Macular Vascular Density Changes following Cataract Surgery in Diabetic Patients: An Optical Coherence Tomography Angiography Study

Purpose. Cataracts and diabetes very commonly coexist. The aim of the present study was to quantify the effect of uncomplicated phacoemulsification on retinal microvasculature in diabetic patients by using optical coherence tomography angiography (OCTA). Methods. A prospective observational study of diabetic and nondiabetic patients at baseline and 1 day, 1 week, 1 month, and 3 months after cataract surgery was performed by using OCTA. We measured the macular thickness (MT), superficial capillary plexus (SCP), deep capillary plexuses (DCP), and foveal avascular zone (FAZ) in the 3 × 3 mm macular images. Results. A total of 32 eyes of 32 type 2 diabetic patients and 40 eyes of 40 nondiabetic patients were assessed. There was a significant increase in MT at 1 month and 3 months after surgery in both groups (all P < 0.05 ), but there was no significant difference between the two groups ( P = 0.217 ). At 3 months postoperatively, the SCP level in the diabetic group was significantly higher than that at baseline ( P < 0.05 ). The MT and SCP were negatively correlated with logMAR best-corrected visual acuity (BCVA), while the FAZ area and perimeter were positively correlated with logMAR BCVA in the diabetic group. Conclusions. Our study demonstrated that phacoemulsification can increase macular thickness in both diabetic and nondiabetic patients and increase SCP in diabetic patients within 3 months after surgery. Whether these changes persist for a longer period still needs to be investigated.

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Retinal microvascular alterations after phacoemulsification in patients with diabetes evaluated using optical coherence tomography angiography

10.21203/rs.2.13588/v1 ◽

2019 ◽

Author(s):

Le Feng ◽

Guliqiwaer Azhati ◽

Tingting Li ◽

Fang Liu

Keyword(s):

Optical Coherence Tomography ◽

Cataract Surgery ◽

Optical Coherence Tomography Angiography ◽

Macular Thickness ◽

Diabetic Group ◽

Foveal Avascular Zone ◽

Diabetic Patients ◽

Optical Coherence ◽

Retinal Microvasculature ◽

Significant Difference

Abstract Purpose: To quantify changes in retinal microvasculature in diabetic patients after phacoemulsificatio by using optical coherence tomography angiography (OCTA). Methods: Macular thickness(MT), superficial capillary plexus (SCP), deep capillary plexuses (DCP) and foveal avascular zone (FAZ) measurements of the 3×3 mm macular images were obtained by OCTA at baseline, 1 day,1 week, 1 month, and 3 months after cataract surgery in diabetic and non- diabetic patients. Results: There was a significant increase in MT at 1 month and 3 months after surgery in both groups (all P<0.05), but no significant difference between the two groups (p= 0.217). At 3 months postoperatively, the SCP increase was significantly higher compared with baseline in diabetic group (P<0.05). The MT and SCP was negatively correlated with logMAR best corrected visual acuity(BCVA), while the FAZ area and perimeter were positively correlated with logMAR BCVA in diabetic group. Conclusions: Cataract surgery can increase macular thickness in both diabetic and non- diabetic patients, and also increase the SCP in diabetic patients. Whether these changes will persist a longer period still needs to be followed up.

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Inter-relationship between retinal and choroidal vasculatures using optical coherence tomography angiography in normal eyes

European Journal of Ophthalmology ◽

10.1177/1120672118816225 ◽

2018 ◽

Vol 30 (1) ◽

pp. 48-57 ◽

Cited By ~ 5

Author(s):

Jaeryung Oh ◽

Daniel Jinhag Baik ◽

Jaemoon Ahn

Keyword(s):

Optical Coherence Tomography ◽

Layer Thickness ◽

Optical Coherence Tomography Angiography ◽

Macular Thickness ◽

Vascular Density ◽

Inner Plexiform Layer ◽

Central Macular Thickness ◽

Optical Coherence ◽

Outer Retina ◽

Capillary Plexus

Purpose: To quantify vascular and structural macular variables in healthy eyes and to investigate correlations between these variables and age using optical coherence tomography angiography. Materials and methods: A total of 261 eyes of 261 subjects with normal fundus were included. Central macular thickness, ganglion cell layer to inner plexiform layer thickness, outer retina layer thickness, subfoveal choroidal thickness, and choroidal vascularity index were measured using optical coherence tomography. Foveal avascular zone area, vascular density, and flow void area were measured using optical coherence tomography angiography. Results: Vascular density in the superficial capillary plexus was correlated with central macular thickness, ganglion cell layer to inner plexiform layer thickness, and outer retina layer thickness ( P < 0.001, P = 0.004, and P < 0.001, respectively). Vascular density in the deep capillary plexus was correlated with central macular thickness and outer retina layer thickness ( P = 0.003 and P = 0.001, respectively). Vascular density of choriocapillaris was correlated with vascular density of superficial capillary plexus and deep capillary plexus ( P < 0.001 and P = 0.001, respectively). Conclusion: Vascular density of choriocapillaris varies with retinal vascular density rather than the structure of choroid using optical coherence tomography angiography. In contrast, retinal vascular density changes as the retinal structure. Our results provide more information about the relationship between retina and choroid.

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Quantitative Evaluation of Vascular Density in Diabetic Retinopathy Subtypes using Optical Coherence Tomography Angiography

10.21203/rs.3.rs-63001/v1 ◽

2020 ◽

Author(s):

Fariba Ghassemi ◽

Kaveh Fadakar ◽

Sahar Berijani ◽

Ameneh Babeli ◽

Alireza Gholizadeh ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Diabetic Retinopathy ◽

Optical Coherence Tomography Angiography ◽

Normal Subjects ◽

Vascular Density ◽

Diabetic Patients ◽

Multivariate Linear Regression Analysis ◽

Optical Coherence ◽

Potential Biomarker ◽

Capillary Plexus

Abstract Background: To determine the discrepancy between quantitative measurement of retinal and choriocapillaris (CC) vascular density (VD) in diabetic retinopathy (DR) stages using spectral domain optical coherence tomography angiography (SD OCTA) and compare it with normal subjects.Methods: 188 eyes of 97 participants were recruited in this cross-sectional study. Macular OCTA (3x3mm) scan was performed and VD at the level of superficial capillary plexus (SCP), deep capillary plexus (DCP) and CC were measured with the device software.Results: In normal subjects, VD in SCP, DCP, and CC were higher in all subsegments. In retinal VD, all calculated parameters were reduced in the more extreme stages of DR, except for foveal VD of SCP. There was a constant pattern of decrease in VD of CC from normal cases to cases of NDR and NPDR and then a slight increase happened in the PDR stage but never touching the normal quantities. Age, fasting blood sugar, and years of diabetes mellitus were correlated with reduced VD in different segments. Multivariate linear regression analysis showed that best-corrected visual acuity (BCVA) was positively correlated with parafoveal VD at SCP and VD of foveal area at CC. VD of all subfields of macular area except foveal DCP VD showed reduced levels in diabetic macular edema (DME) patients compared to those without DME.Conclusions: The findings of the study endorse retina VD changes as a potential biomarker for DR development before retinopathy becomes clinically evident. It seems that parafoveal VD of SCP and foveal VD of CC are good biomarkers to predict VA in the diabetic patients.

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A Comparative Evaluation of Macular Thickness after Phacoemulsification and Manual SICS in Diabetic Patients by Optical Coherence Tomography

International Journal of Research and Review ◽

10.52403/ijrr.20210766 ◽

2021 ◽

Vol 8 (7) ◽

pp. 468-472

Author(s):

Saswati Biswas ◽

Santosh Yadawrao Ingle ◽

Samiran Das

Keyword(s):

Optical Coherence Tomography ◽

Cataract Surgery ◽

Macular Edema ◽

Macular Thickness ◽

Diabetic Patients ◽

Optical Coherence ◽

Small Incision Cataract Surgery ◽

High Rise ◽

Small Incision ◽

Before And After

Background: The main aim of the study is to compare the change in macular thickness after uncomplicated phacoemulsification versus uncomplicated manual SICS in known diabetic patients by optical coherence tomography Methods: This study was an observational study involving 50 patients with each group having 25 patients. Group 1 was operated with Phacoemulsification through limbal 2.8 mm incision with Foldable PCIOL implantation. & Manual small incision cataract surgery through 5.5 to 6.5 mm incision with sclerocorneal tunnel with PMMA PCIOL implantation. For all patients, macular OCT was performed during preoperative period & post-op 1st day,7th day, 1st month, 3rd month & 6th month. Statistical software SPSS, version 21.0 was used for statistical analysis. Results: In both PHACO & SICS group MCFT rose steadily during post-operative period and SICS group shows high rise during follow up.The MCFT shows a difference between PHACO & SICS group with the highest MCFT observed in 1st month follow up i.e., 231.6 micrometer (SD ±7.831) in PHACO group & 241.64 (SD ±7.35) micrometer in SICS group. The MCFT returned to near pre-op value by the 6th month. Conclusion: There is no effect of age and sex on macular thickness before and after in both PHACO and SICS groups. In SICS group significant macular thickness was observed as compared to PHACO group, so there should be more cautious to undertake SICS in those patients who are at risk of developing macular edema or who have a higher macular thickness as seen in diabetes patients. Keywords: Phacoemulsification (PHACO), small incision cataract surgery (SICS), Cystoid macular edema.

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Changes in Retinal Vasculature and Thickness After Femtosecond Laser-assisted Cataract Surgery and Conventional Cataract Surgery Using Optical Coherence Tomography Angiography

10.21203/rs.3.rs-1212191/v1 ◽

2022 ◽

Author(s):

Hong Zhang ◽

Liangzhang Tan ◽

Fang Tian ◽

Xue Gong ◽

Lu Chen ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Visual Acuity ◽

Femtosecond Laser ◽

Cataract Surgery ◽

Optical Coherence Tomography Angiography ◽

Macular Thickness ◽

Retinal Vasculature ◽

Optical Coherence ◽

Age Related

Abstract Purpose To assess the changes in retinal vasculature and thickness after femtosecond laser-assisted cataract surgery (FLACS) using optical coherence tomography angiography (OCTA).Methods Fifty-six eyes of 56 patients with age-related cataract were enrolled in this study. Patients were divided into FLACS or conventional phacoemulsification surgery (CPS) due to the choice of operation. Vessel density (VD) and thickness at the macular area and optic nerve head (ONH) were checked by OCTA at baseline and at 1 day, 1 month and 3 months after cataract surgery.Results In the FLACS group: The radial peripapillary capillary (RPC) density displayed a significant reduction during the follow-up (P < 0.05), even when the retinal nerve fiber layer (RNFL) thickness was not significantly changed. There was a significant negative correlation between the changes in RPC density and femtosecond laser-assisted pre-treatment time (FLAPT) at 1 day and 1 month after cataract surgery respectively (both P < 0.05). At 3 months postoperatively, the macular thickness had a significant increase in all regions (all P < 0.05). In the CPS group, the retinal VD and thickness did not show statistically significant changes in all regions during the follow-up (all P > 0.05). However, the best corrected visual acuity (BCVA) was significantly improved in both groups postoperatively (both P < 0.001).Conclusions OCTA provided a promising analysis of retinal vascular alterations, demonstrating the reduction of RPC density and the increase of macular thickness after FLACS. However, these changes had no effect on the improvement of visual acuity after cataract surgery.

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Changes In The Macular Vascular Density after Bariatric Surgery Measured by Optical Coherence Tomography Angiography

10.21203/rs.3.rs-303145/v1 ◽

2021 ◽

Author(s):

Malak I ElShazly ◽

Marwa M Salama ◽

Kareem Elessawy

Keyword(s):

Bariatric Surgery ◽

Optical Coherence Tomography ◽

Optical Coherence Tomography Angiography ◽

Macular Thickness ◽

Vascular Density ◽

Optical Coherence ◽

Obese Patients ◽

Short Term ◽

Capillary Plexus ◽

Superficial Capillary Plexus

Abstract Purpose: To evaluate the effect of the weight loss, 3 months after bariatric surgery on the macular thickness and macular vascular density by optical coherence tomography angiography (OCTA).Methods: Forty obese patients were included in this prospective study. Body mass index (BMI), macular thickness (whole, fovea, parafovea and perifovea), macular vascular density (VD) in superficial capillary plexus (whole, fovea, parafovea and perifovea), and macular vascular density in deep capillary plexus (whole, fovea, parafovea and perifovea) were measured before and 3 months after bariatric surgery.Results: The BMI was significantly reduced postoperatively to 43.75±4.4 kg/m2 compared to the preoperative results 55.31±5.1 kg/m2 (p<0.0001). There was significant increase in the macular thickness in the fovea and parafovea postoperatively (p <0.001), but was not significant in the perifovea. There was significant increase in the macular vascular density in the deep capillary plexus postoperatively (p<0.05), but, there was no significant increase in the macular vascular density in the superficial capillary plexus postoperatively (p = 0.4). Significant correlations were detected between the BMI changes and changes in different macular parameters.Conclusion: Bariatric surgery showed significant effect on certain indices in the macular thickness and macular vascular density especially in the deep capillary plexus. Therefore, OCTA is considered a valuable tool to assess the short term changes in the macular microcirculation following significant weight reduction.

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Assessment of Macular Capillary Perfusion by Optical Coherence Tomography Angiography on Quiescent Unilateral Anterior Pediatric Uveitis

10.21203/rs.3.rs-967105/v1 ◽

2021 ◽

Author(s):

Junyan Xiao ◽

Yi Qu ◽

Chan Zhao ◽

Hang Song ◽

Anyi Liang ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Optical Coherence Tomography Angiography ◽

Foveal Avascular Zone ◽

Flow Density ◽

Vascular Density ◽

Optical Coherence ◽

Pediatric Uveitis ◽

Retinal Microvasculature ◽

Capillary Plexus ◽

Fellow Eyes

Abstract Purpose: Using spectral domain optical coherence tomography angiography (SD-OCTA) to evaluate tomographic and microvascular parameters in the macula in quiescent unilateral anterior pediatric uveitis (APU) patients.Methods: Forty-two eyes of 21 patients diagnosed with unilateral APU and 21 eyes of 21 normal controls (NC) were included in this study. 6*6 mm macular scanning mode of SD-OCTA was used for all subjects. The central macular thickness (CMT), subfoveal choroidal thickness (SFCT), vascular density (VD) of superficial capillary plexus (SCP) and the deep capillary plexus (DCP), the foveal avascular zone (FAZ) area, and choriocapillary flow density (CFD) were analyzed and compared among affected, fellow, and NC eyes. Correlation analysis were used to evaluate the potential correlating factors with CFD.Results: DCP VD and CFD were significantly lower in quiescent affected eyes as compared to fellow and NCs eyes (DCP VD both p<0.001; CDF1.0: p=0.012 and p=0.003; CDF1.5: p=0.015 and p=0.006; CDF3.0: p=0.036 and p=0.010, respectively). SCP VD, DCP VD and CMT were significantly lower in the fellow eyes as compared to NC eyes (p=0.021; p<0.001; p=0.037, respectively); CFD was negatively correlated with FAZ and CMT in affected eyes and fellow eyes. No significant differences were detected in FAZ among the 3 groups (p > .05).Conclusions: As compared to NC eyes, both retinal and choroidal microvasculature were impaired in eyes with quiescent APU; retinal microvasculature in unaffected fellow eyes of unilateral APU was also impaired. OCTA is a useful technology for detection of subclinical microvascular changes in APU and may be useful as an additional prognostic tool.

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Changes in the Retinal Microvasculature Measured Using Optical Coherence Tomography Angiography According to Age

Journal of Clinical Medicine ◽

10.3390/jcm9030883 ◽

2020 ◽

Vol 9 (3) ◽

pp. 883 ◽

Cited By ~ 2

Author(s):

Seung Hun Park ◽

Heeyoon Cho ◽

Sun Jin Hwang ◽

Beomseo Jeon ◽

Mincheol Seong ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Foveal Avascular Zone ◽

Vascular Density ◽

Inner Plexiform Layer ◽

Optical Coherence ◽

Cross Sectional ◽

Swept Source ◽

Age Related ◽

Retinal Microvasculature ◽

Significant Difference

In this cross-sectional study, we examined age-related changes in the retinal vessels of 100 healthy participants, aged from 5 to 80 years, and divided into four groups (G1, under 20 years of age; G2, from 20 to 39 years of age; G3, from 40 to 59 years of age; G4, age 60 years or older). All subjects underwent swept-source optical coherence tomography (SS-OCT) and OCT angiography (OCTA). The vascular density (VD) of the superficial (SCP) and deep capillary plexus (DCP), and choriocapillaris (CCP) were measured using OCTA. The vascular density of each capillary layer, foveal avascular zone (FAZ) area, ganglion cell-inner plexiform layer (GC-IPL) thickness, retinal thickness (RT), and choroidal thickness (CT) were compared between age groups. Most OCT variables were correlated with OCTA variables. The FAZ area; VD of the SCP, DCP, and CCP; GC-IPL thickness; RT; and CT showed significant difference (p < 0.001) between G1 + G2 and G3 + G4, except for central GC-IPL thickness (p = 0.14) and central RT (p = 0.25). Density of the retinal capillary vasculature reduced and FAZ area increased after age 40, which represents the onset of middle age.

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Quantifying the Pattern of Retinal Vascular Orientation in Diabetic Retinopathy Using Optical Coherence Tomography Angiography

10.21203/rs.3.rs-139438/v1 ◽

2021 ◽

Author(s):

Yanhui Ma ◽

Matthew Ohr ◽

Cynthia Roberts

Keyword(s):

Optical Coherence Tomography ◽

Diabetic Retinopathy ◽

Optical Coherence Tomography Angiography ◽

Preferred Orientation ◽

Quantitative Approach ◽

Optical Coherence ◽

Retinal Microvasculature ◽

Significant Difference ◽

Vessel Orientation ◽

Orientation Pattern

Abstract Quantitative imaging using optical coherence tomography angiography (OCTA) could provide objective tools for the detection and characterization of diabetic retinopathy (DR). In this study, we developed a novel quantitative approach using OCTA images to delineate the vessel orientation pattern of a specific region of interest, which is an orientation distribution curve depicting the probability of vessels at each angle from 0 to 360 degrees. Three quantitative metrics including vessel preferred orientation, vessel anisotropy and vessel mass were extracted from the orientation pattern and analyzed in each of eight 45° sectors at the macula. Differential retinal microvascular orientation patterns were observed between three healthy subjects and three subjects with DR. Greater variability of vessel preferred orientation (p<0.001) and vessel mass (p<0.001) was exhibited among subjects with DR than healthy in eight sectors. In the nasal-superior sector, there was a significant difference between healthy and DR subjects in preferred orientation and vessel anisotropy. The vessel mass characterized from the vascular orientation pattern was shown to be strongly correlated with the traditionally reported vessel density (p<0.00001). These preliminary results suggest the feasibility and advantage of our vessel orientation-based quantitative approach using OCTA to characterize DR-associated changes in retinal microvasculature.

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Quantifying the pattern of retinal vascular orientation in diabetic retinopathy using optical coherence tomography angiography

Scientific Reports ◽

10.1038/s41598-021-95219-9 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Yanhui Ma ◽

Matthew P. Ohr ◽

Xueliang Pan ◽

Cynthia J. Roberts

Keyword(s):

Optical Coherence Tomography ◽

Diabetic Retinopathy ◽

Optical Coherence Tomography Angiography ◽

Preferred Orientation ◽

Vessel Density ◽

Optical Coherence ◽

Vessel Area ◽

Retinal Microvasculature ◽

Significant Difference ◽

Orientation Pattern

AbstractQuantitative imaging using optical coherence tomography angiography (OCTA) could provide objective tools for the detection and characterization of diabetic retinopathy (DR). In this study, an operator combining the second derivative and Gaussian multiscale convolution is applied to identify the retinal orientation at each pixel in the OCTA image. We quantified the pattern of retinal vascular orientation and developed three novel quantitative metrics including vessel preferred orientation, vessel anisotropy, and vessel area. Each of eight 45º sectors of the circular disk centered at the macular region was defined as the region of interest. Significant sectoral differences were observed in the preferred orientation (p < 0.0001) and vessel area (p < 0.0001) in the 34 healthy subjects, whereas vessel anisotropy did not demonstrate a significant difference among the eight sectors (p = 0.054). Differential retinal microvascular orientation patterns were observed between healthy controls (n = 34) and the DR subjects (n = 7). The vessel area characterized from the vascular orientation pattern was shown to be strongly correlated with the traditionally reported vessel density (Pearson R > 0.97, p < 0.0001). With three metrics calculated from the vascular orientation pattern simultaneously and sectorally, our quantitative assessment for retinal microvasculature provides more information than vessel density alone and thereby may enhance the detection of DR. These preliminary results suggest the feasibility and advantage of our vessel orientation-based quantitative approach using OCTA to characterize DR-associated changes in retinal microvasculature.

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