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Tomoaki Murakami, Yoko Dodo, Kiyoshi Suzuma, Akihito Uji, Shin Yoshitake, Masahiro Fujimoto, RIMA GHASHUT, Rina Yoza, Nagahisa Yoshimura; Three-dimensional vascular remodeling in inner nuclear layer using swept-source optical coherence tomography in diabetic retinopathy. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):5954.
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© ARVO (1962-2015); The Authors (2016-present)
As one of microvascular complications by diabetes, diabetic retinopathy (DR) is accompanied by the remodeling of retinal capillaries, i.e., microaneurysms, intraretinal microvascular abnormalities (IRMA), and nonperfused areas (NPA). In this study, we evaluated the morphologies and location of deep INL capillary network in DR.
We retrospectively reviewed 42 eyes of 31 patients suffering from DR (6 eyes with no apparent retinopathy, 4 with mild NPDR, 9 with moderate NPDR, 9 with severe NPDR, and 16 with PDR) on whom 3x3mm volume scans of sufficient quality were obtained using swept-source optical coherence tomography (SS-OCT; DRI OCT-1, Topcon). After B-scan images were aligned by the flattening using the border between inner plexiform layer (IPL) and inner nuclear layer (INL), en face OCT images were constructed by the average of three pixels in z-axis in order to delineate the deep INL capillary network. We then counted the pixels (1 pixel = 2.6μm) from Henle’s layer to deep INL capillary network in order to measure the distance.
Eyes with no apparent retinopathy had the homogeneous diameter and density of deep INL capillary network, whereas such capillaries in eyes with DR showed the heterogeneity in the diameter and density. Eyes with DR but not CSME tended to have larger distances between Henle’s layer and deep INL capillary network than those with no apparent retinopathy, but without statistical significance (4.6±1.4 pixels vs 6.1±2.8 pixels; p=0.208). Especially, the distances were larger in eyes with PDR than those with NPDR (5.1±1.9 pixels vs. 7.3±3.4 pixels; p=0.037). In eyes with CSME, cystoid spaces reside mainly in INL and OPL. The deep INL capillary network was delineated within the septa between cystoid spaces in INL, but not beneath them. The areas with cystoid spaces in INL were accompanied with the larger distances than those without such cystoid spaces (24.2±8.8 vs. 5.2±1.6 pixels; p<0.001).
En face images of SS-OCT showed three-dimensional vascular remodeling in the deep INL capillary network of DR.
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