scholarly journals Retinal Capillary Nonperfusion on OCT-Angiography and Its Relationship to Kidney Function in Patients with Diabetes

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Elysse S. Tom ◽  
Steven S. Saraf ◽  
FuPeng Wang ◽  
Qinqin Zhang ◽  
Gautam Vangipuram ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Diabetic Retinopathy ◽  
Kidney Disease ◽  
Kidney Function ◽  
Optical Coherence Tomography Angiography ◽  
Creatinine Ratio ◽  
Swept Source ◽  
Urine Albumin ◽  
Retinal Capillary ◽  
Patients With Diabetes

Background. Diabetic retinopathy and kidney disease share underlying mechanisms of microvascular damage and are often comorbid in people with diabetes. We evaluated whether there is a relationship between retinal capillary perfusion as measured by swept-source optical coherence tomography angiography and estimated glomerular filtration rate (eGFR) and albuminuria in patients with diabetes and chronic kidney disease (CKD). Method. A cross-sectional pilot study was conducted at the University of Washington among a subset of participants with diabetes and CKD participating in a larger cohort study. Participants were excluded if they were known to have kidney disease from conditions other than diabetes. Ten participants (11 eyes) were included. Retinal nonperfusion (RNP) and vessel density (VD) were measured by swept-source optical coherence tomography angiography in 30° and 60° field of view (FOV) regions centered at the fovea. Correlations of RNP and VD with eGFR and albuminuria were analyzed. Results. Participants had a mean age of 72 years, hemoglobin A1c of 8.1%, eGFR of 45 mL/min/1.73 m2, and urine albumin-to-creatinine ratio of 162 mg/g. Mean (SD) RNP was 6.6% (4.2%) and 16.9% (7.7%) in 30° and 60° FOV regions, respectively. eGFR was negatively correlated to RNP in both the 30° and 60° FOV regions (R = −0.69, p = 0.004 , and R = −0.46, p = 0.057 , respectively), and correlations were stronger among a subset of 7 participants with evidence of diabetic retinopathy on exam and fundus photos. The estimated GFR was not significantly correlated with vessel density. Urine albumin-to-creatinine ratio was not significantly correlated with RNP or VD. Conclusions. Our proof-of-concept study showed that lower eGFR was significantly correlated with retinal nonperfusion in participants with diabetes and CKD. Advanced retinal imaging may enhance the noninvasive evaluation of kidney function in diabetes.

scholarly journals Optical Coherence Tomography Angiography in Diabetes and Diabetic Retinopathy

2020 ◽  
Vol 9 (6) ◽  
pp. 1723 ◽  
Author(s):  
Jacqueline Chua ◽  
Ralene Sim ◽  
Bingyao Tan ◽  
Damon Wong ◽  
Xinwen Yao ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Diabetic Retinopathy ◽  
Optical Coherence Tomography Angiography ◽  
Vision Loss ◽  
Longitudinal Design ◽  
Optical Coherence ◽  
Retinal Microvasculature ◽  
Retinal Capillary ◽  
Patients With Diabetes ◽  
Motion Contrast

Diabetic retinopathy (DR) is a common complication of diabetes mellitus that disrupts the retinal microvasculature and is a leading cause of vision loss globally. Recently, optical coherence tomography angiography (OCTA) has been developed to image the retinal microvasculature, by generating 3-dimensional images based on the motion contrast of circulating blood cells. OCTA offers numerous benefits over traditional fluorescein angiography in visualizing the retinal vasculature in that it is non-invasive and safer; while its depth-resolved ability makes it possible to visualize the finer capillaries of the retinal capillary plexuses and choriocapillaris. High-quality OCTA images have also enabled the visualization of features associated with DR, including microaneurysms and neovascularization and the quantification of alterations in retinal capillary and choriocapillaris, thereby suggesting a promising role for OCTA as an objective technology for accurate DR classification. Of interest is the potential of OCTA to examine the effect of DR on individual retinal layers, and to detect DR even before it is clinically detectable on fundus examination. We will focus the review on the clinical applicability of OCTA derived quantitative metrics that appear to be clinically relevant to the diagnosis, classification, and management of patients with diabetes or DR. Future studies with longitudinal design of multiethnic multicenter populations, as well as the inclusion of pertinent systemic information that may affect vascular changes, will improve our understanding on the benefit of OCTA biomarkers in the detection and progression of DR.

VASCULAR ABNORMALITIES IN DIABETIC RETINOPATHY ASSESSED WITH SWEPT-SOURCE OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY WIDEFIELD IMAGING

Retina ◽  
2019 ◽  
Vol 39 (1) ◽  
pp. 79-87 ◽  
Author(s):  
Karen B. Schaal ◽  
Marion R. Munk ◽  
Iris Wyssmueller ◽  
Lieselotte E. Berger ◽  
Martin S. Zinkernagel ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Diabetic Retinopathy ◽  
Optical Coherence Tomography Angiography ◽  
Optical Coherence ◽  
Swept Source ◽  
Vascular Abnormalities

scholarly journals Quantitative assessment of choriocapillaris flow deficits in diabetic retinopathy: A swept-source optical coherence tomography angiography study

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243830
Author(s):  
Yining Dai ◽  
Hao Zhou ◽  
Qinqin Zhang ◽  
Zhongdi Chu ◽  
Lisa C. Olmos de Koo ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Diabetic Retinopathy ◽  
Healthy Subjects ◽  
Optical Coherence Tomography Angiography ◽  
Optical Coherence ◽  
Swept Source ◽  
Significant Difference ◽  
En Face ◽  
The Mean

Purpose To quantitatively assess choriocapillaris (CC) flow deficits in eyes with diabetic retinopathy (DR) using swept-source optical coherence tomography angiography (SS-OCTA). Methods Diabetic subjects with different stages of DR and age-matched healthy subjects were recruited and imaged with SS-OCTA. The en face CC blood flow images were generated using previously published and validated algorithms. The percentage of CC flow deficits (FD%) and the mean CC flow deficit size were calculated in a 5-mm-diameter circle centered on the fovea from the 6×6-mm scans. Results Forty-five diabetic subjects and 27 control subjects were included in the study. The CC FD% in diabetic eyes was on average 1.4-fold greater than in control eyes (12.34±4.14% vs 8.82±2.61%, P < 0.001). The mean CC FD size in diabetic eyes was on average 1.4-fold larger than in control eyes (2151.3± 650.8μm2 vs 1574.4±255.0 μm2, P < 0.001). No significant difference in CC FD% or mean CC FD size was observed between eyes with nonproliferative DR and eyes with proliferative DR (P = 1.000 and P = 1.000, respectively). Conclusions CC perfusion in DR can be objectively and quantitatively assessed with FD% and FD size. In the macular region, both CC FD% and CC FD size are increased in eyes with DR. SS-OCTA provides new insights for the investigations of CC perfusion status in diabetes in vivo.

scholarly journals Comparison of Quantitative Parameters in Diabetics Without Clinical Signs of Diabetic Retinopathy and Healthy Individuals Using Swept-source Optical Coherence Tomography Angiography

2021 ◽  
Author(s):  
Sophie Beka ◽  
Dominika Podkowinski ◽  
Jascha Wendelstein ◽  
Anna-Sophie Mursch-Edlmayr ◽  
Siegfried Mariacher ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Diabetic Retinopathy ◽  
Optical Coherence Tomography Angiography ◽  
Automated Image Analysis ◽  
Foveal Avascular Zone ◽  
Data Set ◽  
Swept Source ◽  
Future Studies ◽  
Avascular Zone ◽  
Perfusion Density

Abstract Automated image analysis is the future for retinal imaging in order to early diagnose retinal diseases like diabetic retinopathy. Swept source coherence tomography angiography offers new insights in retinal vascularization. Data sets for each stage of diabetic retinopathy are crucial to compare findings to the healthy population and to develop further algorithms. We recruited 39 eyes of Type-2 diabetics without diabetic retinopathy comparing them to 43 eyes of age and gender matched individuals using swept source coherence tomography angiography. Vessel and perfusion density in the superficial and deep retinal plexus, as well foveal-avascular zone expansion, using Macular Density V 0.7 algorithm were evaluated. We found no significant change in vessel and perfusion density in both plexus, as well no difference in the foveal-avascular zone between healthy and diabetic eyes without clinical diabetic retinopathy. Current parameters of vascular analysis used in swept- source optical coherence tomography angiography are not valid to detect possible early, subclinical changes in patients with diabetes. However, the presented data set is of high value for future studies, as is represents a complete and clean data set. As automated image analysis is the future in diabetic retinopathy the presented data will be used in future studies.

Detection of neovascularisation in the vitreoretinal interface slab using widefield swept-source optical coherence tomography angiography in diabetic retinopathy

2020 ◽  
pp. bjophthalmol-2020-317983
Author(s):  
Edward S Lu ◽  
Ying Cui ◽  
Rongrong Le ◽  
Ying Zhu ◽  
Jay C Wang ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Diabetic Retinopathy ◽  
Optic Disc ◽  
Proliferative Diabetic Retinopathy ◽  
Optical Coherence Tomography Angiography ◽  
Optical Coherence ◽  
Vitreoretinal Interface ◽  
Cross Sectional ◽  
Swept Source ◽  
Detection Rates

AimsTo compare the efficacy of diabetic retinal neovascularisation (NV) detection using the widefield swept-source optical coherence tomography angiography (WF SS-OCTA) vitreoretinal interface (VRI) Angio slab and SS-OCT VRI Structure slab.MethodsA prospective, observational study was performed at Massachusetts Eye and Ear from January 2019 to June 2020. Patients with proliferative diabetic retinopathy (PDR), patients with non-proliferative diabetic retinopathy and patients with diabetes but without diabetic retinopathy were included. All patients were imaged with WF SS-OCTA using the 12×12 mm Angio scan protocol centred on the fovea and optic disc. The en-face SS-OCTA VRI Angio slab and SS-OCT VRI Structure slab were evaluated for the presence or absence of NV. SS-OCTA B-scan was used to classify NV according to cross-sectional morphology (forward, tabletop or flat). All statistical analyses were performed using SPSS V.26.0.ResultsOne hundred and forty-two eyes of 89 participants were included in the study. VRI Angio detected NV at higher rates compared with VRI Structure (p<0.05). Combining VRI Angio and Structure improved detection rates compared with VRI Angio alone (p<0.05). Due to segmentation errors of the internal limiting membrane, NV with flat morphological classification had lower rates of detection on VRI Angio compared with NV with forward and tabletop morphology (p<0.05).ConclusionsWF SS-OCTA 12×12 mm VRI Angio and SS-OCT VRI Structure imaging centred on the fovea and optic disc detected NV with high sensitivity and low false positives. The VRI slab may be useful to diagnose and monitor PDR in clinical practice.

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