June 2020
Volume 61, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2020
Impaired Layer Specific Retinal Vascular Reactivity Among Diabetic Subjects
Author Affiliations & Notes
  • Maxwell Singer
    USC Roski Eye Institute, Los Angeles, California, United States
  • Bright Senyo Ashimatey
    USC Roski Eye Institute, Los Angeles, California, United States
  • Xiao Zhou
    Bioengineering, University of Washington, Washington, United States
  • Zhongdi Chu
    Bioengineering, University of Washington, Washington, United States
  • Melissa Mert
    Department of Preventative Medicine (Biostatistics), Southern California Clinical and Translational Science Institute, University of Southern California, California, United States
  • Ruikang K Wang
    Bioengineering, University of Washington, Washington, United States
  • Amir H Kashani
    USC Roski Eye Institute, Los Angeles, California, United States
    USC Ginsberg Institute for Biomedical Therapeutics, Los Angeles, California, United States
  • Footnotes
    Commercial Relationships   Maxwell Singer, None; Bright Ashimatey, None; Xiao Zhou, None; Zhongdi Chu, None; Melissa Mert, None; Ruikang Wang, Carl Zeiss Meditec Inc (C), Insight Phototonic Solutions (C); Amir Kashani, Carl Zeiss Meditec Inc (F), Carl Zeiss Meditec Inc (R)
  • Footnotes
    Support  NIH R01EY030564, NIH K08EY027006, Unrestricted Departmental Grant From Research To Prevent Blindness, Research Grants from Carl Zeiss Meditec, Tai Family Research Scholars Fund
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 4095. doi:
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    • Get Citation

      Maxwell Singer, Bright Senyo Ashimatey, Xiao Zhou, Zhongdi Chu, Melissa Mert, Ruikang K Wang, Amir H Kashani; Impaired Layer Specific Retinal Vascular Reactivity Among Diabetic Subjects. Invest. Ophthalmol. Vis. Sci. 2020;61(7):4095.

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

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Abstract

Purpose : To investigate layer specific retinal vascular reactivity in diabetic subjects using swept-source OCTA.

Methods : This was a single-armed, prospective, observational study. A previously described (Ashimatey et al., IOVS 2019) non-rebreathing apparatus was used to deliver room air, a 5% CO2 gas mixture, and 100% O2 to controls (N=30) and diabetics (N=22) with simultaneous acquisition of 3x3 mm2 swept-source OCTA images (PlexEliteTM, Carl Zeiss Meditec, Dublin, CA) centered on the fovea. Vessel skeleton density (VSD) metric was calculated for each condition for the segmented superficial retinal layer (SRL) and deep retinal layer (DRL) as previously described (Kim et al., IOVS 2016). Analyses were performed using averaged OCTA images derived from 2 or more scans for each subject. Data analysis was performed using mixed factorial analysis of covariance (ANCOVA) stratified by diabetic stats. All models were adjusted for age, gender, and hypertension.

Results : There is a significant effect of retinal layer (p<0.001) and gas-layer interactions on VSD for both non-diabetics (p=0.001) and diabetics (p<0.001). There is a significant effect of gas on VSD among non-diabetics (p<0.001). This difference is driven by both change in the SRL (p<0.001) and DRL (p<0.001). Within each layer there is a significantly higher VSD during room air and CO2 conditions than during O2 (both p<0.017). Among diabetics, there is a borderline significant effect of gas on VSD regardless of layer (p=0.04). The magnitude of this effect is less than in non-diabetics and this effect is driven primarily by lower VSD in the DRL between gas conditions (p<0.007). Specifically, in the DRL the VSD is significantly lower under O2 conditions compared to room air conditions (p<0.017). The magnitude of change in VSD between gas conditions by layer is exhibited in Figure 1. Similar results were obtained when only single images were used for the analysis.

Conclusions : Impairment in RVR in diabetic subjects is driven largely by a decrease in the robustness of the response to O2 in the SRL as well as almost complete attenuation of CO2 in all layers. These layer and gas specific impairments in diabetics may play a useful role in disease detection.

This is a 2020 ARVO Annual Meeting abstract.

 

Fig 1: Magnitude of change of VSD between gas conditions by layer for controls and diabetics (DM) with or without retinopathy (DR). Asterisk denotes significant differences in reactivity between layers by paired t-test.

Fig 1: Magnitude of change of VSD between gas conditions by layer for controls and diabetics (DM) with or without retinopathy (DR). Asterisk denotes significant differences in reactivity between layers by paired t-test.

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