Abstract
Purpose :
To investigate the clinical significance of intercapillary space spectrum on swept source optical coherence tomography angiography (SS-OCTA) images in diabetic retinopathy (DR).
Methods :
We retrospectively reviewed consecutive 96 eyes of 82 patients suffering from DR without macular edema. Automatic image processing of en-face OCTA images provided the quantitative parameters and location of intercapillary spaces within central 2 mm circle The parafoveal areas were divided into 40 sectors according to the distance and octant. We evaluated how the intercapillary spaces are associated with logarithm of the minimum angle of resolution (logMAR) and feasible to diagnose diabetic macular ischemia.
Results :
Among several quantitative parameters, total counts of the intercapillary spaces showed most significant correlation to logMAR (ρ＝-0.408, P<0.001). The size thresholding did not improve the statistical association, whereas numbers of the spaces in 2 highly significant sectors showed better associations with logMAR (ρ＝-0.488, P<0.001). Multivariate regression analyses revealed that both the FAZ area (β=0.226, P=0.043), and the number of the intercapillary spaces (β=-0.270, P=0.014) were related to logMAR. The clustering using the FAZ area and the intercapillary spaces revealed two major clusters, one of which might be proposed as diabetic macular ischemia. Subsequent receiver operating characteristic analyses demonstrated that the intercapillary spaces (area under the curve [AUC] = 0.999) rather than the FAZ area (AUC =0.785) discriminated these two clusters.
Conclusions :
Both enlarged FAZ and decreased interapillary spaces contribute to visual impairment and propose an objective and quantitative diagnosis of diabetic macular ischemia in DR without macular edema.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.