June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Clinically significant nonperfusion areas in diabetic retinopathy on widefield optical coherence tomography angiography
Author Affiliations & Notes
  • Kentaro Kawai
    Department of Ophthalmology and Visual Sciences, Kyoto Daigaku Daigakuin Igaku Kenkyuka Igakubu, Kyoto, Kyoto, Japan
  • Tomoaki Murakami
    Department of Ophthalmology and Visual Sciences, Kyoto Daigaku Daigakuin Igaku Kenkyuka Igakubu, Kyoto, Kyoto, Japan
  • Yuki Mori
    Department of Ophthalmology and Visual Sciences, Kyoto Daigaku Daigakuin Igaku Kenkyuka Igakubu, Kyoto, Kyoto, Japan
  • Kenji Ishihara
    Department of Ophthalmology and Visual Sciences, Kyoto Daigaku Daigakuin Igaku Kenkyuka Igakubu, Kyoto, Kyoto, Japan
  • Yoko Dodo
    Department of Ophthalmology and Visual Sciences, Kyoto Daigaku Daigakuin Igaku Kenkyuka Igakubu, Kyoto, Kyoto, Japan
  • Noriko Terada
    Department of Ophthalmology and Visual Sciences, Kyoto Daigaku Daigakuin Igaku Kenkyuka Igakubu, Kyoto, Kyoto, Japan
  • Keiichi Nishikawa
    Department of Ophthalmology and Visual Sciences, Kyoto Daigaku Daigakuin Igaku Kenkyuka Igakubu, Kyoto, Kyoto, Japan
  • Kazuya Morino
    Department of Ophthalmology and Visual Sciences, Kyoto Daigaku Daigakuin Igaku Kenkyuka Igakubu, Kyoto, Kyoto, Japan
  • Akitaka Tsujikawa
    Department of Ophthalmology and Visual Sciences, Kyoto Daigaku Daigakuin Igaku Kenkyuka Igakubu, Kyoto, Kyoto, Japan
  • Footnotes
    Commercial Relationships   Kentaro Kawai None; Tomoaki Murakami None; Yuki Mori None; Kenji Ishihara None; Yoko Dodo None; Noriko Terada None; Keiichi Nishikawa None; Kazuya Morino None; Akitaka Tsujikawa Canon, Code F (Financial Support)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 2927 – F0080. doi:
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    • Get Citation

      Kentaro Kawai, Tomoaki Murakami, Yuki Mori, Kenji Ishihara, Yoko Dodo, Noriko Terada, Keiichi Nishikawa, Kazuya Morino, Akitaka Tsujikawa; Clinically significant nonperfusion areas in diabetic retinopathy on widefield optical coherence tomography angiography. Invest. Ophthalmol. Vis. Sci. 2022;63(7):2927 – F0080.

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

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Abstract

Purpose : To examine the distribution of nonperfusion areas (NPAs) and its clinical relevance in diabetic retinopathy (DR) of different severities using widefield optical coherence tomography angiography (OCTA).

Methods : One hundred and forty-two eyes in 113 patients with diabetes (27 eyes with no DR [NDR], 71 with nonproliferative DR [NPDR], and 44 eyes with proliferative DR [PDR]) were prospectively participated. We obtained nominal 20 × 23mm (1614 × 1856 pixels) OCTA images using Xephilio OCT-S1. We evaluated NPAs within the 20mm-diameter circle centered on the fovea. After automatic detection of vessel edges using an ImageJ plug-in (Canny edge detection), the image was divided into regions of interest (ROIs) of 10 × 10 pixels, and ROIs without the edges were defined as NPAs. The frequency of the NPAs were calculated for each ROI. The ROIs with greater differences in the frequency than the third quartile were defined as significant areas. We evaluated area under the receiver operating characteristic curve (AUC) for DR severity discrimination using the NPA rates.

Results : The differences in the NPA rates between NDR and NPDR in each ROI were 1.4% (interquartile range [IQR], 0.0-2.7). Within central 10 mm, 34.5%, 13.8%, 7.1%, and 5.2% in temporal, superior, nasal, and inferior quadrants corresponded to the significant areas. The percentages outside it were 36.2%, 27.2%, 27.2%, and 30.3% in individual quadrants. The AUCs of NPA rates in total or significant areas to discriminate NPDR from NDR were 0.772 (95% confidence interval [CI], 0.687-0.856) and 1.000 (95% CI, 1.000-1.000), respectively. Further comparative study revealed that the differences in the NPA rate between NPDR and PDR in each ROI were 5.8 % (IQR, 1.9-10.2). The percentage of significant area was 0.0% in the quadrants other than the temporal subfield within central 10mm, while the percentages of significant area outside it were 39.1%, 36.5%, 19.8%, and 38.7%, respectively. The AUCs of NPA rate was 0.887 (95% CI, 0.828-0.946) and 0.946 (95% CI, 0.906-0.986) in the total and significant areas, respectively.

Conclusions : Clinically significant NPAs on widefield OCTA images might be useful in diagnosing NPDR and PDR as well as suggest the processes of vasoregression in DR.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

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