June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Association of capillary plexus vessel density with risk of proliferative diabetic retinopathy in eyes with advanced nonproliferative diabetic retinopathy
Author Affiliations & Notes
  • Konstantina Sampani
    Beetham Eye Institute, Joslin Diabetes Center, Boston, Massachusetts, United States
    Medicine, Harvard Medical School, Boston, Massachusetts, United States
  • Mohamed Ashraf
    Beetham Eye Institute, Joslin Diabetes Center, Boston, Massachusetts, United States
    Ophthalmology, Harvard Medical School, Boston, Massachusetts, United States
  • Paolo S Silva
    Beetham Eye Institute, Joslin Diabetes Center, Boston, Massachusetts, United States
    Ophthalmology, Harvard Medical School, Boston, Massachusetts, United States
  • Lloyd Paul Aiello
    Beetham Eye Institute, Joslin Diabetes Center, Boston, Massachusetts, United States
    Ophthalmology, Harvard Medical School, Boston, Massachusetts, United States
  • Jennifer K Sun
    Beetham Eye Institute, Joslin Diabetes Center, Boston, Massachusetts, United States
    Ophthalmology, Harvard Medical School, Boston, Massachusetts, United States
  • Footnotes
    Commercial Relationships   Konstantina Sampani None; Mohamed Ashraf None; Paolo Silva Optos, Code F (Financial Support), Optomed, Code F (Financial Support); Lloyd Aiello Kalvista, Code C (Consultant/Contractor), Novo Nordisk, Code C (Consultant/Contractor), Kalvista, Code I (Personal Financial Interest); Jennifer Sun American Medical Association (JAMA Ophthalmology), Code C (Consultant/Contractor), American Diabetes Association , Code C (Consultant/Contractor), Adaptive Sensory Technologies, Code F (Financial Support), Boehringer Ingelheim, Code F (Financial Support), Genentech/Roche, Code F (Financial Support), Janssen, Code F (Financial Support), Physical Sciences, Inc, Code F (Financial Support), Novartis, Code F (Financial Support)
  • Footnotes
    Support  Research to Prevent Blindness, Massachusetts Lions Eye Research Fund
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 2894 – F0047. doi:
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    • Get Citation

      Konstantina Sampani, Mohamed Ashraf, Paolo S Silva, Lloyd Paul Aiello, Jennifer K Sun; Association of capillary plexus vessel density with risk of proliferative diabetic retinopathy in eyes with advanced nonproliferative diabetic retinopathy. Invest. Ophthalmol. Vis. Sci. 2022;63(7):2894 – F0047.

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

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Abstract

Purpose : To investigate whether retinal vessel density (VD) of the superficial (SCP), intermediate (ICP) or deep (DCP) capillary plexuses is associated with the risk of progression to proliferative DR (PDR) in eyes with moderate to severe nonproliferative DR (NPDR).

Methods : Treatment-naïve eyes with moderate to severe NPDR within the ETDRS fields on ultrawide field photographs were imaged using 3x3 mm scans on OCTA (AngioVue). DR severity was graded by certified graders. OCTA images were exported to ImageJ (ver 1.51, National Institutes of Health) to manually calculate VD of the parafovea. Clinical data, including treatment history and demographics were reviewed and recorded on standardized forms.

Results : The study group was 75 treatment-naive eyes (70 subjects) with moderate (N=37), moderately severe (N=20) or severe (N=18) NPDR at baseline and a mean follow-up of 2.9±1.3 yrs. Mean±SD age was 49.4±13.4 yrs, 47.2% were female and 61.1% had type 1 diabetes with 26.1±11.8 yrs duration. Eleven eyes, all with baseline severe NPDR, developed PDR within 1.3±1.2 yrs. In the whole cohort, no significant difference was found in mean baseline OCTA SCP, ICP or DCP VD between eyes with or without 2 or more step DR severity worsening or between eyes that did and did not progress to PDR. Time to event analyses of the subgroup with moderately severe or severe NPDR found eyes with decreased DCP VD had higher risk of PDR [point estimate (95% CI): 1.43 (1.1-15.3), p=0.03]. In the subgroup with baseline severe NPDR, time to PDR onset was significantly faster in eyes with increased SCP [1.43 (1.1-15.3), p=0.03], decreased ICP [-0.97 (0.2-0.9), p=0.04] or decreased DCP [-2.51 (0.1-0.6), p=0.02] VD, even after adjusting for age, signal strength index and spherical equivalent.

Conclusions : Subgroup analyses from this study suggest that retinal capillary plexus VD is potentially associated with risk of PDR onset in eyes with moderately severe to severe NPDR. Findings from this cohort are consistent with the hypothesis that eyes with lower DCP, and possibly ICP VD may have faster onset of PDR. The association of higher PDR risk with higher SCP VD could be due to greater SCP perfusion from vascular shunting and capillary remodeling that precedes neovascularization, but additional studies are needed to validate and address this issue.

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

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