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

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 vascular density and morphology using different swept-source optical coherence tomography angiographic scan patterns in diabetic retinopathy

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2018-311942 ◽

2018 ◽

Vol 103 (2) ◽

pp. 216-221 ◽

Cited By ~ 35

Author(s):

Takao Hirano ◽

Jyunya Kitahara ◽

Yuichi Toriyama ◽

Hirotsugu Kasamatsu ◽

Toshinori Murata ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Diabetic Retinopathy ◽

Characteristic Curve ◽

Vascular Density ◽

Optical Coherence ◽

Image Size ◽

Healthy Individuals ◽

Cross Sectional ◽

Swept Source ◽

Retinal Microvasculature

AimsTo evaluate quantitative metrics of the retinal microvasculature in eyes with diabetic retinopathy (DR) using various en face swept-source optical coherence tomography angiography (SS-OCTA) image sizes.MethodsNon-segmented and segmented images were acquired using an SS-OCTA device (PLEX Elite 9000; Carl Zeiss Meditec, Dublin, California, USA). The scanning protocols included the 3×3 mm, 6×6 mm and 12×12 mm fields of view. Quantitative analysis of the perfusion density (PD), vessel length density (VLD) and fractal dimension (FD) was performed. The area under the receiver operating characteristic curve was estimated to assess the ability of each image size to predict DR.ResultsThis prospective, cross-sectional study included 60 eyes, (non-DR, 13 eyes; non-proliferative DR (NPDR), 24 eyes; proliferative DR (PDR), 23 eyes) of 46 patients with diabetes and 21 eyes of 16 healthy individuals. In the 12×12 mm images, the PD of healthy individuals was significantly greater than that of patients with NPDR or PDR for all layers (NPDR, p<0.05; PDR, p<0.001 0.001; FD, p<0.001) or PDR (VLD, p<0.001; FD, p<0.001 for all layers). The results were similar for the 3×3 mm and 6×6 mm images. Overall, PD, VLD and FD progressively decreased with worsening DR severity in segmented and non-segmented layers for all SS-OCTA scan sizes. For detecting DR, 3×3 mm images best predicted DR for all evaluated quantitative parameters.ConclusionsVascular changes in DR can be monitored in detail through quantitative evaluations that combine different SS-OCTA scan sizes and parameters.

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Identification of microvascular and morphological alterations in eyes with central retinal non-perfusion

PLoS ONE ◽

10.1371/journal.pone.0241753 ◽

2020 ◽

Vol 15 (11) ◽

pp. e0241753

Author(s):

Dorottya Hajdu ◽

Reinhard Told ◽

Orsolya Angeli ◽

Guenther Weigert ◽

Andreas Pollreisz ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Visual Acuity ◽

Visual Outcome ◽

Retinal Ischemia ◽

Foveal Avascular Zone ◽

Optical Coherence ◽

Cross Sectional ◽

Swept Source ◽

Morphological Alterations ◽

Significant Difference

Purpose To evaluate the characteristics and morphological alterations in central retinal ischemia caused by diabetic retinopathy (DR) or retinal vein occlusion (RVO) as seen in optical coherence tomography angiography (OCTA) and their relationship to visual acuity. Methods Swept-source optical coherence tomography (SSOCT) and OCTA (Topcon, Triton) data of patients with central involving retinal ischemia were analyzed in this cross-sectional study. The following parameters were evaluated: vessel parameters, foveal avascular zone (FAZ), intraretinal cysts (IRC), microaneurysms (MA), vascular collaterals in the superficial (SCP) and deep plexuses (DCP), hyperreflective foci (HRF), epiretinal membrane (ERM), external limiting membrane (ELM) and ellipsoid zone (EZ) disruption, as well as the disorganization of retinal inner layers (DRIL). Best-corrected visual acuity (BCVA), age, gender, disease duration and ocular history were also recorded. Results 44 eyes of 44 patients (22 with RVO, 22 with DR) were analyzed. The mean age was 60.55 ± 11.38 years and mean BCVA 0.86 ± 0.36 (Snellen, 6m). No significant difference was found between DR subgroups (non proliferative vs. proliferative). Between RVO subgroups (CRVO vs. BRVO) a significant difference was found in term of collateral vessel of the DCP (p = 0.014). A pooled DR and RVO group were created and compared. Significantly more MAs (p = 0.007) and ERM (p = 0.007) were found in the DR group. Statistically significant negative correlation was demonstrated between FAZ and BCVA (p = 0.45) when analyzing all patients with retinal ischemia. Conclusion This study has shown that the best predictor of visual outcome in center involved ischemic diseases is the size of FAZ. Besides the presence of MAs and ERM, all other OCT and OCTA parameters were present in a similar extent in DR and RVO group despite the completely different disease origins. Our results suggest that as soon as retinal ischemia in the macular region is present, it has a similar appearance and visual outcome independently of the underlying disease.

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Comparison of two different optical coherence tomography angiography devices in detecting healthy versus glaucomatous eyes – an observational cross-sectional study

BMC Ophthalmology ◽

10.1186/s12886-020-01701-9 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

A. R. Kee ◽

V. C. H. Yip ◽

E. L. T. Tay ◽

C. W. Lim ◽

J. Cheng ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Diagnostic Accuracy ◽

Optic Disc ◽

Optical Coherence Tomography Angiography ◽

Optical Coherence ◽

Cross Sectional ◽

Swept Source ◽

Retest Reliability ◽

Significant Difference ◽

Test Retest Reliability

Abstract Background To understand the differences between two different optical coherence tomography angiography (OCTA) devices in detecting glaucomatous from healthy eyes by comparing their vascular parameters, diagnostic accuracy and test-retest reliability. Methods A cross-sectional observational study was performed on healthy and glaucoma subjects, on whom two sets of OCTA images of optic disc and macula were acquired using both AngioVue (Optovue, USA) and Swept Source (Topcon, Japan) OCTA devices during one visit. A novel in-house software was used to calculate the vessel densities. Diagnostic accuracy of the machines in differentiating healthy versus glaucomatous eyes was determined using area under the receiver operating characteristic curve (AUROC) and test-retest repeatability of the machines was also evaluated. Results A total of 80 healthy and 38 glaucomatous eyes were evaluated. Glaucomatous eyes had reduced mean vessel density compared to healthy controls in all segmented layers of the optic disc and macula using AngioVue (p ≤ 0.001). However, glaucomatous eyes had higher mean vessel density on optic disc scans using Swept Source, with lack of statistically significant difference between healthy and glaucomatous eyes. The AUROC showed better diagnostic accuracy of AngioVue (0.761–1.000) compared to Swept Source (0.113–0.644). The test-retest reliability indices were generally better using AngioVue than Swept Source. Conclusions AngioVue showed better diagnostic capability and test-retest reliability compared to Swept Source. Further studies need to be undertaken to evaluate if there is any significant difference between the various machines in diagnosing and monitoring glaucoma.

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Optical Coherence Tomography and Optical Coherence Tomography Angiography Findings After Optic Neuritis in Multiple Sclerosis

Frontiers in Neurology ◽

10.3389/fneur.2020.618879 ◽

2020 ◽

Vol 11 ◽

Author(s):

Olwen C. Murphy ◽

Grigorios Kalaitzidis ◽

Eleni Vasileiou ◽

Angeliki G. Filippatou ◽

Jeffrey Lambe ◽

...

Keyword(s):

Multiple Sclerosis ◽

Optical Coherence Tomography ◽

Optic Neuritis ◽

Visual Function ◽

Inner Plexiform Layer ◽

Optical Coherence ◽

Cross Sectional ◽

Mixed Effect ◽

Retinal Microvasculature ◽

History Of

Background: In people with multiple sclerosis (MS), optic neuritis (ON) results in inner retinal layer thinning, and reduced density of the retinal microvasculature.Objective: To compare inter-eye differences (IEDs) in macular optical coherence tomography (OCT) and OCT angiography (OCTA) measures in MS patients with a history of unilateral ON (MS ON) vs. MS patients with no history of ON (MS non-ON), and to assess how these measures correlate with visual function outcomes after ON.Methods: In this cross-sectional study, people with MS underwent OCT and OCTA. Superficial vascular plexus (SVP) density of each eye was quantified using a deep neural network. IEDs were calculated with respect to the ON eye in MS ON patients, and with respect to the right eye in MS non-ON patients. Statistical analyses used mixed-effect regression models accounting for intra-subject correlations.Results: We included 43 MS ON patients (with 92 discrete OCT/OCTA visits) and 14 MS non-ON patients (with 24 OCT/OCTA visits). Across the cohorts, mean IED in SVP density was −2.69% (SD 3.23) in MS ON patients, as compared to 0.17% (SD 2.39) in MS non-ON patients (p = 0.002). When the MS ON patients were further stratified according to time from ON and compared to MS non-ON patients with multiple cross-sectional analyses, we identified that IED in SVP density was significantly increased in MS ON patients at 1–3 years (p = < 0.001) and >3 years post-ON (p < 0.001), but not at <3 months (p = 0.21) or 3–12 months post-ON (p = 0.07), while IED in ganglion cell + inner plexiform layer (GCIPL) thickness was significantly increased in MS ON patients at all time points post-ON (p ≦ 0.01 for all). IED in SVP density and IED in GCIPL thickness demonstrated significant relationships with IEDs in 100% contrast, 2.5% contrast, and 1.25% contrast letter acuity in MS ON patients (p < 0.001 for all).Conclusions: Our findings suggest that increased IED in SVP density can be detected after ON in MS using OCTA, and detectable changes in SVP density after ON may occur after changes in GCIPL thickness. IED in SVP density and IED in GCIPL thickness correlate well with visual function outcomes in MS ON patients.

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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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A Novel Automatic Method to Estimate Visual Acuity and Analyze the Retinal Vasculature in Retinal Vein Occlusion Using Swept Source Optical Coherence Tomography Angiography

Journal of Clinical Medicine ◽

10.3390/jcm8101515 ◽

2019 ◽

Vol 8 (10) ◽

pp. 1515 ◽

Cited By ~ 1

Author(s):

Díez-Sotelo ◽

Díaz ◽

Abraldes ◽

Gómez-Ulla ◽

Penedo ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Visual Acuity ◽

Optical Coherence Tomography Angiography ◽

Foveal Avascular Zone ◽

Depth Information ◽

Vascular Density ◽

Optical Coherence ◽

Automatic Method ◽

Correlation Index ◽

Swept Source

The assessment of vascular biomarkers and their correlation with visual acuity is one of the most important issues in the diagnosis and follow-up of retinal vein occlusions (RVOs). The high workloads of clinical practice make it necessary to have a fast, objective, and automatic method to analyze image features and correlate them with visual function. The aim of this study is to propose a fully automatic system which is capable of estimating visual acuity (VA) in RVO eyes, based only on information obtained from macular optical coherence tomography angiography (OCTA) images. We also propose an automatic methodology to rapidly measure the foveal avascular zone (FAZ) area and the vascular density (VD) in the superficial and deep capillary plexuses in swept-source OCTA images centered on the fovea. The proposed methodology is validated using a representative sample of 133 visits of 50 RVO patients. Our methodology estimates VA with very high precision and is even more accurate when we integrate depth information, providing a high correlation index of 0.869 with the real VA, which outperforms the correlation index of 0.855 obtained when estimating VA from the data obtained by the semiautomatic existing method. In conclusion, the proposed method is the first computational system able to estimate VA in RVO, with the additional benefits of being automatic, less time-consuming, objective and more accurate. Furthermore, the proposed method is able to integrate depth information, a feature which is lacking in the existing method.

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Early alterations in retinal microvasculature on swept-source optical coherence tomography angiography in acute central serous chorioretinopathy

Scientific Reports ◽

10.1038/s41598-021-82650-1 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Dominika Podkowinski ◽

Bernhard Foessl ◽

Luis de Sisternes ◽

Sophie Beka ◽

Anna-Sophie Mursch-Edlmayr ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Central Serous Chorioretinopathy ◽

Subretinal Fluid ◽

Retinal Blood Flow ◽

Optical Coherence ◽

Swept Source ◽

Retinal Microvasculature ◽

Significant Difference ◽

Capillary Plexus ◽

Acute Central Serous Chorioretinopathy

AbstractThe purpose of the study was to evaluate the retinal blood flow in patients with acute central serous chorioretinopathy (CSC) over an observational period of 1 month using swept-source optical coherence tomography (SS-OCTA), focusing especially on changes in the area of subretinal fluid (A-SRF). We correlated these findings with conventional indocyanine green angiography (ICGA). ICGA and SS-OCTA images were collected and analyzed of 12 eyes of 12 patients. The A-SRF was annotated and a qualitative analysis of choriocapillaris, the vessel density (VD) and perfusion density (PD) of the retinal superficial capillary plexus (SCP) and the deep capillary plexus (DCP) was performed in A-SRF and the unaffected remaining area (RA). The VD and PD in the DCP were statistically significantly lower in A-SRF than in the RA at baseline. (VD: p = 0.014; PD: p = 0.036). After 1 month, there was a statistically significant difference in the VD and PD of the DCP (VD: p = 0.015; PD: p = 0.014), and for the PD of the SCP between the A-SRF and the RA (p = 0.015), with lower values in the A-SRF. We found low perfused areas in choriocapillaris corresponding to hypofluorescent areas on ICGA. In conclusion there is a difference in VD and VD of the DCP in the area of SRF in acute CSC. These alterations may lead to a chronic change in the microvasculature and potentially to morphological changes.

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Macular perfusion density evaluation in constant and intermittent exotropia by means of optical coherence tomography angiography

BMC Ophthalmology ◽

10.1186/s12886-021-02006-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jing Zhai ◽

Wei Fang ◽

Xueting Yu ◽

Xinjie Ye ◽

Lijie Hou

Keyword(s):

Optical Coherence Tomography ◽

Optical Coherence Tomography Angiography ◽

Cross Sectional Study ◽

Foveal Avascular Zone ◽

Optical Coherence ◽

Intermittent Exotropia ◽

Cross Sectional ◽

Significant Difference ◽

Capillary Plexus ◽

Perfusion Density

Abstract Background To quantify and compare retinal microvascular features using optical coherence tomography angiography (OCTA) in constant (XT) and intermittent exotropia (IXT). Methods An observational cross-sectional study was conducted from September 2020 to November 2020 at the Affiliated Eye Hospital of Wenzhou Medical University. OCTA examination was performed to evaluate the macular perfusion density of the deep capillary plexus (DCP), superficial capillary plexus (SCP), and foveal avascular zone (FAZ) parameters in XT and IXT patients, and in age-matched controls. The study parameters were analyzed. Results A total of 76 participants, including 16 (21%) XT patients, 24 (32%) IXT patients, and 36 (47%) controls, were recruited. The exodeviation angle was 39.06 ± 10.38 prism degrees (PD) at near and 43.00 ± 9.74 PD at distance in the XT group, and 27.13 ± 18.28 PD at near and 31.04 ± 18.82 PD at distance in the IXT group. The macular perfusion density of the DCP in 6 × 6-mm scans and the SCP in 3 × 3-mm scans were lower in the deviating eyes than in the fixating eyes of XT patients (p < 0.001, p = 0.032, respectively). The macular perfusion density of the DCP in the deviating eyes of XT and IXT patients was significantly lower than that of the controls. There was no significant difference in the FAZ parameters among the groups. Conclusions In XT patients, OCTA revealed lower macular perfusion density in deviating eyes than in fixating eyes and control eyes. IXT patients showed no difference between the two eyes, but the macular perfusion density of the DCP was lower than that of the controls.

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Wide-field swept-source optical coherence tomography angiography in the assessment of retinal microvasculature and choroidal thickness in patients with myopia

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2021-319540 ◽

2021 ◽

pp. bjophthalmol-2021-319540

Author(s):

Jade Y. Moon ◽

Itika Garg ◽

Ying Cui ◽

Raviv Katz ◽

Ying Zhu ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Choroidal Thickness ◽

Optical Coherence Tomography Angiography ◽

Foveal Avascular Zone ◽

Systemic Hypertension ◽

Wide Field ◽

Optical Coherence ◽

Swept Source ◽

Retinal Microvasculature ◽

Capillary Plexus

Background/aimsPathological myopia (PM) is a leading cause of blindness worldwide. We aimed to evaluate microvascular and chorioretinal changes in different stages of myopia with wide-field (WF) swept-source (SS) optical coherence tomography angiography (OCTA).MethodsThis prospective cross-sectional observational study included 186 eyes of 122 patients who had undergone imaging between November 2018 and October 2020. Vessel density (VD) and vessel skeletonised density (VSD) of superficial capillary plexus, deep capillary plexus and whole retina, as well as foveal avascular zone parameters, retinal thickness (RT) and choroidal thickness (CT), were calculated.ResultsThis study evaluated 75 eyes of 48 patients with high myopia (HM), 43 eyes of 31 patients with mild to moderate myopia and 68 eyes of 53 age-matched controls. Controlling for age and the presence of systemic hypertension, we found that HM was associated with decrease in VD and VSD in all layers on 12×12 mm² scans. Furthermore, HM was associated with a VD and VSD decrease in every Early Treatment Diabetic Retinopathy Study grid, with a larger decrease temporally (βVD=−0.39, βVSD=−10.25, p<0.01). HM was associated with decreased RT and CT. Reduction in RT was outside the macular region, while reduction in CT was in the macular region.ConclusionUsing WF SS-OCTA, we identified reduction in microvasculature and structural changes associated with myopia. Decrease in VD and VSD was greater in the temporal quadrant, and reductions in RT and CT were uneven across the retina. Further work may help identify risk factors for the progression of PM and associated vision-threatening complications.

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Evaluation of retinochoroidal tissues in third trimester pregnants: An optical coherence tomography angiography study

European Journal of Ophthalmology ◽

10.1177/1120672120966566 ◽

2020 ◽

pp. 112067212096656

Author(s):

Abdulmutalip Yildirim ◽

Emin Kurt ◽

Muhammed Altinisik ◽

Yildiz Uyar

Keyword(s):

Optical Coherence Tomography ◽

Pregnant Women ◽

Optical Coherence Tomography Angiography ◽

Foveal Avascular Zone ◽

Control Group ◽

Vascular Density ◽

Optical Coherence ◽

Third Trimester ◽

The Third ◽

Significant Difference

Introduction: The structural and vascular changes in the retina and choroid in women in the third trimester of pregnancy were analyzed using optical coherence tomography angiography (OCTA). Methods: Forty women in the third trimester of uncomplicated pregnancy and 40 age-matched healthy women were included. Vascular density (VD) in the superficial and deep capillary plexuses (SCP/DCP), foveal density (FD), and foveal avascular zone (FAZ) area and perimetry measured with OCTA, as well as OCT measurements of central macular thickness (CMT) and choroidal thickness (CT) were compared between the groups. Correlations between structural OCT parameters and vascular OCTA metrics were analyzed. Results: The mean gestational age was 34 (28–41) weeks. Mean age was comparable in the groups ( p = 0.732). The pregnant women had significantly higher parafoveal DCP-VD ( p = 0.015), FAZ area ( p = 0.044), and FD ( p = 0.002). Mean subfoveal CT was 21 µm higher in pregnant women but was not significant ( p = 0.472). There was no difference in CMT ( p = 0.448). FAZ metrics were positively correlated with CT in pregnants and with CMT in the control group ( p < 0.05). Parafoveal VD was negatively correlated with CT in the control group ( p < 0.05). After adjusting for CT and CMT, the significant difference in VD and FD persisted ( p < 0.05), while the difference in FAZ area lost significance ( p > 0.05). Conclusions: Considering the effects of the probable covariant factors CMT and CT, systemic changes in pregnant women in their third trimester may cause an increase in VD in the macula and parafoveal DCP.

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