Analysis of Foveal Microvascular Abnormalities in Diabetic Retinopathy Using Optical Coherence Tomography Angiography with Projection Artifact Removal

Purpose. To analyze foveal microvascular abnormalities in different stages of diabetic retinopathy (DR) using optical coherence tomography angiography (OCTA) with projection artifact removal (PAR). Methods. We analyzed 93 eyes of 59 patients with diabetes—31 with no DR (no DR), 34 with mild to moder...

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Main Authors: Lun Liu, Jian Gao, Weili Bao, Chengyang Hu, Yajing Xu, Bingying Zhao, Jie Zheng, Lingling Fan, Yehuan Sun
Format: Article
Language:English
Published: Wiley 2018-01-01
Series:Journal of Ophthalmology
Online Access:http://dx.doi.org/10.1155/2018/3926745
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author Lun Liu
Jian Gao
Weili Bao
Chengyang Hu
Yajing Xu
Bingying Zhao
Jie Zheng
Lingling Fan
Yehuan Sun
author_facet Lun Liu
Jian Gao
Weili Bao
Chengyang Hu
Yajing Xu
Bingying Zhao
Jie Zheng
Lingling Fan
Yehuan Sun
author_sort Lun Liu
collection DOAJ
description Purpose. To analyze foveal microvascular abnormalities in different stages of diabetic retinopathy (DR) using optical coherence tomography angiography (OCTA) with projection artifact removal (PAR). Methods. We analyzed 93 eyes of 59 patients with diabetes—31 with no DR (no DR), 34 with mild to moderate nonproliferative DR (mild DR), and 28 with severe nonproliferative DR to proliferative DR (severe DR)—and 31 age-matched healthy controls. Sections measuring 3 × 3 mm2 centered on the fovea were obtained using OCTA. The area, perimeter, and acircularity index (AI) of the foveal avascular zone (FAZ), vessel density within a 300 μm wide region of the FAZ (FD-300), and parafoveal vessel density in the superficial capillary plexus (SCP) and deep capillary plexus (DCP) were calculated using novel built-in software with PAR. Results. There was no statistically significant difference in the FAZ area (p=0.162). There was a statistically significant difference in the FAZ perimeter (p=0.010) and the AI (p<0.001) between the four groups. There was a correlation between the AI and the increasing severity of DR (p=0.010). Statistically significant decreases of vessel density in the FD-300, SCP, and DCP were observed (all p<0.001). There was a difference in parafoveal vessel density in the DCP between the healthy control eyes and the eyes with diabetes without DR (p=0.027). There was a significant correlation between vessel density and increasing severity of DR (p<0.001). Conclusion. Compared with the FAZ area, AI allows a more helpful quantitative assessment of the changes in the FAZ. Vessel density determined using OCTA with PAR might be a useful parameter indicating the progression of DR. Parafoveal vessel density in the DCP after PAR might be a potential early biomarker of DR before appearance of clinically evident retinopathy and needs further investigation.
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spelling doaj-art-be44e8794d954ccd8d34333a92d29cc02025-08-20T02:18:35ZengWileyJournal of Ophthalmology2090-004X2090-00582018-01-01201810.1155/2018/39267453926745Analysis of Foveal Microvascular Abnormalities in Diabetic Retinopathy Using Optical Coherence Tomography Angiography with Projection Artifact RemovalLun Liu0Jian Gao1Weili Bao2Chengyang Hu3Yajing Xu4Bingying Zhao5Jie Zheng6Lingling Fan7Yehuan Sun8Department of Epidemiology and Health Statistics, School of Public Health of Anhui Medical University, Hefei, Anhui, ChinaDepartment of Ophthalmology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, ChinaDepartment of Ophthalmology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, ChinaDepartment of Epidemiology and Health Statistics, School of Public Health of Anhui Medical University, Hefei, Anhui, ChinaDepartment of Ophthalmology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, ChinaDepartment of Ophthalmology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, ChinaDepartment of Ophthalmology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, ChinaDepartment of Ophthalmology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, ChinaDepartment of Epidemiology and Health Statistics, School of Public Health of Anhui Medical University, Hefei, Anhui, ChinaPurpose. To analyze foveal microvascular abnormalities in different stages of diabetic retinopathy (DR) using optical coherence tomography angiography (OCTA) with projection artifact removal (PAR). Methods. We analyzed 93 eyes of 59 patients with diabetes—31 with no DR (no DR), 34 with mild to moderate nonproliferative DR (mild DR), and 28 with severe nonproliferative DR to proliferative DR (severe DR)—and 31 age-matched healthy controls. Sections measuring 3 × 3 mm2 centered on the fovea were obtained using OCTA. The area, perimeter, and acircularity index (AI) of the foveal avascular zone (FAZ), vessel density within a 300 μm wide region of the FAZ (FD-300), and parafoveal vessel density in the superficial capillary plexus (SCP) and deep capillary plexus (DCP) were calculated using novel built-in software with PAR. Results. There was no statistically significant difference in the FAZ area (p=0.162). There was a statistically significant difference in the FAZ perimeter (p=0.010) and the AI (p<0.001) between the four groups. There was a correlation between the AI and the increasing severity of DR (p=0.010). Statistically significant decreases of vessel density in the FD-300, SCP, and DCP were observed (all p<0.001). There was a difference in parafoveal vessel density in the DCP between the healthy control eyes and the eyes with diabetes without DR (p=0.027). There was a significant correlation between vessel density and increasing severity of DR (p<0.001). Conclusion. Compared with the FAZ area, AI allows a more helpful quantitative assessment of the changes in the FAZ. Vessel density determined using OCTA with PAR might be a useful parameter indicating the progression of DR. Parafoveal vessel density in the DCP after PAR might be a potential early biomarker of DR before appearance of clinically evident retinopathy and needs further investigation.http://dx.doi.org/10.1155/2018/3926745
spellingShingle Lun Liu
Jian Gao
Weili Bao
Chengyang Hu
Yajing Xu
Bingying Zhao
Jie Zheng
Lingling Fan
Yehuan Sun
Analysis of Foveal Microvascular Abnormalities in Diabetic Retinopathy Using Optical Coherence Tomography Angiography with Projection Artifact Removal
Journal of Ophthalmology
title Analysis of Foveal Microvascular Abnormalities in Diabetic Retinopathy Using Optical Coherence Tomography Angiography with Projection Artifact Removal
title_full Analysis of Foveal Microvascular Abnormalities in Diabetic Retinopathy Using Optical Coherence Tomography Angiography with Projection Artifact Removal
title_fullStr Analysis of Foveal Microvascular Abnormalities in Diabetic Retinopathy Using Optical Coherence Tomography Angiography with Projection Artifact Removal
title_full_unstemmed Analysis of Foveal Microvascular Abnormalities in Diabetic Retinopathy Using Optical Coherence Tomography Angiography with Projection Artifact Removal
title_short Analysis of Foveal Microvascular Abnormalities in Diabetic Retinopathy Using Optical Coherence Tomography Angiography with Projection Artifact Removal
title_sort analysis of foveal microvascular abnormalities in diabetic retinopathy using optical coherence tomography angiography with projection artifact removal
url http://dx.doi.org/10.1155/2018/3926745
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