June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
Association of capillary plexus vessel density with risk of worsening and future anti-VEGF treatment in eyes with severe and proliferative diabetic retinopathy (DR)
Author Affiliations & Notes
  • Konstantina Sampani
    Joslin Diabetes Center Beetham Eye Institute, Boston, Massachusetts, United States
    Harvard Medical School, Boston, Massachusetts, United States
  • Mohamed Ashraf
    Joslin Diabetes Center Beetham Eye Institute, Boston, Massachusetts, United States
    Harvard Medical School, Boston, Massachusetts, United States
  • Paolo Antonio Silva
    Joslin Diabetes Center Beetham Eye Institute, Boston, Massachusetts, United States
    Harvard Medical School, Boston, Massachusetts, United States
  • Lloyd Aiello
    Joslin Diabetes Center Beetham Eye Institute, Boston, Massachusetts, United States
    Harvard Medical School, Boston, Massachusetts, United States
  • Jennifer K Sun
    Joslin Diabetes Center Beetham Eye Institute, Boston, Massachusetts, United States
    Harvard Medical School, Boston, Massachusetts, United States
  • Footnotes
    Commercial Relationships   Konstantina Sampani None; Mohamed Ashraf None; Paolo Antonio Silva Optos, Code F (Financial Support), Optomed, Code F (Financial Support); Lloyd Aiello Kalvista, Novo Nordisk, Ceramedix, MantraBio, Code C (Consultant/Contractor), Optos, Code F (Financial Support), Kalvista, Code I (Personal Financial Interest), Optos, Code R (Recipient); Jennifer Sun American Medical Association (JAMA Ophthalmology), American Diabetes Association, Code C (Consultant/Contractor), Adaptive Sensory Technologies, Boehringer Ingelheim, Genentech/Roche, Janssen, Physical Sciences, Inc, Novartis, Novo Nordisk, Optovue, Code F (Financial Support)
  • Footnotes
    Support  Research to Prevent Blindness, Massachusetts Lions Eye Research Fund
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 2557. doi:
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    • Get Citation

      Konstantina Sampani, Mohamed Ashraf, Paolo Antonio Silva, Lloyd Aiello, Jennifer K Sun; Association of capillary plexus vessel density with risk of worsening and future anti-VEGF treatment in eyes with severe and proliferative diabetic retinopathy (DR). Invest. Ophthalmol. Vis. Sci. 2023;64(8):2557.

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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 plexus is associated with risk of progression to proliferative DR (PDR) in eyes with severe nonproliferative DR (NPDR) and the need for future anti-VEGF treatment in eyes with PDR.

Methods : Treatment-naïve eyes with severe NPDR and eyes with no treatment in the previous year with PDR based on grading of ETDRS fields on ultrawide field photographs were imaged using 3x3 mm scans on OCTA (AngioVue). OCTA images were exported to ImageJ (ver 1.51, NIH) to manually calculate VD. Clinical data, including treatment history and demographics were reviewed and recorded on standardized forms.

Results : In the 32 eyes with severe NPDR at baseline and a mean follow-up (f/u) of 2.5±1.5 yrs, 17 eyes developed PDR within 1.3±1.2 yrs. Time to event analysis, adjusted for age and OCTA signal strength index (SSI), demonstrated greater mean baseline OCTA DCP VD, but not SCP or ICP VD, was significantly associated with increased risk of progression to PDR [SCP HR=0.89, p= 0.13; ICP HR=1.14, p=0.20; DCP HR=1.46, p=0.01]. The 84 eyes with pre-existing PDR at baseline were followed for 2.0±1.8 yrs after OCTA imaging. 26 eyes received subsequent anti-VEGF therapy with mean number of injections 3.3±2.3. Increased DCP VD, but not SCP or ICP VD, was significantly associated with increased number of injections in the injected PDR eyes [DCP: point estimate (95% CI) 0.3(0.08, 0.6), p=0.01] even after adjusting for age and OCTA SSI.

Conclusions : These findings suggest that increased DCP VD is potentially associated with the risk of progression to PDR in eyes with severe NPDR and with more anti-VEGF injections in eyes with PDR. The association of higher DCP VD could be due to greater DCP perfusion from vascular shunting and capillary remodeling that precedes neovascularization, but additional studies are required to determine whether macular VD is a reliable biomarker of risk of progression and future treatment burden in eyes with DR.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

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