Reduced Vessel Density in the Mid-Periphery and Peripapillary Area of the Superficial Capillary Plexus in Non-Proliferative Diabetic Retinopathy.

Amira Chaher,Sandrine Tabary,Franck Fajnkuchen,Audrey Giocanti-Aurégan

doi:10.3390/jcm11030532

Amira Chaher, Sandrine Tabary + Show 2 more

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https://doi.org/10.3390/jcm11030532

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Abstract

Our aim in this study was to assess the vessel density (VD) and vessel skeleton density (VSD) in the nasal area of the superficial capillary plexus (SCP) of diabetic subjects without diabetic retinopathy (DR), or in those with a non-proliferative diabetic retinopathy (NPDR), and to evaluate the relationship between the VD and VSD and the severity of DR. In this prospective study, the VD and VSD in the SCP were measured and analyzed on 6 × 6-mm macular and nasal optical coherence tomography angiography scans. The three concentric circles of the Early Treatment of Diabetic Retinopathy Study (ETDRS) grid were used and divided into zones numbered from 1 to 9 in the macular area and from 1 to 8 in the nasal area. The VD was significantly lower in the nasal peripapillary area (p = 0.0028), and both the VD and VSD were significantly lower in the macular area (p = 0.0131 and p = 0.0132, respectively) in patients with more severe DR. The SD was significantly lower in zones 5 (p = 0.0315) and 6 (p = 0.0324) in the nasal grid in patients with more severe DR. We showed a lower superficial capillary flow in the nasal periphery and peripapillary area in patients with more severe DR.

Highlights

Optical coherence tomography angiography (OCT-A) is a depth-resolved imaging modality, allowing the visualization of vessels by detecting the decorrelation signal between successive OCT B-scans due to blood flow motion
OCT-A allows for the assessment of the retinal vasculature, and the software can separate the superficial vascular plexus (SVP) from the deep vascular complex (DVC), which is useful for studying diabetic retinopathy (DR)
Several studies have reported a reduced macular capillary density in the superficial capillary plexus (SCP) and/or in the deep capillary plexus (DCP) on OCT-A in patients with DR compared to healthy controls, and most studies have found a linear correlation with disease severity when the healthy, without DR, non-proliferative DR (NPDR) and proliferative DR (PDR) groups were compared [1,2,3,4,5]

Summary

Introduction

Optical coherence tomography angiography (OCT-A) is a depth-resolved imaging modality, allowing the visualization of vessels by detecting the decorrelation signal between successive OCT B-scans due to blood flow motion. Unlike fluorescein angiography, it is a non-invasive, dyeless examination. Numerous artifacts may alter macular perfusion analysis and prevent visualization of the actual anatomy To avoid these limitations, we analyzed two parameters that are and automatically available on most OCTA devices, the vessel density (VD) and vessel skeleton density (VSD) in the nasal area of the SCP, in a cohort of diabetic subjects, knowing that this area is usually the most ischemic part of the retina

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