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Qi Sheng You, Jonathan C. H. Chan, Alex L. K. Ng, Bonnie K. N. Choy, Kendrick C. Shih, Janice J. C. Cheung, Jasper K. W. Wong, Jennifer W. H. Shum, Michael Y. Ni, Jimmy S. M. Lai, Gabriel M. Leung, Chui Ming Gemmy Cheung, Tien Yin Wong, Ian Y. H. Wong; Macular Vessel Density Measured With Optical Coherence Tomography Angiography and Its Associations in a Large Population-Based Study. Invest. Ophthalmol. Vis. Sci. 2019;60(14):4830-4837. doi: https://doi.org/10.1167/iovs.19-28137.
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We investigate macular perfusion and the systemic and ocular associations in a population-based setting.
In this cross-sectional study, 2018 adults residing in Hong Kong underwent detailed ophthalmic examinations after consenting to participate. Macular perfusion was measured with optical coherence tomography angiography (OCTA) using the split-spectrum amplitude decorrelation angiography algorithm. The parafoveal flow index and vessel area density were quantified using automated custom-built software.
Of the 2018 participants, the OCTA measurements were available for 1940, and 1631 (84.1%) had good quality scans. The right eyes of these 1631 participants (43.1% men) were included for final analysis. Mean age was 49.8 years (range, 18–92 years). Mean global macular vessel density was 47.3% and 55.1% for the superficial and deep retinal layers, respectively. In multivariate analysis, lower superficial vessel density remained significantly associated with lower signal strength index (SSI; P < 0.001, standardized β = 0.607) and male sex (P < 0.001, β = 0.162), and borderline associated with older age (P = 0.09, β = −0.045) and longer axial length (AL; P = 0.09, β = −0.037), while lower deep layer vessel density was significantly associated with lower SSI (P < 0.001, standardized β = 0.667), longer AL (P < 0.001, β = −0.097), and higher creatinine (P < 0.001, β = −0.072).
This large population-based study provided normative OCTA data of macular vessel density and demonstrated that a lower superficial retinal vessel density was significantly associated with lower SSI and male sex, while a lower deep layer retinal vessel density was significantly associated with lower SSI, longer AL, and higher level of creatinine. These associations must be considered when interpreting clinical quantitative OCTA data.
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