Abstract

ObjectiveTo examine factors affecting foveal avascular zone (FAZ) area in healthy eyes using swept-source optical coherence tomography angiography (OCTA).MethodsThis prospective, cross-sectional study included 144 eyes of 144 individuals (77 women, 67 men) with a best corrected visual acuity of at least 20/20 and no history of ocular disorders. The area of the superficial FAZ was assessed using OCTA. Age, gender, central retinal thickness (CRT), retinal vascular density, refractive error, and axial length were examined to determine associations with FAZ area.ResultsThe mean age of the subjects was 42.1 ± 20.2 years (range: 10–79 years). The mean FAZ area was 0.32 ± 0.11 mm2, while the mean retinal vascular density was 35.53 ± 0.92%. Multivariate regression analysis was performed using FAZ area as the dependent variable and age, gender, CRT, retinal vascular density, refractive error, and axial length as independent variables. The results of this analysis demonstrate that CRT and retinal vascular density were significantly associated with FAZ area in our sample (P < 0.001, R2 = 0.425). Age, gender, refractive error, and axial length were not significantly correlated with FAZ area, while CRT and retinal vascular density were negatively correlated with FAZ area (CRT: P < 0.001, R2 = 0.356; retinal vascular density: P < 0.001, R2 = 0.189).ConclusionsOCTA results suggest that CRT and retinal vascular density negatively affect FAZ area in healthy eyes.

Highlights

  • Optical coherence tomography angiography (OCTA) is a non-invasive imaging system with microvasculature visualization capability superior to that of fluorescein angiography.[1]

  • Multivariate regression analysis was performed using foveal avascular zone (FAZ) area as the dependent variable and age, gender, central retinal thickness (CRT), retinal vascular density, refractive error, and axial length as independent variables. The results of this analysis demonstrate that CRT and retinal vascular density were significantly associated with FAZ area in our sample (P < 0.001, R2 = 0.425)

  • Gender, refractive error, and axial length were not significantly correlated with FAZ area, while CRT and retinal vascular density were negatively correlated with FAZ area (CRT: P < 0.001, R2 = 0.356; retinal vascular density: P < 0.001, R2 = 0.189)

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Summary

Introduction

Optical coherence tomography angiography (OCTA) is a non-invasive imaging system with microvasculature visualization capability superior to that of fluorescein angiography.[1] Dyefree OCTA is not affected by multiple scattering caused by fluorescein fluorescence arising from nerve fiber bundles. Higher resolution images of the radial peripapillary capillary network and the deep capillary network can be obtained by OCTA compared to FA.[1] Recently, OCTA has been used to visualize retinal microvasculature, within the foveal avascular zone (FAZ)[2,3,4]. The FAZ is a capillary-free area in the central macula and is a specialized region of the human retina that is in proximity to the region of highest cone photoreceptor density and oxygen consumption.[5,6,7] Variations in the area of the FAZ may be associated with visual function and have been shown to be of both diagnostic and prognostic value in various retinal diseases.[7,8,9,10,11,12,13,14,15] For example, in cases of diabetic retinopathy and retinal vein occlusion, FAZ area is expanded compared to healthy eyes, and this expansion has been reported to be related to visual function.[7,8,9,10,11,12,13,14,15] diabetic eyes are known to exhibit macular microcirculation impairment even before the onset of retinopathy, and FAZ area assessment has been reported to allow early detection of diabetic retinopathy.[9]

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