Choriocapillaris and retinal vascular plexus density of diabetic eyes using split-spectrum amplitude decorrelation spectral-domain optical coherence tomography angiography

Conti, Felipe F.; Qin, Vivian L.; Rodrigues, Eduardo B; Sharma, Sumit; Rachitskaya, Aleksandra; Ehlers, Justis P.; Singh, Rishi P.

doi:10.1136/bjophthalmol-2018-311903

Cited by 71 publications

(47 citation statements)

References 23 publications

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“…In contrast, other groups demonstrated that no significant differences were found in the superficial, deep, or whole parafoveal VAD between the two groups. 13,14 Compared with VAD, VSD is a more sensitive metric to measure perfusion changes at the capillary level. 24 However, VSD has not been compared between diabetic patients without retinopathy and nondiabetic controls.…”

Section: Discussionmentioning

confidence: 99%

“…Some groups reported a small but significant enlargement of the FAZ area in diabetic eyes without retinopathy compared to controls, 16,34 while others reported no significant difference of FAZ between the two groups. [13][14][15][35][36][37] All of the aforementioned measurements were conducted using the builtin default settings of commercial systems with automatic segmentation into two slabs (superficial and deep). Because of inherent errors in automatic segmentation of the superficial and deep capillary plexuses within the central fovea, FAZ measurements using default settings are likely to be biased.…”

Section: Meanmentioning

confidence: 99%

“…Several groups have reported either normal or abnormal CC perfusion in diabetic eyes without DR by using spectral-domain OCTA (SD-OCTA). [13][14][15][16] However, one of the limitations of SD-OCTA is its shorter laser wavelength, which is more strongly scattered by the retinal pigment epithelium (RPE), resulting in significant sensitivity loss when imaging structures beneath the RPE, such as the CC. 17 Swept-source OCTA (SS-OCTA), with a longer laser wavelength, has proven to be less affected by the RPE, allowing for more reliable visualization and detection of the CC.…”

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confidence: 99%

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Microvascular Changes in the Choriocapillaris of Diabetic Patients Without Retinopathy Investigated by Swept-Source OCT Angiography

Dai

Zhou

Chu

et al. 2020

Invest. Ophthalmol. Vis. Sci.

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Purpose To investigate the microvascular changes in macular retina and choriocapillaris (CC) in diabetic eyes without retinopathy using swept-source optical coherence tomography angiography (SS-OCTA). Methods A commercial SS-OCTA system was used to collect 6 × 6-mm macular scans from patients. Three depth-resolved retinal slabs and a CC slab were segmented by a validated semiautomated algorithm. Retinal vessel area density, vessel skeleton density, and nonperfusion area were calculated on segmented retinal slabs. Foveal avascular zone was automatically measured based on en face image of the whole retinal layer. For CC quantification, the percentage of flow deficits (FD%) and the flow deficit (FD) sizes were measured. Results Sixteen eyes from 16 diabetic patients without clinically detectable retinopathy and 16 eyes from 16 age-matched nondiabetic controls were included. There was no significant difference between the two groups in all retinal vessel quantitative parameters (all P > 0.05). However, the mean FD% and mean FD sizes were significantly increased in CC in the central 1.0-mm disk ( P = 0.011 and P = 0.017, respectively), the central 1.5-mm rim ( P = 0.003 and P = 0.009, respectively), the central 2.5-mm rim ( P = 0.018 and P = 0.020, respectively), and the entire 5.0-mm disk ( P = 0.009 and P = 0.008, respectively) in diabetic eyes compared with controls. Conclusions CC perfusion in the macula is decreased in diabetic patients without retinopathy as compared to age-matched normal controls. Decreased CC perfusion in the macula may be an early indicator of otherwise clinically undetectable diabetic vasculopathy.

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Section: Discussionmentioning

confidence: 99%

Section: Meanmentioning

confidence: 99%

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confidence: 99%

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Microvascular Changes in the Choriocapillaris of Diabetic Patients Without Retinopathy Investigated by Swept-Source OCT Angiography

Dai

Zhou

Chu

et al. 2020

Invest. Ophthalmol. Vis. Sci.

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“…Therefore, further studies with a larger scan area are needed. Third, several studies have already shown that systemic diseases, including diabetes, contribute to a macular VD decrease and an increase in the foveal avascular zone area [44][45][46] . However, an ADRVD was not detected in any of the examined patients with diabetes.…”

Section: Discussionmentioning

confidence: 98%

Glaucomatous vertical vessel density asymmetry of the temporal raphe detected with optical coherence tomography angiography

Yoshikawa

Shoji

Kanno

et al. 2020

Sci Rep

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changes in retinal vasculature and ocular circulation may play an important role in the glaucoma development and progression. We evaluated the vertical asymmetry across the temporal raphe of the deep retinal layer vessel density, using swept-source optical coherence tomography angiography (SS-OCTA), and its relationship with the central visual field (VF) loss. Thirty-four eyes of 27 patients with open-angle glaucoma were included. SS-OCTA macular scanning was performed within a 3 × 3 mm (300 × 300 pixels) volume, centred on the fovea. The relationships between the vertical asymmetrical deep retinal vessel density reduction (ADRVD) across the temporal raphe and various ocular parameters were analysed. Twenty-two glaucomatous eyes with ADRVDs had central VF loss. Contrarily, ADRVDs were not found in any of the 12 eyes without central VF loss. Thirteen eyes (59.1%) with central VF loss had ADRVDs topographically corresponding to the central VF loss and macular ganglion cell complex thinning. The glaucomatous eyes with ADRVDs exhibited inferior rather than superior central VF loss (P = 0.032). Thus, ADRVD specifically indicates the glaucomatous central visual loss. Further analysis of ADRVD may improve our understanding on glaucoma pathogenesis, offering new treatment insights.Glaucoma is a progressive optic neuropathy constituting the world's leading cause of irreversible blindness 1-4 . The disease is characterised by a progressive loss of retinal ganglion cells and their axons. Although mechanical stress related to intraocular pressure (IOP) is a principal risk factor for the disease, ocular blood flow may also have an important role in the development and progression of glaucoma 5-8 .Several fundus fluorescein angiography studies have shown that glaucoma may be associated with changes in the retinal vasculature and ocular circulation 9-11 . Optical coherence tomography angiography (OCTA) is an in vivo, non-invasive technique for imaging retinal blood vessels. Information from OCTA studies may enhance our understanding of how ocular blood flow and the retinal microvasculature influence glaucoma development and progression. Additionally, OCTA retinal vasculature imaging does not require a dye injection 12-14 . Previous OCTA investigations have shown that glaucoma is associated with ocular microvasculature changes; changes in the optic nerve head vessel density (VD) [15][16][17][18]20 , macular VD 16,[20][21][22] , and foveal avascular zone area 23,24 , and the parapapillary choroidal microvascular dropout 25,26 .The OCTA technique is a promising tool for the microvasculature analysis, but OCTA images may contain critical image artefacts (i.e. projection artefacts [PAs]) that may compromise the deep retinal layer (DRL) image analysis 27 . However, the PA removal software has recently been developed, and several studies have successfully used it 28,29 . Using the DRL OCTA images that have had PAs removed, we have noticed that patients with glaucoma often exhibit vertical asymmetry of vessel-density loss across the te...

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“…9 Bir diğer yazılım olan Flow değerlendirme aracı ise koryokapillarisin flow alanını değerlendirmemize olanak sağlar. 10 DRP'nin etiyopatogenezi hakkında, mevcut bilgilerimiz ışığında hâlâ aydınlatılmayı bekleyen mekanizmalar bulunmaktadır. Dış retinayı besleyen ve zengin bir vasküler ağa sahip olan koroidin bu patolojik süreçte nasıl etkilendiği önemli bir konu olarak ortaya çıkmaktadır ve bu yönde ilerleyen birçok çalışma bulunmaktadır.…”

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Choriocapillaries Signal Voids in Patients with Diabetic Retinopathy

Göker¹,

Tekin²,

Kızıltoprak³

et al. 2019

Turkiye Klinikleri J Ophthalmol

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Ö ÖZ ZE ET T A Am ma aç ç: : Nonproliferatif diyabetik retinopatisi (NPDRP) olan hastalarda optik koherens tomografi anjiyografinin (OKTA) flow değerlendirme aracı kullanılarak koryokapillaris flow alanlarını değerlendirmek ve sağlıklı bireyler ile karşılaştırmaktır. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Bu retrospektif araştırma kapsamında, kliniğimiz retina biriminde Diyabetik Retinopati Erken Tedavi Çalışması'na göre çok hafif, hafif ve orta NPDRP nedeni ile izlem altında olan hastalar ve genel polikliniğe rutin göz muayenesi için başvuranlar değerlendirildi. Hastaların en iyi düzeltilmiş görme keskinlikleri, ön ve arka segment muayeneleri, göz içi basınçları, aksiyel uzunlukları, merkezi kornea kalınlıkları ve refraktif hata ölçümleri kaydedildi. Aynı zamanda, spektral domain optik koherens tomografi (SD-OKT), fluoresein anjiyografi ve OKTA görüntülemeleri yapıldı. Tüm OKTA görüntülemeleri RTVue XR Avanti cihazının AngioVue yazılımı kullanılarak (Opto-Vue, Inc., Fremont, CA, Versiyon 2017.1.0.151) ve 6×6 görüntüler alarak gerçekleştirildi. Cihazın flow değerlendirme aracı ile merkezi foveal avasküler zon olan 1 mm, 2 mm ve 3 mm yarıçaplı sabit daireler içinde kalan bölgelerde koryokapillarisin flow alanı hesaplandı. B Bu ul lg gu ul la ar r: : Otuz (21 kadın, 9 erkek) bireyin 30 gözü çalışma grubu, 30 (20 kadın, 10 erkek) sağlıklı olgunun 30 gözü kontrol grubu olarak incelendi. Çalışma ve kontrol grubunun yaş ortalaması sırasıyla 58,82±3,50 ve 57,65±5,84 yıl olarak bulundu. OKTA ölçümlerinde NPDRP'si olan grubun her üç yarıçaplı alan içindeki koryokapillaris flow alanları kontrol grubuna göre istatistiksel anlamlı olarak daha düşük bulunmuştur. (sırasıyla p=0,004, p=0,004 ve p=0,008). S So on nu uç ç: : Sonuç olarak bu çalışma, görüntüleme metodu olarak OKTA kullanılarak gerçekleştirilmiş ve NPDRP'si olan hastalarda koryokapillaris flow alanının sağlıklı bireylere göre daha düşük olduğunu göstermiştir.A An na ah h t ta ar r K Ke e l li i m me e l le er r: : Diyabetik koroidopati; optik koherens tomografi anjiyografi A AB BS S T TR RA AC CT T O Ob bj je ec ct ti iv ve e: : To evaluate the choriocapillaris flow areas of patients with non-proliferative diabetic retinopathy (NPDRP) using optical coherence tomography angiography (OCTA) flow assesment tool and to compare the results with those obtained in healthy controls. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : In this retrospective study, patients who were followed up as having for very mild, mild and moderate NPDRP according to Early Treatment Diabetic Retinopathy Study in the retina unit of our clinic and patients who applied to general outpatient clinic for routine ophthalmologic examination were evaluated. The best corrected visual acuity values, anterior and posterior segment examinations, intraocular pressure values, axial lengths, central corneal thicknesses and refractive error measurements of patients were recorded. At the same time spectral domain optical coherence tomography (SD-OCT), fluorescein angiography and OCTA...

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Choriocapillaris and retinal vascular plexus density of diabetic eyes using split-spectrum amplitude decorrelation spectral-domain optical coherence tomography angiography

Abstract: Choriocapillaris and retinal CPD are reduced in diabetic retinopathy, while FAZ area is increased in eyes with PDR. Vascular changes captured by new imaging modalities can further characterise diabetic choroidopathy.

Cited by 71 publications

References 23 publications

Microvascular Changes in the Choriocapillaris of Diabetic Patients Without Retinopathy Investigated by Swept-Source OCT Angiography

Microvascular Changes in the Choriocapillaris of Diabetic Patients Without Retinopathy Investigated by Swept-Source OCT Angiography

Glaucomatous vertical vessel density asymmetry of the temporal raphe detected with optical coherence tomography angiography

Choriocapillaries Signal Voids in Patients with Diabetic Retinopathy

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