Association of renal function with retinal vessel density in patients with type 2 diabetes by using swept-source optical coherence tomographic angiography

2020 ◽  
Vol 104 (12) ◽  
pp. 1768-1773 ◽  
Author(s):  
Wei Wang ◽  
Miao He ◽  
Xia Gong ◽  
Lanhua Wang ◽  
Jie Meng ◽  
...  
Keyword(s):  
Renal Function ◽  
Retinal Vessel ◽  
Vessel Density ◽  
Optical Coherence ◽  
Microvascular Damage ◽  
Cross Sectional ◽  
Swept Source ◽  
Patients With Diabetes ◽  
Retinal Vessel Density ◽  
Tomographic Angiography

AimsTo investigate the relationship between retinal vessel density and renal function in patients with diabetes mellitus (DM) using non-invasive optical coherence tomographic angiography (OCTA).MethodsThis prospective cross-sectional study recruited ocular-treatment-naïve patients with DM registered in the community of Guangzhou, China. The retinal vessel density of the superficial capillary plexus in the macula was obtained by using swept-source OCTA imaging. The Xiangya equation was used to calculate the estimated glomerular filtrate rate (eGFR). Participants were divided into the following groups by eGFR: no chronic kidney disease (non-CKD), mild CKD and moderate-to-severe CKD (MS-CKD).ResultsA total of 874 patients with DM (874 eyes), with a mean age of 64.8±7.1 years, were included in the final analysis. The vessel density was significantly lower in patients with CKD than in non-CKD patients in a dose–response pattern, with a parafoveal vessel density of 49.1%±2.1% in non-CKD, 48.4%±1.9% in mild CKD and 47.2%±1.7% in MS-CKD (p<0.001). The sparser retinal capillaries were related to lower eGFR (β=0.037; 95% CI 0.025 to 0.049; p<0.001) and higher microalbuminuria (β = –0.023; 95% CI –0.039 to –0.008; p=0.002). The eGRF was independently associated with parafoveal vessel density (β=0.029; 95% CI 0.016 to 0.042; p<0.001), even after adjusting for other factors.ConclusionRetinal vessel density decreased with renal function impairment, underlining the potential value of OCTA to detect early microvascular damage in the kidney in patients with diabetes.

scholarly journals Quantitative analysis of retinal vessel density and thickness changes in diabetes mellitus evaluated using optical coherence tomography angiography: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xinyue Li ◽  
Yu Yu ◽  
Xueting Liu ◽  
Yan Shi ◽  
Xin Jin ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Optical Coherence Tomography Angiography ◽  
Retinal Vessel ◽  
Cross Sectional Study ◽  
Vessel Density ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Patients With Diabetes ◽  
Retinal Vessel Density

Abstract Background Diabetic retinopathy is the most common microvascular complication of diabetes; however, early changes in retinal microvessels are difficult to detect clinically, and a patient’s vision may have begun to deteriorate by the time a problem is identified. Optical coherence tomography angiography (OCTA) is an innovative tool for observing capillaries in vivo. The aim of this study was to analyze retinal vessel density and thickness changes in patients with diabetes. Methods This was a retrospective, observational cross-sectional study. Between August 2018 and February 2019, we collected OCTA data from healthy participants and diabetics from the First Affiliated Hospital of Harbin Medical University. Analyzed their retinal vessel density and thickness changes. Results A total of 97 diabetic patients with diabetes at different severity stages of diabetic retinopathy and 85 controls were involved in the experiment. Diabetic patients exhibited significantly lower retinal VD (particularly in the deep vascular complexes), thickening of the neurosensory retina, and thinning of the retinal pigment epithelium compared with controls. In the control group, nondiabetic retinopathy group and mild diabetic retinopathy group, superficial VD was significantly correlated with retinal thickness (r = 0.3886, P < 0.0001; r = 0.3276, P = 0.0019; r = 0.4614, P = 0.0024, respectively). Conclusions Patients with diabetes exhibit ischemia of the retinal capillaries and morphologic changes in vivo prior to vision loss. Therefore, OCTA may be useful as a quantitative method for the early detection of diabetic retinopathy.

scholarly journals Quantification of Optical Coherence Tomography Angiography in Age and Age-related Macular Degeneration using Vessel Density analysis

2019 ◽  
Author(s):  
Ehsan Vaghefi ◽  
Sophie Hill ◽  
Hannah M Kersten ◽  
David Squirrell
Keyword(s):  
Optical Coherence Tomography ◽  
Macular Degeneration ◽  
Optical Coherence Tomography Angiography ◽  
Retinal Vessel ◽  
Vessel Density ◽  
Age Related Macular Degeneration ◽  
Optical Coherence ◽  
Age Related ◽  
Capillary Plexus ◽  
Retinal Vessel Density

AbstractPurposeTo determine whether vessel density (VD) as measured by optical coherence tomography angiography (OCT-A) provide insights into retinal and choriocapillaris vascular changes with ageing and intermediate dry age related macular degeneration (AMD).MethodsSeventy-five participants were recruited into three cohorts; young healthy (YH) group, old healthy (OH) and those at high-risk for exudative AMD. Raw OCT and OCT-A data from TOPCON DRI OCT Triton were exported using Topcon IMAGENET 6.0 software, and 3D datasets were analysed to determine retinal thickness and vessel density.ResultsCentral macular thickness measurements revealed a trend of overall retinal thinning with increasing age. VD through the full thickness of the retina was highest in ETDRS sector 4 (the inferior macula) in all the cohorts. Mean VD was significantly higher in the deep capillary plexus than the superficial capillary plexus in all ETDRS sectors in all cohorts but there was no significant difference noted between groups. Choriocapillaris VD was significantly lower in all ETDRS sectors in the in the AMD group compared with the YH and the OH groups.ConclusionsRetinal vessel density maps, derived from the retinal plexi are not reliable biomarkers for assessing the ageing macular. Our non-proprietary analysis of the vascular density of the choriocapillaris revealed a significant drop off of VD with age and disease but further work is required to corroborate this finding. If repeatable, choriocapillaris VD may provide a non-invasive biomarker of healthy ageing and disease.Brief SummaryIn this manuscript, we have studied the potential of retinal vessel density as measured by optical coherence tomography angiography (OCT-A), as a biomarker for detection of high-risk of developing exudative age-related macular degeneration (AMD).

scholarly journals Using OCT Angiography as a Biomarker of Retinopathy Severity in Patients with Diabetes

2020 ◽  
Vol 3 ◽  
Author(s):  
Melanie Scheive ◽  
Kathryn Reinhart ◽  
Amir Hajrasouliha
Keyword(s):  
Visual Acuity ◽  
Retinal Vessel ◽  
Clinical Severity ◽  
Long Term Effects ◽  
Cross Sectional ◽  
Anti Vegf ◽  
Mixed Analysis ◽  
Patients With Diabetes ◽  
Retinal Vessel Density ◽  
Sectional Analysis

Background and Hypothesis: Diabetic retinopathy (DR), the leading microvasculature and blindness-causing complication of diabetes mellitus, can be diagnosed and monitored using optical coherence tomography angiography (OCT-A) to visualize all retinal vasculature layers with greater resolution and limited invasiveness compared to the established technique of fluorescein angiography. We hypothesize that OCT-A can be used as a biomarker to correlate retinal vessel density (VD) from OCT-A with clinical severity of DR, visual acuity, and patient demographics as well as track anti-vascular endothelial growth factor (VEGF) treatment efficacy.  Methods: This retrospective cohort study analyzed the automatically quantified VDs of the superficial vascular complex (SVC) and deep vascular complex (DVC), including the whole, foveal, and parafoveal VDs, on quality OCT-A scans in patients with diagnosed DR. A multivariate linear regression and ANOVA analysis was completed to compare VDs to DR severity, visual acuity, and demographic factors in patients with at least one quality OCT-A scan. A linear mixed analysis was performed to determine how VD was affected by whether anti-VEGF therapy was given to patients with OCT-A scans at two or more different timepoints.   Results: There was found to be a positive correlation of the VDs in both the SVC whole and parafoveal VD and DVC parafoveal VD with decreased DR severity and increased visual acuity in the cross-sectional analysis (p ≤0.001). The DVC whole VD was also positively correlated with increased visual acuity (p<0.001). There was no difference in the VDs associated with anti-VEGF treatment over time.  Conclusions and Potential Impact: OCT-A shows promise for the diagnosis and monitoring of DR as a biomarker for disease severity which correlates with visual acuity. Anti-VEGF did not show significant change in VD in DR patients. Longer follow-up periods may be needed to elaborate on the long-term effects of anti-VEGF. 

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