scholarly journals Macular and peripapillary vessel density measurement in the evaluation of Non-proliferative Diabetic Retinopathy

2019 ◽  
Author(s):  
Dawei Yang ◽  
Dan Cao ◽  
Honghua Yu ◽  
Xiaohong Yang ◽  
Zhongning Huang ◽  
...  

Abstract Purpose: To compare vessel density in macular and peripapillary area between control subjects and patients with non-proliferative diabetic retinopathy (NPDR) using optical coherence tomography angiography (OCTA) and to evaluate the association between RNFL thickness and different stage of diabetic retinopathy. Methods: A total of 170 eyes (normal control, 43; mild NPDR, 43; moderate NPDR, 42; severe NPDR, 42) underwent OCTA imaging. Optical coherence tomography angiographic parameters were vessel densities of superficial capillary plexus (SCP), deep capillary plexus (DCP) in macular area and peripapillary area. Results: Vessel density of SCP and DCP in macular area, peripapillary area as well as RNFL thickness were 53.13%±3.03%, 52.07%±2.28%, 53.78%±3.66% and 128.86μm±11.32μm, respectively, in control subjects; 50.24%±3.81%, 47.40%±45.02%, 46.50%±6.03% and 124μm±13.97μm, respectively, in mild NPDR; 46.80%±5.23%; 44.39%±3.99%; 44.64%±4.23%; 121.02μm±20.86μm, respectively, in moderate NPDR; 42.82%±5.46%, 42.34%±5.14%, 43.16%±4.47%, 118.60μm±21.91μm in severe NPDR. The reduction of vessel density of SCP and DCP in macular area, peripapillary area as well as RNFL thickness were correlated with increasing severity of DR. Vessel density of SCP and DCP in macular area, peripapillary area and foveal density 300 (FD 300) in normal control were significantly higher than that of mild, moderate and severe NPDR groups. (all P<0.001). Vessel density of DCP shows better ability to identify the severity of DR (0.913; 95% CI=0.867-0.958; cut off value:0.75) than FD 300, vessel density of SCP in macular area and peripapillary area. Conclusion: Macular and peripapillary vessel density as well as RNFL thickness decreased as DR progresses. Vessel density in DCP could be an objective and sensitive indicator for monitoring progression of DR. OCTA might be clinically useful to evaluate microvascular and microstructural alterations in macula and optive nerve head (ONH), thus providing a new method to study the course of DR.

2019 ◽  
Author(s):  
Dawei Yang ◽  
Dan Cao ◽  
Honghua Yu ◽  
Xiaohong Yang ◽  
Zhongning Huang ◽  
...  

Abstract Purpose: To compare vessel density in macular and peripapillary area between control subjects and patients with non-proliferative diabetic retinopathy (NPDR) using optical coherence tomography angiography (OCTA) and to evaluate the association between RNFL thickness and different stage of diabetic retinopathy. Methods: A total of 170 eyes (normal control, 43; mild NPDR, 43; moderate NPDR, 42; severe NPDR, 42) underwent OCTA imaging. Optical coherence tomography angiographic parameters were vessel densities of superficial capillary plexus (SCP), deep capillary plexus (DCP) in macular area and peripapillary area. Results: Vessel density of SCP and DCP in macular area, peripapillary area as well as RNFL thickness were 53.13%±3.03%, 52.07%±2.28%, 53.78%±3.66% and 128.86μm±11.32μm, respectively, in control subjects; 50.24%±3.81%, 47.40%±45.02%, 46.50%±6.03% and 124μm±13.97μm, respectively, in mild NPDR; 46.80%±5.23%; 44.39%±3.99%; 44.64%±4.23%; 121.02μm±20.86μm, respectively, in moderate NPDR; 42.82%±5.46%, 42.34%±5.14%, 43.16%±4.47%, 118.60μm±21.91μm in severe NPDR. The reduction of vessel density of SCP and DCP in macular area, peripapillary area as well as RNFL thickness were correlated with increasing severity of DR. Vessel density of SCP and DCP in macular area, peripapillary area and foveal density 300 (FD 300) in normal control were significantly higher than that of mild, moderate and severe NPDR groups. (all P<0.001). Vessel density of DCP shows better ability to identify the severity of DR (0.913; 95% CI=0.867-0.958; cut off value:0.75) than FD 300, vessel density of SCP in macular area and peripapillary area. Conclusion: Macular and peripapillary vessel density as well as RNFL thickness decreased as DR progresses. Vessel density in DCP could be an objective and sensitive indicator for monitoring progression of DR. OCTA might be clinically useful to evaluate microvascular and microstructural alterations in macula and optive nerve head (ONH), thus providing a new method to study the course of DR.


2018 ◽  
Author(s):  
Dawei Yang ◽  
Dan Cao ◽  
Honghua Yu ◽  
Xiaohong Yang ◽  
Zhongning Huang ◽  
...  

Abstract Purpose: To compare vessel density in macular and peripapillary area between control subjects and patients with non-proliferative diabetic retinopathy (NPDR) using optical coherence tomography angiography (OCTA) and to evaluate the association between RNFL thickness and different stage of diabetic retinopathy. Methods: A total of 170 eyes (normal control, 43; mild NPDR, 43; moderate NPDR, 42; severe NPDR, 42) underwent OCTA imaging. Optical coherence tomography angiographic parameters were vessel densities in superficial capillary plexus (SCP), deep capillary plexus (DCP) in macular area and peripapillary area. Results: The reduction of vessel density of SCP and DCP in macular area, peripapillary area as well as RNFL thickness were correlated with increasing severity of DR. Vessel density of SCP and DCP in macular area, peripapillary area and FD300 in NPDR groups decreased as compared to normal control (P<0.001). Vessel density of DCP shows better ability to identify the severity of DR (sensitivity, and specificity of 88.1%, and 85.2%, respectively) than in FD 300, vessel density of SCP in macular area and peripapillary area Conclusion: Macular and peripapillary vessel density as well as RNFL thickness were significantly decreased in different stage of NPDR compared to normal controls. Vessel density in DCP could be an objective and sensitive indicator for monitoring progression of DR. OCTA might be clinically useful to evaluate microvascular and microstructural alterations in macula and ONH, thus providing a new method to study the course of DR. Key Words: Diabetic retinopathy, optical coherence tomography angiography, vessel density, RNFL thickness, FD 300


2019 ◽  
Vol 30 (6) ◽  
pp. 1418-1423 ◽  
Author(s):  
Claudio Furino ◽  
Grazia Montrone ◽  
Maria Vittoria Cicinelli ◽  
Stefania Balestra ◽  
Maria Oliva Grassi ◽  
...  

Purpose: To investigate a subset of diabetic patients without diabetic retinopathy with optical coherence tomography angiography, assessing the differences in macular perfusion between diseased eyes and healthy controls. Methods: Monocentric cross-sectional study, including 86 eyes from 43 diabetic patients with no clinical signs of diabetic retinopathy and 78 eyes from 39 controls. Patients underwent 3.0 × 3.0 mm and 4.5 × 4.5 mm swept-source optical coherence tomography angiography. Vessel density (%), foveal avascular zone area (mm2), and avascular density (%) were provided for the superficial capillary plexus and the deep capillary plexus. Results: The foveal avascular zone area at the superficial capillary plexus was larger in the study group compared to controls, irrespective of the area of the slab considered. A meaningful difference was found in the vessel density at the deep capillary plexus of the 3.0 × 3.0 mm slab (p = 0.03). Almost all the variables considered in the study showed a significant within-subject effect. Age significantly correlated with vessel density of superficial capillary plexus on 4.5 × 4.5 mm in both control and diabetic eyes. Conclusion: Diabetic patients with subclinical diabetic retinopathy feature a larger foveal avascular zone at the superficial capillary plexus compared with controls, as well as relative reduction of the vessel density at the deep capillary plexus. These findings might serve as the basis for screening between normal and diabetic subjects.


QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
Alshaimaa M Lotfy ◽  
A H Saad ◽  
T H Mohamed ◽  
Y A Elzankalony

Abstract Background Diabetes mellitus is a metabolic disorder characterized by chronic hyperglyaemia. Diabetes cause many complication. diabetic retinopathy is common complication which affects up to 80 percent of all patients who have diabetes for more than10 years or more. Retinal functional abnormalities as reduced contrast sensitivity and ERG abnormalities could be detected in diabetic patients before microvascular lesions can be detected in ophalmological examination. Purpose to determine correlation between retinal nerve fibre layer thickness measured by Optical coherence tomography and glycosylated haemoglobin in type 2 non proliferative diabetic retinopathy. Patients and Methods In our study was conducted on patient recruited from National institute of Diabetes and endocrinology in the ophthalmic clinic. Patients were evaluated for peri-papillary retinal nerve fibre layer ( RNFL) thickness by optical coherence tomography (RS 3000 advance). Blood were taken for HbA1c. The study was included 164 eyes from 87 patients. The patients were non proliferative diabetic retinopathy(NPDR) classified into three groups according to Early Treatment Diabetic Retinopathy Study into; Mild group was 69 eyes from 35 patients, moderate group58 eyes from 31 patient, Severe group 37 eyes from 21 patients. Results The severe group show statistically significant difference with the others (P &lt; 0.001) except with mild group in nasal and inferior quadrant, therefore the thickness was high in the severe groups because the edema in RNFL. In our study we observed decrease in total thickness of RNFL in peripapillary area. However, among each quadrant we observed that the superior quadrant was thinner compared to other quadrants (p &lt; 0.001). There was insignificant correlation between RNFL thickness with the Glycosylated haemoglobin ( HbA1c )in all NPDR groups. Conclusion Early NPDR patients appear to have thinner RNFL thickness and severe NPDR patients show increasing RNFL thickness. There are not correlation between RNFL thickness and glycosylated haemoglobin.


2021 ◽  
Vol 62 (10) ◽  
pp. 1397-1406
Author(s):  
Chang Woo Cho ◽  
Woo Hyun Jung ◽  
Jung Lim Kim

Purpose: The purpose of this study was to analyze retinal capillary parameters using optical coherence tomography angiography (OCTA) of the affected eye and the fellow eye of unilateral normal tension glaucoma (NTG) patients and compare the findings with eyes from a normal control group.Methods: A retrospective cross-sectional study was carried out on patients diagnosed with unilateral NTG (24 affected eyes and 24 fellow eyes each) and normal individuals (29 eyes, the control group). OCTA was used to measure the vascular density (VD) and perfusion density (PD) of the macular area and the peripapillary area.Results: In the superficial capillary plexus, the fellow eye group of unilateral NTG patients showed a decrease in VD of the inner-inferior and PD of the inner-inferior and outer-average peripapillary area, compared with the normal control group (p = 0.008, p < 0.001, and p = 0.001). In the affected NTG eye group, the VD (p = 0.014, p = 0.011, p < 0.001, p < 0.001, and p < 0.001) and PD (p = 0.017, p = 0.023, p < 0.001, p = 0.001, and p < 0.001) of the total, inner-average, inner-inferior, and outer-inferior peripapillary area, and the outer-inferior macular area decreased compared to the fellow eye and normal control group, as well as the VD of the outer-average peripapillary area (p = 0.010). The PD of the outer-average peripapillary area (p = 0.003); the VD (p = 0.041, p = 0.008, p = 0.006) and the PD (p = 0.013, p < 0.001, p = 0.001) of the total, inner-inferior, and outer-average macular area; and the PD of the outer-temporal macular area (p = 0.003) were lower than the normal control group. There was no difference in the VD or PD obtained from the deep capillary plexus of the macular area among the groups.Conclusions: It is useful to observe retinal capillary parameters using OCTA for patients with unilateral NTG.


2021 ◽  
Vol 13 ◽  
pp. 251584142199538
Author(s):  
Hilal Kılınç Hekimsoy ◽  
Ali Mehmet Şekeroğlu ◽  
Ali Mert Koçer ◽  
Vedat Hekimsoy ◽  
Ali Akdoğan

Objectives: To investigate the optical coherence tomography angiography (OCTA) parameters of the optic nerve head and peripapillary retina and to assess macular and peripapillary retinal nerve fiber layer (RNFL) thickness by using spectral-domain optical coherence tomography (SD-OCT) in patients with limited scleroderma and to compare these results with those of healthy control subjects. Materials and Methods: 42 patients with a confirmed diagnosis of limited scleroderma and 32 age- and sex-matched healthy control subjects were included in the study. OCTA was performed for the radial peripapillary capillary plexus (RPCP) whole image, inside disc, and peripapillary vessel densities in all participants with XR Avanti AngioVue OCTA (Optovue, Fremont, California, USA). OCT images were obtained with Spectralis OCT with eye-tracking dual-beam technology (Heidelberg Engineering GmbH, Heidelberg, Germany), and peripapillary RNFL thickness was evaluated with circle program. The data from the right eyes of all participants were used for statistical analysis. Results: No significant difference was found between the radial RPCP whole image, inside disc, and peripapillary vessel density values or the RNFL parameters of the scleroderma patients when compared with the controls ( p > 0.05 for all). Conclusion: Decreased peripapillary vessel density on OCTA, which can be an early sign of glaucoma, could not be observed in scleroderma patients in this study. However, further long-term studies are still needed to identify glaucoma tendency in patients with scleroderma before clinically detectable glaucoma.


2020 ◽  
Author(s):  
Hongjing Zhu ◽  
Weiwei Zhang ◽  
Qinghuai Liu

Abstract Aim: To describe the changes of optical coherence tomography angiography (OCTA) characteristics in severe non-proliferative Diabetic Retinopathy(S-NPDR) eyes. And study the effect of Panretinal photocoagulation(PRP) on these characteristics.Methods: This is a prospective study including 31 eyes from 18 consecutive patients with S-NPDR and 31 eyes of healthy subjects. We measured macular vascular density (VD) and foveal avascular zone(FAZ) area by an OCTA device. All patients with S-NPDR underwent PRP treatment. In S-NPDR eyes, the VD and foveal avascular zone(FAZ) area were assessed at 1 week before PRP, 1 month, 3 months and 6 months following PRP.Results: Compared with the normal control group ,in superficial retinal capillary plexus (SCP), macular VD decreased in S-NPDR group expect foveal VD. In foveal ,p=0.7;In parafoveal and perifoveal, p<0.001. In deep retinal capillary plexus (DCP), macular VD was also lower in S-NPDR group. In foveal, p=0.01.In parafoveal and perifoveal, p<0.001. And FAZ area expanded in S-NPDR eyes(p=0.05). In S-NPDR eyes , at 3 months after PRP, foveal VD in DCP increased significantly(p=0.04). At 6 months after PRP, foveal VD increased both in SCP and DCP (P=0.01,P=0.008,respectively). At 6 months after PRP,FAZ area decreased (p=0.04).Conclusions : Patients with S-NPDR have retinal microcirculation disorder, and PRP can partially improve the macular microcirculation. VD and FAZ can be used as sensitive indicators for follow-up observation of diabetic retinopathy.


2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Jin Li ◽  
Yue Zhou ◽  
Feng Chen ◽  
Yingzi Li ◽  
Rong Zhou ◽  
...  

Abstract Purpose We investigated the effects of retinal ischemia, neurodegeneration, and subclinical edema on best-corrected visual acuity (BCVA) in the early stages of diabetic retinopathy (DR). Methods Ischemia was evaluated by the microvascular parameters measured by optical coherence tomography angiography. Neurodegeneration and subclinical edema were identified by the intraretinal layer thickness obtained by optical coherence tomography. Eyes with nonproliferative diabetic retinopathy (n = 132) from 89 patients were analyzed. Eyes were classified as having normal BCVA (n = 88 [66.7%], Snellen equivalent ≥ 20/20) or decreased BCVA (n = 44 [33.3%], Snellen equivalent < 20/20). The prevalence of ischemia, neurodegeneration, and subclinical edema was explored in patients with and without decreased BCVA, and correlations between BCVA and these pathological pathways were determined. Results Vessel density in the deep retinal capillary plexus (DRCP) and thickness of ganglion cell layer plus inner plexiform layer (GCL-IPL) were significantly lower in eyes with decreased BCVA compared with eyes with normal BCVA (both P < 0.05). In the final multiple regression predictive model, age, DRCP vessel density, and GCL-IPL thickness (all P ≤ 0.044) were predictors of BCVA. DRCP vessel density and GCL-IPL thickness have an interactive effect on visual acuity. The proportions of ischemia and neurodegeneration were significantly higher in eyes with decreased BCVA than in eyes with normal BCVA (P = 0.001 and P = 0.004, respectively). Conclusion During the natural course of the early stages of DR, ischemia and neurodegeneration were the main disease pathways associated with visual acuity, and the mechanisms varied among patients.


2021 ◽  
Vol 10 (19) ◽  
pp. 4484
Author(s):  
Hongkun Zhao ◽  
Minzhong Yu ◽  
Lijun Zhou ◽  
Cong Li ◽  
Lin Lu ◽  
...  

Background: This study compares the change of retinal vessel density (VD) after pan-retinal photocoagulation (PRP) and intravitreal conbercept (IVC) treatment in proliferative diabetic retinopathy (PDR) eyes with optical coherence tomography angiography (OCTA). Methods: A total of 55 treatment-naïve PDR eyes were included in this retrospective study. Of these, 29 eyes were divided into a PRP group, and 26 eyes were divided into an IVC group based on the treatment they received. OCTA was performed to measure macular and papillary VD at each follow-up in both groups. Results: The macular VD for superficial capillary plexus (SCP), deep capillary plexus (DCP), choriocapillaris (CC) and papillary VD for radial peripapillary capillary (RPC) between the two groups demonstrated no significant difference at baseline and month 12 (p > 0.05). The paired t-test results showed that the macular VD for SCP, DCP, CC and papillary VD for the RPC at month 12 did not differ to the baseline in each group (p > 0.05). Conclusions: During the 12-month follow-up, there was no significant change of macular and papillary VD between the PRP and IVC treatment in PDR eyes. Additionally, compared to the baseline, there were no significant changes of macular and papillary VD after either the PRP or IVC treatment. Considering the decrease in VD as DR progress, both treatments have potential protection of macular and papillary VD loss in PDR.


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