Dataset Information

A Study of the Association Between Retinal Vessel Geometry and Optical Coherence Tomography Angiography Metrics in Diabetic Retinopathy.

ABSTRACT:

Purpose

The purpose of this study was to investigate whether optical coherence tomography angiography (OCTA) metrics are related to retinal vessel geometry parameters in diabetic retinopathy (DR).

Methods

In total, 119 eyes (119 patients) were included in this retrospective cross-sectional study. Retinal vessel geometry parameters were analyzed using semi-automated software. OCTA metrics were analyzed using automated manufacturer-provided algorithms. Associations between the severity of DR and retinal vessel geometry parameters and OCTA metrics were evaluated. Multivariable regression analyses were performed to evaluate associations between retinal vessel geometry parameters and OCTA metrics after adjusting for clinical characteristics and DR severity.

Results

DR severity was negatively associated with the following: arteriole-venular ratio (P = 0.039), arteriolar network fractal dimension (FDa; P = 0.003), arteriolar junctional exponent deviation (P = 0.037), venular junctional exponent deviation (P = 0.036), vessel area density (VAD) of the superficial capillary plexus (SCP) and deep capillary plexus (DCP; P < 0.001, both), vessel length density (VLD) of the SCP and DCP (P < 0.001, both), and foveal avascular zone (FAZ) circularity (P < 0.001). DR severity was positively associated with the central retinal venular equivalent caliber (P = 0.005), arteriolar branching coefficient (BCa; P = 0.010), venular branching coefficient (P = 0.007), and FAZ size (P = 0.002). In multivariable regression analyses, the following retinal vessel geometry parameters and OCTA metrics were associated: FDa with VAD of the SCP (β = 0.40, P < 0.001), FDa with VLD of the SCP (β = 0.01, P < 0.001), and BCa with FAZ circularity (β = -1.02, P = 0.001).

Conclusions

In DR, changes in retinal arteriolar geometry parameters were significantly associated with OCTA metrics, which reflect DR pathophysiology.

SUBMITTER: Choi JM

PROVIDER: S-EPMC8525825 | biostudies-literature | 2021 Oct

REPOSITORIES: biostudies-literature

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Publications

A Study of the Association Between Retinal Vessel Geometry and Optical Coherence Tomography Angiography Metrics in Diabetic Retinopathy.

Choi Ji Min JM Kim Seong Mi SM Bae Young Hwan YH Ma Dae Joong DJ

Investigative ophthalmology & visual science 20211001 13

<h4>Purpose</h4>The purpose of this study was to investigate whether optical coherence tomography angiography (OCTA) metrics are related to retinal vessel geometry parameters in diabetic retinopathy (DR).<h4>Methods</h4>In total, 119 eyes (119 patients) were included in this retrospective cross-sectional study. Retinal vessel geometry parameters were analyzed using semi-automated software. OCTA metrics were analyzed using automated manufacturer-provided algorithms. Associations between the sever ...[more]

PMID: 34661607

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Project description:BackgroundDiabetic retinopathy (DR) is a leading cause of blindness and involves retinal capillary damage, microaneurysms, and altered blood flow regulation. Optical coherence tomography angiography (OCTA) is a non-invasive way of visualizing retinal vasculature but has not been used extensively to study blood flow heterogeneity. The purpose of this study is to detect and quantify blood flow heterogeneity utilizing en-face swept source OCTA in patients with DR.MethodsThis is a prospective clinical study which examined patients with either type 1 or 2 diabetes mellitus. Each included eye was graded clinically as no DR, mild DR, or moderate-severe DR. Ten consecutive en face 6 × 6 mm foveal SS-OCTA images were obtained from each eye using a PLEX Elite 9000 (Zeiss Meditec, Dublin, CA). Built-in fixation-tracking, follow-up functions were utilized to reduce motion artifacts and ensure same location imaging in sequential frames. Images of the superficial and deep vascular complexes (SVC and DVC) were arranged in temporal stacks of 10 and registered to a reference frame for segmentation using a deep neural network. The vessel segmentation was then masked onto each stack to calculate the pixel intensity coefficient of variance (PICoV) and map the spatiotemporal perfusion heterogeneity of each stack.ResultsTwenty-nine eyes were included: 7 controls, 7 diabetics with no DR, 8 mild DR, and 7 moderate-severe DR. The PICoV correlated significantly and positively with DR severity. In patients with DR, the perfusion heterogeneity was higher in the temporal half of the macula, particularly in areas of capillary dropout. PICoV also correlates as expected with the established OCTA metrics of perfusion density and vessel density.ConclusionPICoV is a novel way to analyze OCTA imaging and quantify perfusion heterogeneity. Retinal capillary perfusion heterogeneity in both the SVC and DVC increased with DR severity. This may be related to the loss of retinal capillary perfusion autoregulation in diabetic retinopathy.

Project description:ImportanceProjection artifacts in optical coherence tomography angiography (OCTA) blur the retinal vascular plexuses together and limit visualization of the individual plexuses.ObjectiveTo describe projection-resolved (PR) OCTA in eyes with diabetic retinopathy (DR) and healthy eyes.Design, setting, and participantsIn this case-control study, patients with DR and healthy controls were enrolled in this observational study from January 26, 2015, to December 4, 2015, at a tertiary academic center. Spectral-domain, 70-kHz OCT obtained 3 × 3-mm macular scans. The PR algorithm suppressed projection artifacts. A semiautomated segmentation algorithm divided PR-OCTA into superficial, intermediate, and deep retinal plexuses. Two masked graders examined 3-layer PR-OCTA and combined angiograms for nonperfusion and abnormal capillaries.Main outcomes and measuresRetinal nonperfusion and capillary abnormalities and the diagnostic accuracy of detecting DR.ResultsTwenty-nine eyes of 15 healthy individuals (mean [SD] age, 36.2 [13.4] years; 11 women) and 47 eyes of 29 patients with DR (mean [SD] age, 55.5 [11.9]; 10 women) underwent imaging. PR-OCTA revealed 3 distinct retinal plexuses in their known anatomical locations in all eyes. The intermediate and deep plexuses of healthy eyes revealed capillary networks of uniform density and caliber, whereas the superficial plexus revealed vessels in the familiar centripetal branching pattern. In eyes with DR, 3-layer PR-OCTA disclosed incongruent areas of nonperfusion and varied vessel caliber and density in the deeper plexuses. Masked grading of capillary nonperfusion on 3-layer PR-OCTA detected DR with 100% sensitivity (95% CI, 90.8%-100%) and 100% specificity (95% CI, 85.4%-100%). With unsegmented retinal angiograms, the sensitivity and specificity were 78.7% (95% CI, 63.9%-88.8%) and 100% (95% CI, 85.4%-100%), respectively (P = .002 for sensitivity). On 3-layer PR-OCTA, sensitivity was 72.2% (95% CI, 54.6%-85.2%) for severe nonproliferative DR and proliferative DR eyes with generalized nonperfusion in 2 or more individual plexuses, but on combined angiogram, sensitivity was 25.0% (95% CI, 12.7%-42.5%) for generalized nonperfusion (P < .001). PR-OCTA disclosed dilated vessels in the intermediate and deep plexuses in 23 eyes (100%) with proliferative DR, 13 eyes (100%) with severe nonproliferative DR, 8 eyes (73%) with mild to moderate nonproliferative DR, and 0 control eyes.Conclusions and relevanceBy presenting 3 retinal vascular plexuses distinctly, PR-OCTA reveals capillary abnormalities in deeper layers with clarity and may distinguish DR from healthy eyes and severe DR from mild DR with greater accuracy compared with conventional OCTA.

Dataset Information

A Study of the Association Between Retinal Vessel Geometry and Optical Coherence Tomography Angiography Metrics in Diabetic Retinopathy.

Purpose

Methods

Results

Conclusions

Publications

A Study of the Association Between Retinal Vessel Geometry and Optical Coherence Tomography Angiography Metrics in Diabetic Retinopathy.

Similar Datasets

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