Abstract
BackgroundTo assess capillary dropout in the superficial retinal capillary plexus (SCP) by optical coherence tomography angiography (OCTA) in the early stage of diabetic retinopathy (DR).MethodsThis study was a cross-sectional observational study. Patients that underwent OCTA examinations in our hospital between November 2015 and May 2016 were included in the study. The subjects were divided into two groups: A) normal controls (41 eyes of 41 subjects) and B) the DR patients (49 eyes of 49 patients with mild non-proliferative DR (NPDR)). The retinal thickness and SCP vessel density were analyzed using built-in software in nine sections of the macular area; whole scan area; fovea; parafovea; and sub-sections of the parafovea, superior-hemi, inferior-hemi, temporal, superior, nasal, and inferior. The correlation between vessel density and retinal thickness was also analyzed.ResultsThe SCP density was significantly lower (P < 0.05) in mild NPDR patients than in normal controls in all areas, with the exception of the fovea (P > 0.05). In the parafovea, superior-hemi, inferior-hemi, temporal, and nasal sectors of group B, the SCP density was negatively correlated with the corresponding retinal thickness (P < 0.05). Specifically, as the SCP density decreased, retinal thickness increased.ConclusionsIn the early stage of NPDR, retinal capillary dropout and retinal thickness changes can be clearly captured and analyzed by OCTA. The results confirm a negative correlation between vessel density and retinal thickness in diabetic patients. This noninvasive technique could be applied for DR detection and monitoring. Further study with a larger sample size is warranted.
Highlights
To assess capillary dropout in the superficial retinal capillary plexus (SCP) by optical coherence tomography angiography (OCTA) in the early stage of diabetic retinopathy (DR)
OCTA, with split spectrum amplitude decorrelation angiography (SSADA), employs motion contrast imaging to obtain high-resolution volumetric blood flow information to generate angiographic images, which does not require the injection of exogenous dyes and provides near-automatic quantification and excellent intra-visit repeatability in the measurement of macular regions [6–8]
A total of 90 adult Chinese subjects (90 eyes) were included in the analysis. They were divided into group A and group B with mild non-proliferative diabetic retinopathy (NPDR), diagnosed according to the international definition of DR stages [13]
Summary
To assess capillary dropout in the superficial retinal capillary plexus (SCP) by optical coherence tomography angiography (OCTA) in the early stage of diabetic retinopathy (DR). Over the last 20 years, time domain and spectral domain optical coherence tomography (SD-OCT) has resulted in the advancement of retinal disease diagnosis [1, 2]. Fundus fluorescein angiography (FFA) is currently considered the gold standard in retinal vascular network imaging for numerous retinovascular. Shen et al BMC Ophthalmology (2018) 18:113 explores the retina only on a single plane, OCTA provides a non-invasive approach for three-dimensional (3D) retinal microcirculation imaging [9, 10]. Vision-threatening retinovascular diseases, such as diabetic retinopathy, retinal vein occlusion, and macular telangiectasia, interfere with retinal microcirculation by modifying the foveal avascular zone (FAZ) size [12]
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