant, but they still lie within the normal range for the patient’s age. The authors have mentioned that all patients had a minimum treatment follow-up period of one year. The mean duration of follow-up should be provided. A correlation between the duration of disease (from the time of diagnosis) and retinal parameters should have been evaluated. This would have helped to know if there is a progressive decrease or worsening of retinal parameters with increased disease duration. Similarly, a correlation between mean hemoglobin and other blood parameters with the retinal parameters should also have been found. The authors have rightly mentioned that further studies are needed. Future studies should try to evaluate whether medical treatment in cases of PV brings about a change in the vascular indices. Financial support and sponsorship: Nil. Conflicts of interest: There are no conflicts of interest.