The goal of this study was to compare the effects of artificial tear lubricating drops on image quality and artifacts of Optical Coherence Tomography Angiography (OCTA).

In an interventional case series, for forty nurses, OCTA was performed in both eyes. In the right eye of all cases, artificial tear eye drop was applied. In twenty cases, artificial tear with preservative containing Hydroxypropyl Methylcellulose (P-HPMC group) and Dextran (Tearlose, Sina Darou, Tehran, Iran) and non-preservative mono-dose (NPMD group) containing TS-polysaccharide and Sodium Hyaluronate (Xiloial-mono, Farmigea, Italy). OCTA cube scans (3×3 mm) were acquired using Split-Spectrum Amplitude-Decorrelation Angiography algorithm, and motion correction technology. Number of horizontal and vertical saccadic, blink, and stretch artifacts and also signal strength of the images were recorded. Moreover, pain and discomfort based on subjective score was recorded as overall discomfort and discomfort experienced by blue focus light and red scanning laser.

Discomfort by blue light and red light experience by the cases and also vertical and horizontal saccadic artifacts were less in the lubricated eye by NPMD drops (p values = 0.023, 0.030, 0.039 and 0.051 respectively). Signal strength, stretch and blink artifacts and overall pain experienced by the patients in NPMD drop group and all parameters in P-HPMC group were not different.

Our study suggests that lubricating the eye with non-preservative artificial tears before OCTA may improve the image quality and reduce patients’ discomfort. Eyes lubricated with preservative contacting drops didn’t improve the cooperation versus control eyes.