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Vivian Qin, Felipe Conti, Sumit Sharma, Aleksandra V. Rachitskaya, Justis Ehlers, Rishi P Singh; Retinal and Choriocapillaris Evaluation of Diabetic Patients using Optical Coherence Tomography Angiography. Invest. Ophthalmol. Vis. Sci. 2018;59(9):1917.
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© ARVO (1962-2015); The Authors (2016-present)
Recent advances in optical coherence tomography angiography (OCTA) imaging allows detailed evaluation of capillary perfusion density (CPD), an indicator of vascular integrity. A retrospective clinical study was performed to assess retinal and choriocapillaris CPD changes in diabetic eyes and controls using OCTA.
Records of eyes who underwent spectral domain-OCT (SD-OCT) imaging at a single institution were reviewed retrospectively. Subject eyes were classified based on pathology: non-diabetic controls (37 eyes), no diabetic retinopathy in a diabetic patient (eyes without DR, 31 eyes), non-proliferative diabetic retinopathy (NPDR, 41 eyes), and proliferative diabetic retinopathy (PDR, 26 eyes). For each eye, Avanti Optovue SD-OCT obtained 3x3mm images of the macular region and split-spectrum amplitude decorrelation angiography (SSADA) algorithm generated angiographic images. Quantitative CPD analysis was performed with AngioVue automated software (Optovue, Inc, Fremont, CA).
Eyes with NPDR and PDR showed significantly decreased choriocapillaris whole image and parafoveal CPD compared to controls, while eyes without DR did not show significant change. Choriocapillaris whole image CPD was decreased by 8.3% in eyes with NPDR (63.8±8.2 from 69.6±4.6, p<0.01) and decreased by 7.1% in eyes with PDR (64.7±8.2, p<0.01). Choriocapillaris parafoveal CPD was decreased by 8.9% in eyes with NPDR (63.1±9 from 69.3±4.4, p<0.01), and decreased by 8.2% in eyes with PDR (63.6±8.8, p<0.01). Compared to controls, only eyes with PDR showed significantly decreased retinal whole image, foveal, and parafoveal CPD, as well as significantly increased foveal avascular zone (FAZ) area. Retinal whole image CPD was decreased by 9.7% (45.7±5.6 from 50.1±6.9, p<0.01), retinal foveal CPD was decreased by 20.5% (23.6±7.7 from 29.7±7.5, p<0.01), and retinal parafoveal CPD was decreased by 11.4% (47.5±5.6 from 53.6±5.6, p<0.01). FAZ area was increased by 50.9% (0.415±0.2 from 0.275±0.1, p<0.01).
Choroidal and retinal capillary perfusion density are reduced in diabetic retinopathy, while foveal avascular zone area is increased, most significantly in eyes with proliferative diabetic retinopathy. Vascular changes captured by new imaging modalities can further characterize diabetic choroidopathy and help monitor the evolution of diabetic ocular disease.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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