Synchronous evaluation of early neurovascular changes in macula and optic nerve head in early diabetic retinopathy using combined optical coherence tomography angiography parameters

2019 ◽  
Author(s):  
Xin Wen ◽  
Zijing Li ◽  
Jiaqi Liang ◽  
Jianhui Xiao ◽  
Yichi Zhang ◽  
...  

Abstract Background This study aim to evaluate neurovascular changes in both macula and optic nerve head (ONH) in early stages of diabetic retinopathy (DR) using combined quantitative optical coherence tomography angiography (OCTA) parameters.Methods We studied 194 right eyes from 64 type 2 diabetic patients without DR (DM), 64 diabetic patients with nonproliferative diabetic retinopathy (NPDR) and 64 age-matched healthy controls. OCTA parameters were analyzed using binary logistic regression models and receiver operating characteristic (ROC) curves.Results There was significant reduction of vessel density (VD) in both macula and ONH comparing DM patients with and without NPDR to controls. The area under the curve (AUC) of the ROC curve for NPDR versus control was 0.963 ( p <0.001), with sensitivity of 93.8% and specificity of 90.6%. The ROC curves for NPDR patients versus NoDR patients (including DM and control groups) exhibited an AUC of 0.923 ( p <0.001), with sensitivity of 90.6% and specificity of 82.8%. The thickness of the retinal nerve fiber layer (RNFL) in both macula and ONH was not significantly different among these three groups.Conclusions VD in both macula and ONH was simultaneously decreased prior to RNFL thinning in DM patients through the course proceeding from preclinical DR to NPDR. Combined analysis of macula and ONH parameters was an comprehensive and accurate OCTA metric to distinguish NPDR patients from healthy controls and DM patients without DR.

2020 ◽  
Vol 29 (2) ◽  
pp. 131
Author(s):  
Melike BALIKOGLU ◽  
Erdinc AYDIN ◽  
Pinar NALCACIOGLU ◽  
Nur DOGANAY KUMCU ◽  
Seher SARITEPE IMREL ◽  
...  

Author(s):  
Fariba Ghassemi ◽  
Sahar Berijani ◽  
Ramak Roohipoor ◽  
Masoumeh Mohebbi ◽  
Ameneh Babeli ◽  
...  

Abstract Purpose To measure optic nerve head (ONH) blood perfusion using optical coherence tomography angiography (OCTA) at various stages of diabetic retinopathy (DR). Methods One hundred seventy six eyes of 94 patients included in this retrospective single-centre cross-sectional study. The subjects were studied in normal, no diabetic retinopathy (NDR), non-proliferative diabetic retinopathy (NPDR) and proliferative retinopathy (PDR) groups. The eyes were subjected to AngioDisc ONH imaging using OCTA for papillary (Disc) and peripapillary (RPC) vascular density (VD) evaluation. Results The mean age of the participants was 56.08 ± 8.87 years and 34 (36.2 percent) were male. With increased DR severity, a statistically significant decrease in peripapillary VD was found. The study showed that only VD of the whole RPC (W-RPC) could be a valid biomarker in the staging assessment. VD of RPC, in all subsections, was considerably different from normal cases in the PDR group. Visual acuity was correlated with whole image ONH VD. The duration of DM, FBS, hyperlipidemia and DME had no effect on the ONH perfusion. Conclusions The study showed that only the W-RPC VD could be a reasonable marker in the staging assessment. VDs assessed by OCTA can be useful for assessing and tracking early ONH changes in DR patients.


2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Michele Figus ◽  
Chiara Posarelli ◽  
Francesco Nasini ◽  
Paolo Perrini ◽  
Mario Miccoli ◽  
...  

Background/Aims. To evaluate optic nerve head with spectral domain optical coherence tomography (OCT) in patients with Chiari I malformation (CMI) compared to healthy controls.Methods. Cross-sectional study. OCT of the optic nerve head of 22 patients with CMI and 22 healthy controls was quantitatively analyzed. The healthy controls were matched for age and sex with the study population. Mean retinal nerve fiber layer (RNFL) thickness was calculated for both eyes; the mean thickness value was also registered for each quadrant and for each subfield of the four quadrants.Results. CMI patients showed a reduction of the RNFL thickness in both eyes. This reduction was more statistically significant (P<0.05) for the inferior quadrant in the right eye and in each quadrant than nasal one in the left eye.Conclusion. A distress of the retinal nerve fibers could explain the observed reduction of the RNFL thickness in patients with CMI; in our series the reduction of the RNFL thickness seems lower when CMI is associated with syringomyelia.


2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Jianfeng Huang ◽  
Bodi Zheng ◽  
Yingyi Lu ◽  
Xiaoya Gu ◽  
Hong Dai ◽  
...  

Aims. To quantify the capillary density of the optic nerve head in healthy control eyes and different stages of diabetic retinopathy (DR) eyes and identify the parameters to detect eyes with or without DR using optical coherence tomographic angiography (OCTA). Methods. In this cross-sectional study, 211 eyes of 121 participants with type 2 diabetes with different stages of DR or without DR and 73 eyes of 38 healthy age-matched controls were imaged by OCTA. Radial peripapillary capillary (RPC) plexus density and retinal nerve fiber layer (RNFL) thickness were examined. The mixed model binary logistic regression model was used to identify the parameters to detect eyes with or without DR. The area under the receiver operating characteristic (ROC) curve was calculated. Results. RPC density decreased significantly in diabetic patients without DR compared with the healthy controls, and it was negatively correlated with the severity of DR (P<0.01). RPC density was a significant parameter to distinguish diabetic eyes with or without DR (P<0.01). The area under the ROC curve was 0.743. Conclusions. Quantification of RPC density by OCTA provides evidence of microvascular changes in the optic nerve in diabetic patients. RPC density can serve as a possible biomarker in detecting eyes with DR. Larger cohort studies need to support this statement.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Reza Mirshahi ◽  
Pasha Anvari ◽  
Hamid Riazi-Esfahani ◽  
Mahsa Sardarinia ◽  
Masood Naseripour ◽  
...  

AbstractThe purpose of this study was to introduce a new deep learning (DL) model for segmentation of the fovea avascular zone (FAZ) in en face optical coherence tomography angiography (OCTA) and compare the results with those of the device’s built-in software and manual measurements in healthy subjects and diabetic patients. In this retrospective study, FAZ borders were delineated in the inner retinal slab of 3 × 3 enface OCTA images of 131 eyes of 88 diabetic patients and 32 eyes of 18 healthy subjects. To train a deep convolutional neural network (CNN) model, 126 enface OCTA images (104 eyes with diabetic retinopathy and 22 normal eyes) were used as training/validation dataset. Then, the accuracy of the model was evaluated using a dataset consisting of OCTA images of 10 normal eyes and 27 eyes with diabetic retinopathy. The CNN model was based on Detectron2, an open-source modular object detection library. In addition, automated FAZ measurements were conducted using the device’s built-in commercial software, and manual FAZ delineation was performed using ImageJ software. Bland–Altman analysis was used to show 95% limit of agreement (95% LoA) between different methods. The mean dice similarity coefficient of the DL model was 0.94 ± 0.04 in the testing dataset. There was excellent agreement between automated, DL model and manual measurements of FAZ in healthy subjects (95% LoA of − 0.005 to 0.026 mm2 between automated and manual measurement and 0.000 to 0.009 mm2 between DL and manual FAZ area). In diabetic eyes, the agreement between DL and manual measurements was excellent (95% LoA of − 0.063 to 0.095), however, there was a poor agreement between the automated and manual method (95% LoA of − 0.186 to 0.331). The presence of diabetic macular edema and intraretinal cysts at the fovea were associated with erroneous FAZ measurements by the device’s built-in software. In conclusion, the DL model showed an excellent accuracy in detection of FAZ border in enfaces OCTA images of both diabetic patients and healthy subjects. The DL and manual measurements outperformed the automated measurements of the built-in software.


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.


2018 ◽  
Vol 27 (5) ◽  
pp. 407-414 ◽  
Author(s):  
Laura M. Schrems-Hoesl ◽  
Wolfgang A. Schrems ◽  
Robert Laemmer ◽  
Friedrich E. Kruse ◽  
Christian Y. Mardin

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Yong-Il Shin ◽  
Ki Yup Nam ◽  
Seong Eun Lee ◽  
Min-Woo Lee ◽  
Hyung-Bin Lim ◽  
...  

Abstract To evaluate changes in peripapillary microvascular parameters in diabetes mellitus (DM) patients using optical coherence tomography angiography (OCTA). Seventy-one diabetic patients (40 in the no diabetic retinopathy [DR] group and 31 in the non-proliferative DR [NPDR] group) and 50 control subjects. OCTA (Zeiss HD-OCT 5000 with AngioPlex) 6 × 6 mm scans centered on the optic disc were analyzed. Peripapillary vessel density (VD), perfusion density (PD) in superficial capillary plexus (SCP) were automatically calculated. The average macular ganglion cell-inner plexiform layer (mGC-IPL) and peripapillary retinal nerve fiber layer (pRNFL) thicknesses of the no DR and NPDR groups were significantly thinner than those of the control group. The no DR and NPDR groups showed lower peripapillary VD and PD in SCP compared with the control group. Using univariate regression analyses, the average mGC-IPL thickness, the pRNFL thickness, the no DR group and NPDR group were significant factors that affected the peripapillary VD and PD in SCP. Multivariate regression analyses showed that the grade of DR was a significant factor affecting the peripapillary VD and PD in SCP. OCTA revealed that peripapillary microvascular parameters in the no DR and NPDR groups were lower than those of normal controls. The peripapillary VD and PD in SCP were correlated with the mGC-IPL thickness, the pRNFL thickness, and the no DR and NPDR groups. Changes in peripapillary OCTA parameters may help with understanding the pathophysiology of DM and evaluating a potentially valuable biomarker for patients with subclinical DR.


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