Quantification of Microvascular Density of the Optic Nerve Head in Diabetic Retinopathy Using Optical Coherence Tomographic Angiography.

Jianfeng Huang,Yingyi Lu,Tong Chen,Hong Dai,Xiaoya Gu,Bodi Zheng

doi:10.1155/2020/5014035

Abstract

Aims To quantify the capillary density of the optic nerve head in healthy control eyes and different stages of diabetic retinopathy (DR) eyes and identify the parameters to detect eyes with or without DR using optical coherence tomographic angiography (OCTA). Methods In this cross-sectional study, 211 eyes of 121 participants with type 2 diabetes with different stages of DR or without DR and 73 eyes of 38 healthy age-matched controls were imaged by OCTA. Radial peripapillary capillary (RPC) plexus density and retinal nerve fiber layer (RNFL) thickness were examined. The mixed model binary logistic regression model was used to identify the parameters to detect eyes with or without DR. The area under the receiver operating characteristic (ROC) curve was calculated. Results RPC density decreased significantly in diabetic patients without DR compared with the healthy controls, and it was negatively correlated with the severity of DR (P < 0.01). RPC density was a significant parameter to distinguish diabetic eyes with or without DR (P < 0.01). The area under the ROC curve was 0.743. Conclusions Quantification of RPC density by OCTA provides evidence of microvascular changes in the optic nerve in diabetic patients. RPC density can serve as a possible biomarker in detecting eyes with DR. Larger cohort studies need to support this statement.

Highlights

Optical coherence topographic angiography (OCTA) is emerging as a noninvasive method to detect the blood flow and microvasculature of retina without intravenous dye injection [1,2,3]
E post hoc analysis in Supplementary Table S1 demonstrates that radial peripapillary capillary (RPC) density of all diabetic retinopathy (DR) groups was significantly different from that of the healthy controls only in the peripapillary area, and severe nonproliferative diabetic retinopathy (NPDR) had significantly reduced vessel density in all the considered scans with regard to lower categories of DR and healthy controls
RPC density in the peripapillary area was found to be an independent predictor. e area under the curve (AUC) of the receiver operating characteristic (ROC) curve was 0.743 (Figure 2)

Summary

Introduction

Optical coherence topographic angiography (OCTA) is emerging as a noninvasive method to detect the blood flow and microvasculature of retina without intravenous dye injection [1,2,3]. E aim of our study was to evaluate the vessel density in the eyes of patients with type 2 diabetes, find effective parameters to distinguish eyes with or without DR changes, and detect preclinical DR. A mixed model binary logistic regression model was employed to find out the related parameters that can distinguish the eyes with or without diabetic retinal changes in the diabetic patients In this model, we included random effects for the correlation of two eyes from the same participants on the OCTA outcome measures, as most participants had bilateral imaging. RPC, radial peripapillary capillary; RNFL, retinal nerve fiber layer; OCTA, optic coherence tomographic angiography; DR, diabetic retinopathy; NPDR, nonproliferative diabetic retinopathy. −0.042 0.547 a, Spearman coefficient R value; b, Pearson coefficient R value; c, partial correlation coefficient R value; RPC, radial peripapillary capillary; DR, diabetic retinopathy; DM, diabetes mellitus; HbA1c, hemoglobin A1c; BCVA, best-corrected vision acuity.

Results

Discussion

Conclusions