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Akihiro Ishibazawa, Lucas R. De Pretto, A. Yasin Alibhai, Malvika Arya, Osama Sorour, Nihaal Mehta, Eric Moult, Caroline R Baumal, Andre J. Witkin, Akitoshi Yoshida, Jay S Duker, James G Fujimoto, Nadia K Waheed; Retinal Capillary Non-Perfusion Relationship to Arteries or Veins as Observed on Widefield Optical Coherence Tomography Angiography: A Pilot Study in Diabetic Retinopathy. Invest. Ophthalmol. Vis. Sci. 2019;60(9):5339. doi: https://doi.org/.
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To evaluate whether retinal capillary non-perfusion is found predominantly adjacent to arteries or veins in eyes with diabetic retinopathy (DR).
63 eyes from 44 patients with proliferative DR (PDR) or non-PDR (NPDR) were included. 12x12 mm foveal-centered optical coherence tomography (OCT) angiography (OCTA) images were taken using an SS-OCT (Plex Elite 9000). In 37 eyes, widefield montages with 5 fixation points were also obtained. A semi-automatic algorithm that detected non-perfusion in full-retina slabs was developed, and the percentages of capillary nonperfusion within the total image area were calculated. Retinal arteries and veins were manually traced. Based on the shortest distance, non-perfusion pixels were labelled as either arterial-side or venous-side. Arterial-adjacent and venous-adjacent non-perfusion, and the A/V ratio (arterial-adjacent non-perfusion divided by venous-adjacent non-perfusion) were quantified.
22 eyes with moderate NPDR, 16 eyes with severe NPDR, and 25 eyes with PDR were scanned. Total non-perfusion area in PDR (median: 8.93%) was greater (p < 0.01) than in moderate NPDR (3.49%). Arterial-adjacent non-perfusion was greater than venous-adjacent non-perfusion for all stages of DR (p < 0.001). The median A/V ratios were 1.93 in moderate NPDR, 1.84 in severe NPDR and 1.78 in PDR. The A/V ratio was negatively correlated with the total non-perfusion area (r = -0.600, p < 0.0001). The results from the widefield montages showed similar patterns: the median A/V ratio was 1.56 in moderate NPDR, 1.59 in severe NPDR and 1.42 in PDR. The A/V ratio for the montage images was also negatively correlated with the total non-perfusion (r = - 0.598, p< 0.0001).
In DR, earlier changes and smaller non-perfusion tends to be artery-adjacent, while later and larger non-perfusion extends towards veins.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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