Abstract
PurposeTo quantitatively assess choriocapillaris (CC) flow deficits in eyes with diabetic retinopathy (DR) using swept-source optical coherence tomography angiography (SS-OCTA).MethodsDiabetic subjects with different stages of DR and age-matched healthy subjects were recruited and imaged with SS-OCTA. The en face CC blood flow images were generated using previously published and validated algorithms. The percentage of CC flow deficits (FD%) and the mean CC flow deficit size were calculated in a 5-mm-diameter circle centered on the fovea from the 6×6-mm scans.ResultsForty-five diabetic subjects and 27 control subjects were included in the study. The CC FD% in diabetic eyes was on average 1.4-fold greater than in control eyes (12.34±4.14% vs 8.82±2.61%, P < 0.001). The mean CC FD size in diabetic eyes was on average 1.4-fold larger than in control eyes (2151.3± 650.8μm2 vs 1574.4±255.0 μm2, P < 0.001). No significant difference in CC FD% or mean CC FD size was observed between eyes with nonproliferative DR and eyes with proliferative DR (P = 1.000 and P = 1.000, respectively).ConclusionsCC perfusion in DR can be objectively and quantitatively assessed with FD% and FD size. In the macular region, both CC FD% and CC FD size are increased in eyes with DR. SS-OCTA provides new insights for the investigations of CC perfusion status in diabetes in vivo.
Highlights
Diabetes mellitus (DM) is a disease affecting most blood vessel types and sizes [1]
The CC flow deficits (FDs)% in diabetic eyes was on average 1.4-fold greater than in control eyes (12.34±4.14% vs 8.82 ±2.61%, P < 0.001)
No significant difference in CC FD% or mean CC FD size was observed between eyes with nonproliferative diabetic retinopathy (DR) and eyes with proliferative DR (P = 1.000 and P = 1.000, respectively)
Summary
Diabetes mellitus (DM) is a disease affecting most blood vessel types and sizes [1]. The advent of indocyanine green angiography (ICGA) allows for visualization of the choroid. Fluorescein angiography (FA) is extensively used for the evaluation of DR, abnormalities on ICGA representing choroidal neovascularization, vascular leakage, choroidal aneurysms, and ischemia have been reported in imaging studies of the choroid in DM [4]. Unlike the large and intermediate-sized choroidal vessels seen on ICGA, the choriocapillaris (CC) appears as a diffuse indistinct haze due to insufficient resolution [5]. The lack of an imaging modality capable of visualizing and quantifying CC perfusion in vivo has hindered our understanding of the role of CC in diabetic eye disease
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