Abstract
Purpose :
To determine the ocular and systemic determinants of macular vessel parameters in healthy eyes in the African American Eye Disease Study population.
Methods :
3x3mm macula spectral-domain optical coherence tomography angiography (OCT-A; CIRRUS 5000 HD-OCT with AngioPlex; ZEISS, Dublin, CA, USA) scans were performed on participants of the African American Eye Disease Study (AFEDS), which consisted of African Americans 40 years and older in Inglewood, California. Subjects with glaucoma, severe non-proliferative diabetic retinopathy (NPDR), PDR, and macular edema were excluded. Custom software quantified vessel area density (VAD), vessel skeleton density (VSD), and vessel diameter index (VDI) in the superficial retinal layer (SRL) of the macula. A multivariable linear regression model controlling for inter-eye correlation was used to identify the ocular and systemic factors associated with each OCTA parameter with a significance level set at 0.05. Candidate variables included: central corneal thickness (CCT), VF mean deviation (MD), intraocular pressure (IOP), axial length (AL), signal strength (SS), mean ocular perfusion pressure (MOPP), body mass index, age, gender, systolic blood pressure (BP), diastolic BP, pulse pressure (PP), mean arterial pressure (MAP), history of smoking, history of diabetes, diabetes duration, and history of stroke or brain hemorrhage (SB).
Results :
Of 797 OCTA imaged eyes from 627 subjects with good quality images, 737 eyes met inclusion and exclusion criteria. The multivariable model for VAD included: SS (β= 0.0085, p<0.0001), PP (β= -0.0001, p=0.019), and SB (β= -0.008, p=0.0004), controlling for AL (β= -0.0013, p=0.101) and age (β= -0.0001, p=0.118). The multivariable model for VSD included: AL (β= 0.0008, p=0.006), SS (β= 0.002, p<0.0001), PP (β= -0.00004, p=0.027), SB (β= -0.003, p=0.019), and age (β= -0.0001, p=0.017). The multivariable model for VDI included: AL (β= -0.026, p< 0.0001), SS (β= 0.019, p< 0.0001), age (β= 0.0009, p=0.0004), female gender (β= -0.0232, p<0.0001), MAP (β= -0.0006, p=0.0001), and diabetes duration (β= 0.0012 p=0.012).
Conclusions :
Older age, longer AL, lower SS, and systemic variables including wider PP and SB were independently associated with reduced VAD or VSD. The effect of these variables need to be considered when evaluating the macular microcirculation on OCTA in the clinical setting.
This is a 2020 ARVO Annual Meeting abstract.