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Br J Ophthalmol. 2019 Apr;103(4):452-456. doi: 10.1136/bjophthalmol-2018-311903. Epub 2018 May 23.

Choriocapillaris and retinal vascular plexus density of diabetic eyes using split-spectrum amplitude decorrelation spectral-domain optical coherence tomography angiography.

Author information

1
Cole Eye Institute, Cleveland Clinic, Cleveland, USA.
2
Federal University of São Paulo, São Paulo, Brazil.
3
Center for Ophthalmic Bioinformatics, Cole Eye Institute, Cleveland Clinic, Cleveland, USA.
4
Case Western Reserve University School of Medicine, Cleveland, USA.
5
Cole Eye Institute, Cleveland Clinic, Cleveland, USA drrishisingh@gmail.com.

Abstract

BACKGROUND/AIMS:

Split-spectrum amplitude decorrelation angiography for spectral-domain optical coherence tomography has enabled detailed, non-invasive assessment of vascular flow. This study evaluates choriocapillaris and retinal capillary perfusion density (CPD) in diabetic eyes using optical coherence tomography angiography (OCTA).

METHODS:

Records of 136 eyes that underwent OCTA imaging at a single institution were reviewed. Eyes were grouped as non-diabetic controls (37 eyes), patients with diabetes mellitus (DM) without diabetic retinopathy (DM without DR, 31 eyes), non-proliferative diabetic retinopathy (NPDR, 41 eyes) and proliferative diabetic retinopathy (PDR, 27 eyes). Quantitative CPD analyses were performed on OCTA images for assessing perfusion density of the choriocapillaris and retinal plexus for all patients and compared between groups.

RESULTS:

Eyes with NPDR and PDR showed significantly decreased choriocapillaris CPD compared with controls, while DM eyes without DR did not show significant change. Choriocapillaris whole-image CPD was decreased by 8.3% in eyes with NPDR (p<0.01) and decreased by 7.1% in eyes with PDR (p<0.01). Choriocapillaris parafoveal CPD was decreased by 8.9% in eyes with NPDR (p<0.01) and decreased by 8.2% in eyes with PDR (p<0.01). Compared with controls, only eyes with PDR showed significantly decreased retinal CPD, as well as significantly increased foveal avascular zone (FAZ) area. In those patients, retinal whole-image CPD was decreased by 9.7% (p<0.01), retinal foveal CPD was decreased by 20.5% (p<0.01) and retinal parafoveal CPD was decreased by 11.4% (p<0.01). FAZ area was increased by 50.9% (p<0.01).

CONCLUSIONS:

Choriocapillaris and retinal CPD are reduced in diabetic retinopathy, while FAZ area is increased in eyes with PDR. Vascular changes captured by new imaging modalities can further characterise diabetic choroidopathy.

KEYWORDS:

angiography; choroidopathy; diabetic; optical coherence tomography; retinopathy

Conflict of interest statement

Competing interests: RPS received grants and personal fees from Regeneron, Genentech/Roche, Apellis, Optos, Zeiss, Biogen and Alcon/Novartis outside the submitted work. JPE received grants and personal fees from Regeneron, Thrombogenics and Alcon/Novartis; royalties from Leica/Bioptigen outside the submitted work. AVR received personal fees from Allergan, Zeiss and Alcon/Novartis outside the submitted work. SS received grants and personal fees from Allergan and Mallingcrofdt outside the submitted work.

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