July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Quantitative assessment of changes in retinal vascular density and morphology among patients with diabetic retinopathy using spectral domain optical coherence tomography angiography (SD-OCTA)
Author Affiliations & Notes
  • Kaitlin Kogachi
    Department of Ophthalmology, USC Roski Eye Institute, University of Southern California, Los Angeles, California, United States
  • TAI-CHI LIN
    Department of Ophthalmology, USC Roski Eye Institute, University of Southern California, Los Angeles, California, United States
    USC Institute for Biomedical Therapeutics, University of Southern California, Los Angeles, California, United States
  • Neal V Palejwala
    Retinal Consultants of Arizona, Phoenix, Arizona, United States
  • Sujit Itty
    Retinal Consultants of Arizona, Phoenix, Arizona, United States
  • Jeremy D. Wolfe
    Associated Retinal Consultants, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan, United States
  • Kimberly A Drenser
    Associated Retinal Consultants, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan, United States
  • Antonio Jr. Capone
    Associated Retinal Consultants, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan, United States
  • Pravin U Dugel
    Retinal Consultants of Arizona, Phoenix, Arizona, United States
    Department of Ophthalmology, USC Roski Eye Institute, University of Southern California, Los Angeles, California, United States
  • Xuejuan Jiang
    Department of Ophthalmology, USC Roski Eye Institute, University of Southern California, Los Angeles, California, United States
  • Anoush Shahidzadeh
    Department of Ophthalmology, USC Roski Eye Institute, University of Southern California, Los Angeles, California, United States
  • Zhongdi Chu
    Department of Bioengineering, University of Washington, Seattle, Washington, United States
  • Ruikang K Wang
    Department of Bioengineering, University of Washington, Seattle, Washington, United States
  • Amir H Kashani
    Department of Ophthalmology, USC Roski Eye Institute, University of Southern California, Los Angeles, California, United States
    USC Institute for Biomedical Therapeutics, University of Southern California, Los Angeles, California, United States
  • Footnotes
    Commercial Relationships   Kaitlin Kogachi, None; TAI-CHI LIN, None; Neal Palejwala, None; Sujit Itty, None; Jeremy Wolfe, Allergan (C), Allergan (F), Allergan (S), Carl Zeiss Meditec (C), Genentech (C), Genetech (S), Regeneron (C), Regeneron (S); Kimberly Drenser, None; Antonio Jr. Capone, None; Pravin Dugel, Annidis (C), Annidis (I), DigiSight (C), DigiSight (I), Optovue (C), PanOptica (C), Pentavision (C), TopCon (C); Xuejuan Jiang, None; Anoush Shahidzadeh, None; Zhongdi Chu, None; Ruikang Wang, Carl Zeiss Meditec (P), Carl Zeiss Meditec (C), Insight Photonic Solutions (C), Kowa (P); Amir Kashani, Carl Zeiss Meditec (F), Carl Zeiss Meditec (R)
  • Footnotes
    Support  NIH K08EY027006, NIH R21EY027879, Research Grants from Carl Zeiss Meditec Inc, Unrestricted Department Funding from Research to Prevent Blindness
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 739. doi:
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    • Get Citation

      Kaitlin Kogachi, TAI-CHI LIN, Neal V Palejwala, Sujit Itty, Jeremy D. Wolfe, Kimberly A Drenser, Antonio Jr. Capone, Pravin U Dugel, Xuejuan Jiang, Anoush Shahidzadeh, Zhongdi Chu, Ruikang K Wang, Amir H Kashani; Quantitative assessment of changes in retinal vascular density and morphology among patients with diabetic retinopathy using spectral domain optical coherence tomography angiography (SD-OCTA). Invest. Ophthalmol. Vis. Sci. 2018;59(9):739.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To describe and quantify SD-OCTA metrics among subjects with varying severities of diabetic retinopathy (DR) and determine correlation with disease severity.

Methods : Retrospective, observational, multicenter, Institutional Review Board-approved study of patients with and without DR at 3 tertiary-care centers using ZEISS AngioPlexTM SD-OCTA (Cirrus, Carl Zeiss Meditec, Dublin, CA). A total of 110 subjects and 201 eyes were included (38 normal, 61 mild non-proliferative DR (NPDR), 27 moderate NPDR, 24 severe NPDR, and 51 proliferative DR (PDR) eyes). A semi-automated segmentation algorithm was used to assess retinal microvasculature in superficial (SRL), deep (DRL), and full-thickness (RET) retinal layers with 3x3-mm scans centered on the fovea. Quantified capillary metrics included vessel skeletal density (VSD), flow impairment region (FIR), and flux. Associations between SD-OCTA metrics and DR status were analyzed with generalized estimating equations accounting for correlations between two eyes from one subject.

Results : When comparing normal to mild NPDR eyes, mean VSD was decreased in SRL (0.153±0.007 vs 0.147±0.010) and DRL (0.151±0.008 vs 0.143±0.013) (p<0.05 for both). Mean FIR were greater in RET (1.27±0.35 mm2 vs 1.60±0.61 mm2), SRL (1.57±0.37 mm2 vs 1.92±0.58 mm2), and DRL (2.03±0.48 mm2 vs 2.56±0.88 mm2) (p<0.05 for all). Mean FIR in all 3 layers were significantly greater for progressively worse DR stages (p<0.05 for all). No differences in flux were observed in normal versus mild NPDR eyes. Significant interactions between age and mild NPDR were seen in FIR of SRL and DRL (p<0.05 for both). Significant trends were also noted in other OCTA morphology parameters.

Conclusions : There are significant differences in capillary density (SRL and DRL) and morphology among normal eyes compared to mild NPDR eyes. Progressively greater changes in density and morphology are seen with worsening DR status. The OCTA-based metrics may objectively assess DR severity.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

 

Non-segmented 3x3-mm SD-OCTA and quantified output images of a normal eye and eyes of varying DR severities. En face (A-E), binary (F-J) and skeleton (K-O) perfusion images correspond with the group in each column. Flow impairment maps (P-T) indicate white areas as lack of OCTA-detected retinal perfusion. Yellow bar (A) indicates 500-μm length.

Non-segmented 3x3-mm SD-OCTA and quantified output images of a normal eye and eyes of varying DR severities. En face (A-E), binary (F-J) and skeleton (K-O) perfusion images correspond with the group in each column. Flow impairment maps (P-T) indicate white areas as lack of OCTA-detected retinal perfusion. Yellow bar (A) indicates 500-μm length.

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