Assessment of morphological and functional alterations in patients with early stage of non-proliferative diabetic retinopathy by optical coherence tomography angiography and microperimetry

Diabetic Retinopathy ◽

Early Stage ◽

Control Group ◽

Flow Density ◽

Retinal Sensitivity ◽

Capillary Plexus ◽

Vessel Flow

Abstract Background To analyze the optical coherence tomography angiography(OCTA) and microperimetry features in diabetic patients without diabetic retinopathy(NDR group) and patients with early stage of non-proliferative diabetic retinopathy(NPDR group). Methods This was a cross-sectional study including 24 eyes of the NDR group, 24 eyes of the NPDR group, and 24 eyes of healthy volunteers(control group). OCTA was used to measure foveal avascular zone(FAZ), vessel flow density of superficial capillary plexus(SCP) and deep capillary plexus(DCP) in the macular area(3×3mm). The latest version of microperimeter, MP-3, was used to quantitate retinal light sensitivity and fixation stability in the central 10° of the macular region. Results The NPDR group had a larger FAZ area, reduced vessel flow densities of both SCP and DCP, deceased retinal sensitivity and less stable fixation compared with the control group. Statistical differences were only found in the FAZ area, vessel flow density of DCP and retinal sensitivity between the NDR and the NDPR group. Conclusions The FAZ enlargement, vessel flow density decrease and retinal sensitivity reduction may be morphological and functional indicators of progression of diabetic retinopathy. Microvascular alterations in deep capillary plexus may precede superficial capillary alterations in diabetic retinopathy.

The role of quantitative deep capillary plexus in the pathogenesis of type 3 macular neovascularization: an optical coherence tomography angiography study

Graefe s Archive for Clinical and Experimental Ophthalmology ◽

10.1007/s00417-021-05330-w ◽

2021 ◽

Author(s):

Marina Concilio ◽

Federica Fossataro ◽

Daniela Montorio ◽

Mariapaola Giordano ◽

Gilda Cennamo

Keyword(s):

Early Stage ◽

Study Groups ◽

Control Group ◽

Main Role ◽

Optical Coherence ◽

Capillary Plexus ◽

Type 3

Abstract Purpose To quantitatively investigate the role of deep capillary plexus (DCP) in patients affected by type 3 macular neovascularization (MNV), compared to patients with reticular pseudodrusen (RPD) eyes and healthy controls, using optical coherence tomography angiography (OCTA). Methods In this prospective observational study, a total of seventy-eight eyes of 78 patients were included. Group 1 consisted of 40 eyes of 40 patients with stage 1 of type 3 MNV (22 males, 18 females, mean age 73.7, SD ± 6.60) and group 2 included 38 eyes of 38 patients with RPD (17 males, 21 females, mean age 73.2, SD ± 4.55). The control group included 40 eyes of 40 healthy subjects (20 males, 20 females, mean age 71.4, SD ± 6.36 years). We evaluated the retinal vessel density (VD) of superficial capillary plexus (SCP) and deep capillary plexus (DCP) using OCTA. Results Patients with diagnosis of type 3 MNV showed statistically lower values of VD in DCP with respect to controls and to RPD group (p < 0.001), while there were no statistical differences between RPD and control group in macular region. No significant differences in VD of SCP were detected among the three study groups. Conclusion OCTA provides a reproducible, non-invasive detailed quantitative analysis of retinal vascular features and changing in early-stage type 3 MNV patients, which allowed to shed the light on the main role of DCP ischemia in the development of type 3 MNV.

Quantitative Analysis of Retinal Microvascular Changes in Optical Coherence Tomography Angiography Of Diabetic Retinopathy

International Journal of Retina ◽

10.35479/ijretina.2018.vol001.iss001.43 ◽

2018 ◽

Vol 1 (1) ◽

pp. 1

Author(s):

Prettyla Yollamanda ◽

Arief Kartasasmita ◽

Iwan Sovani ◽

Erwin Iskandar ◽

Rova Virgana ◽

...

Keyword(s):

Diabetic Retinopathy ◽

Imaging Modality ◽

Foveal Avascular Zone ◽

Control Group ◽

Optical Coherence ◽

Non Invasive ◽

Microvascular Changes

Introduction: Diabetic Retinopathy (DR) is a common microvascular complication in patients with Diabetes Mellitus (DM) that can cause visual impairment and blindness in adult populations. Retinal microvascular changes, reflecting capillary drop out, non perfusion, and retinal ischemia seen in patients with DM can be assessed not only qualitatively, but also quantitatively with the introduction of a new, non invasive imaging modality Optical Coherence Tomography Angiography (OCTA), avoiding potential advese risks that can occur with the use of dye-injection imaging technique. We quantified retinal microvascular changes in healthy control eyes and Diabetic Retinopathy using OCTA. Methods: A cross sectional study included 13 eyes of 9 patients with DR, consists of 11 eyes with Non Proliferative Diabetic Retinopathy (NPDR) and 2 eyes with Proliferative Diabetic Retinopathy (PDR) and 5 eyes of 5 age-matched controls. Participants were imaged with commercial OCTA device (CIRRUS HD-OCT 5000 Angioplex). We analyzed in the Superficial Capillary Plexus (SCP) the following OCTA parameters : Vessel Density (VD), Foveal Avascular Zone (FAZ) area, and FAZ circularity. Result: Normal eyes had a higher mean VD, FAZ circularity (p >0.05) and lower mean FAZ area ( p <0.05) in the SCP compared with the DR (NPDR + PDR) group. If we excluded the PDR eyes from the analytic data, mean VD and FAZ area were found to be lower in control group, and mean FAZ circularity was higher. However, no quantitative parameters were statistically significant between control group and NPDR group. Conclusion: Microvascular changes in DR can be assessed with the use of Optical Coherence Tomography Angioraphy, which is non invasive and provides high quality of images acquired from the chosen level of retina.

Assessment of capillary dropout in the superficial retinal capillary plexus by optical coherence tomography angiography in the early stage of diabetic retinopathy

BMC Ophthalmology ◽

10.1186/s12886-018-0778-2 ◽

2018 ◽

Vol 18 (1) ◽

Cited By ~ 18

Author(s):

Ceying Shen ◽

Shu Yan ◽

Min Du ◽

Hong Zhao ◽

Ling Shao ◽

...

Keyword(s):

Diabetic Retinopathy ◽

Early Stage ◽

Optical Coherence ◽

Retinal Capillary ◽

Capillary Plexus

Effects of panretinal photocoagulation on macular vascular density and Foveal avascular zone area in patients with severe non-proliferative diabetic retinopathy by optical coherence tomography angiography

10.21203/rs.3.rs-118201/v1 ◽

2020 ◽

Author(s):

Hongjing Zhu ◽

Weiwei Zhang ◽

Qinghuai Liu

Keyword(s):

Diabetic Retinopathy ◽

Foveal Avascular Zone ◽

Vascular Density ◽

Panretinal Photocoagulation ◽

Retinal Capillary ◽

Avascular Zone ◽

Capillary Plexus

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.

Comparison of the Effect of Pan-Retinal Photocoagulation and Intravitreal Conbercept Treatment on the Change of Retinal Vessel Density Monitored by Optical Coherence Tomography Angiography in Patients with Proliferative Diabetic Retinopathy

Journal of Clinical Medicine ◽

10.3390/jcm10194484 ◽

2021 ◽

Vol 10 (19) ◽

pp. 4484

Author(s):

Hongkun Zhao ◽

Minzhong Yu ◽

Lijun Zhou ◽

Cong Li ◽

Lin Lu ◽

...

Keyword(s):

Diabetic Retinopathy ◽

Retinal Vessel ◽

Pan Retinal Photocoagulation ◽

Capillary Plexus ◽

Retinal Vessel Density ◽

Retinal Photocoagulation

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.

Foveal Avascular Zone Evaluation in Patients with Diabetic Retinopathy without Diabetic Macular Edema Using Optical Coherence Tomography Angiography

10.21203/rs.3.rs-280313/v1 ◽

2021 ◽

Author(s):

Mohamed Mahmoud Halfawy ◽

Abelrahman Gaber Salman ◽

Azza M.A. Said ◽

Tarek El Beltagi ◽

Marwa A. Karim

Keyword(s):

Diabetic Retinopathy ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Foveal Avascular Zone ◽

Control Group ◽

Optical Coherence ◽

Avascular Zone

Abstract Purpose:To evaluate dimensions of Foveal Avascular Zone (FAZ) at level of superficial and deep capillary plexuses (SCP/DCP), in patients with different grades of non proliferative diabetic retinopathy without Diabetic Macular Edema (DME) using Optical Coherence Tomography Angiography (OCTA).Patients and Methods: 80 type II diabetes mellitus patients and 20 healthy control subjects were included in this cross sectional study ,aged from 40-60 years with DM type 2 of more than five years ,ecxluding proliferative diabetic retinopathy and DME.Patients were subdivided into four groups according to ETDRS Classification (without retinopathy,mild ,moderate and sever retinopathy) .All subjects undewent: measurement of glycosylated hemoglobin level ,standard Structural Optical coherence tomography for the macula and optic nerve head with OCTA for evaluation of FAZ in both SCP and DCP networks of all eyes using (Heidelberg engineering, OCT spectralis, Germany) (SD-OCT). Results: Mean total macular thickness in control group (322.89 ± 16.31 μm) vs (316.57 ± 20.21 μm) in patients` group.Average RNFL thickness(158.61 ± 12.99 μm )in control group vs(156.07 ± 22.58) μm in patients` group.Mean FAZ in SCP in control group ( 0.32 ± 0.12) mm2 versus( 0.44 ± 0.17) mm2 in patients` group, while FAZ IN DCP (0.23) mm2 ± 0.12 in controls versus ( 0.34 ± 0.16) mm2 in patients.There was a statistically significant wider FAZ in DR patients (P-value 0.003).Conclusion: Enlargement of FAZ in SCP and DCP in patients with moderate to severe NPDR without DME was detected using OCTA, proceeded by neurodegenerative changes with reduction in thickness of ORL and GCC layer. This can be used to monitor the progression of the disease and to evaluate the response to treatment.