Deep Foveal Avascular Zone Area Research Articles

Changes in foveal avascular zone parameters in individuals with prediabetes compared to normoglycemic controls: a systematic review and meta-analysis.

To investigate changes in foveal avascular zone parameters in individuals with prediabetes compared to normoglycemic controls. PUBMED, Scopus and Cochrane Library were searched for published articles comparing the foveal avascular zone between prediabetic individuals and normoglycemic controls as assessed by optical coherence tomography angiography (OCTA). Standardised Mean Difference (SMD) with 95% confidence interval (CI) was computed for the comparison. A total of seven studies were included in our analysis, 6 provided data for the superficial capillary plexus from 345 eyes of individuals with prediabetes and 347 eyes of controls and 4 provided data on the deep capillary plexus from 285 eyes from individuals with prediabetes and 325 eyes of controls. Foveal avascular zone (FAZ) area in the superficial capillary plexus was enlarged in individuals with prediabetes compared to normoglycemiccontrols (SMD = 0.23, 95% CI = 0.03-0.44, p = 0.03, I2 = 27%, 6 studies). There was no statistically significant change in the deep capillary plexus FAZ area between the two groups (SMD = 1.14, 95% CI = -0.06-2.34, p = 0.06, I2 = 97%, 4 studies). FAZ area in the superficial capillary plexus was larger in individuals diagnosed with prediabetes compared to normoglycemic controls. This finding suggests that prediabetes could induce retinal microvascular changes before the onset of clinical diabetes. More original studies are needed to validate the results of the current meta-analysis.

Retinal Microvasculature in Systemic Sclerosis Patients and the Correlation between Nailfold Capillaroscopic Findings and Optical Coherence Angiography Results.

Background: The comparison of retinal perfusion in the eyes of patients with systemic sclerosis (SSc) and in healthy controls using optical coherence tomography angiography (OCTA). The correlation between nailfold capillaroscopy results and OCTA findings among SSc. Methods: The study enrolled 31 patients with systemic sclerosis and 41 healthy controls. OCTA was performed in both groups to assess the retinal vasculature in the superficial (SCP) and deep (DCP) capillary plexuses and the foveal avascular zone (FAZ) area. Nailfold capillaroscopy (NC) was performed in SSc patients and compared to the FAZ area and the superficial and the deep vessel density. Results: In the SSc group, the parafoveal vessel density in DCP was significantly higher in relation to the mean value (p < 0.0001) and in each quadrant of the macula (p < 0.0001) compared to healthy subjects (p < 0.0001). The patients with early scleroderma patterns in capillaroscopy had a larger superficial and deep FAZ (p = 0.0104, p = 0.0076, respectively) than those with active and late patterns. There was a statistically significant difference in the FAZ when comparing early to active (p < 0.0001) and early to late scleroderma patterns (p < 0.0001). A statistically significant difference was found in the type of interstitial lung disease and the deep FAZ area (p = 0.0484). SSc patients with nonspecific interstitial pneumonia (NSIP) had a larger FAZ than those with usual interstitial pneumonia (UIP) (p = 0.0484). Moreover, NSIP cases had a higher parafoveal mean superficial vessel density than those with UIP (p = 0.0471). Conclusions: Our investigation showed that the peripheral microvascular system correlates with ocular microcirculatory impairment. The results indicate the important role of OCTA in the diagnosis, monitoring, and prognosis of microvascular changes in SSc.

Mean Ocular Perfusion Pressure Effect During Pars Plana Vitrectomy on the Foveal Avascular Zone: A Pilot Study.

Purpose: To evaluate the effect of mean ocular perfusion pressure on the foveal avascular zone (FAZ) area in eyes with successful retinal detachment (RD) surgery. Methods: This prospective pilot fellow eye-controlled study measured the intraoperative mean ocular perfusion pressure in eyes having surgery for rhegmatogenous RD (RRD). Postoperatively, the FAZ area was measured; the change was calculated as the difference in the FAZ area between the operated eye and the contralateral control eye. Results: The study comprised 8 patients with a mean age (±SD) of 53.38 ± 13.92 years. The mean superficial FAZ area was not different between operated eyes and control eyes, while the deep FAZ area was significantly larger in operated eyes. There was a strong negative correlation between the mean ocular perfusion pressure and the change in the deep FAZ area (Spearman ρ, -0.73; P = .04); the correlation between the mean ocular perfusion pressure and the change in the superficial FAZ area was not significant (Spearman ρ, -0.24; P = .57). A significant linear regression was found between the mean ocular perfusion pressure and the change in the deep FAZ area (R2 = 0.388). The predicted enlargement of the deep FAZ area was 0.03 mm with every 1 mm Hg decrease in the mean ocular perfusion pressure. Conclusions: Lower intraoperative mean ocular perfusion pressure is associated with enlargement of the deep FAZ area in eyes having successful RRD surgery.

Efficacy and safety of subthreshold micropulse laser in the treatment of acute central serous chorioretinopathy.

To analyze the efficacy and safety of subthreshold micropulse laser (SML) in the treatment of acute central serous chorioretinopathy (CSC). This is a retrospective case analysis study. Totally 58 eyes of 58 patients were enrolled, and they were divided into different groups. And 39 patients were treated with SML (SML group) and 19 patients were only observed (observation group). The follow-up period was 3mo after diagnosis. The best corrected visual acuity (BCVA), central retinal thickness (CRT), superficial retinal vascular density (SRVD), deep retinal vascular density (DRVD), the superficial and deep foveal avascular zone (FAZ) area, retinal light sensitivity (RLS), perfusion area of choroidal capillary layer (CCL), subfoveal choroidal thickness (SFCT) and fundus autofluorescence (FAF) were investigated. The BCVA, CRT, SRVD, DRVD, the superficial and deep FAZ area, RLS, SFCT of SML group were significantly improved at 3mo (all P<0.05). In the observation group, only CRT, DRVD and SFCT were improved (all P<0.05). Other research items in the observation group were not significantly different from baseline (all P>0.05). At the last follow-up, the BCVA and RLS in the SML group were better than those in the observation group, and CRT was lower, SRVD and DRVD, perfusion area of CCL were larger (all P<0.05). On FAF, no change of treatment spots was found after treatment. No structural laser damage was observed on optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA), and no choroidal neovascularization was observed. SML treatment of acute CSC can improve BCVA, RLS, and perfusion area of CCL, reduce CRT, increase SRVD and DRVD, and is safe.

Distribution of the Retinal Microcirculation Based on the Morphology of Peripapillary Atrophy in High Myopia

Introduction: The objective of this study was to evaluate the retinal microvasculature of the optic nerve head and macula in high myopia (HM), investigate the association between the vascular parameters and peripapillary atrophy (PPA) deformation, and assess and identify the PPA morphology changes during the development of HM. Methods: One hundred sixty-seven right eyes from 167 HM patients were enrolled in this cross-sectional study. Using the optical coherence tomography angiography (OCTA) and fundus camera, we evaluated the following parameters: radian and type of PPA, intrapapillary vascular density (IVD), peripapillary vascular density (PVD), macular vascular density (MVD), and foveal avascular zone (FAZ). Based on the PPA radian, subjects were divided into four groups: the non-PPA, temporal PPA, advanced PPA, and annular PPA. At the same time, the above parameters were compared between the groups using analysis of variance (ANOVA) and least significant difference test. Results: Total enrolled patients were divided into the non-PPA group (22 eyes), temporal-PPA group (70 eyes), advanced-PPA group (60 eyes), and annular-PPA group (15 eyes). The results showed that the PVD in the annular-PPA group was smaller than that in the non-PPA group, especially in the superonasal, nasosuperior, nasoinferior, inferotemporal, temporoinferior, and superotemporal directions (F = 4.059, 5.014, 2.830, 4.798, 5.892, 3.439; p p Conclusion: The retinal microvasculature differed significantly in HM according to the PPA morphology. In addition to PVD and SFCT, the PPA can also affect FAZ. Finally, we speculated that PVD demonstrated better predictability of myopic progression than MVD.

Normative Vascular Features on OCT Angiography in Healthy Nepalese Eyes.

To establish normative data on morphological characteristics and quantitative parameters of Foveal Avascular Zone (FAZ) as well as their systemic and ocular associations using OCT angiography (OCT-A) in healthy Nepalese subjects. A prospective, cross-sectional, population-based study recruiting 210 healthy samples (420 eyes) aged 10 to 70 years was conducted. All the samples underwent detailed comprehensive eye examination followed by Optical Coherence Tomography Angiography (OCTA) and Enhanced Depth Imaging performed in each eye using Spectral Domain Optical Coherence Tomography. Foveal avascular zone area and vessel density in superficial and deep retinal plexus and Sub foveal Choroidal Thickness (SFCT) were evaluated. Ocular and systemic associations of these parameters were also studied in a multivariate analysis utilizing linear regression. The mean superficial and deep FAZ area was 459.96 ± 124.75 μm (95% confidence interval [CI], 443.08-476.83) and 589.0 ± 141.39 μm (95% CL, 570.77-609.02), respectively. The vessel density in superficial capillary plexus was 54.03 ± 9.34% (95% CL, 53.98-54.11) while the vessel density in deep capillary plexus was 25.91 ± 38% (95% CL, 25.85-25.96). The mean SFCT in this study was 308.89 ± 68.87μm (95% CL, 299.64-318.14 μm). There was no statistically significant inter-eye difference in the FAZ parameters. Myopic eyes had smaller FAZ, lesser vessel density and thinner SFCT. Association was observed between superficial FAZ area and systolic blood pressure, and deep FAZ area and diastolic blood pressure. This study reports the normative data on FAZ parameters in healthy Nepalese subjects which can serve as references for interpreting these parameters in different retinal-choroidal diseases.

Comparison of retinochoroidal microvascular circulation in menstrual and postmenopausal periods using swept-source optical coherence tomography angiography.

We aimed to examine the possible effects of the postmenopausal period on retinal and choroidal microvascular circulation using swept-source optical coherence tomography angiography (SS-OCTA). This cross-sectional study included 45 eyes of 45 subjects in menstrual group and 40 eyes of 40 subjects in postmenopausal group. SS-OCTA was used for the assessment of vessel density (VD), foveal avascular zone (FAZ), choroidal thickness (CT), choriocapillaris VD, central macular thickness (CMT), nerve fiber layer thickness (RNFL), and ganglion cell layer (GCL) measurements. The VDs of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) measurements were similar in both group. FAZ area was wider in postmenopausal group (0.305 mm2 (range, 0.212-0.498 mm2)) compared to menstrual group (0.271 mm2 (range, 0.131-0.464 mm2)) (p = 0.013). Choriocapillaris VD was significantly lower in postmenopausal group (p = 0.049). CT was thicker in the postmenopausal group, but with no statistically significant difference (p = 0.066). Central macular thickness, RNFL, and GCL were similar in both groups. This is the first study in the literature to evaluate the retinochoroidal microcirculation in the menstrual and postmenopausal periods with SS-OCTA. We observed an increase in both superficial and deep FAZ area and a decrease in choroidal blood flow in the postmenopausal period. We think that this enlargement in the FAZ area may be related to the decreased amount of estrogen.

Evaluation of macular vascular density and foveal avascular zone changes by optical coherence tomography angiography (OCT-A) after intravitreal dexamethasone implant in diabetic macular edema resistant to Anti-VEGF treatment.

Analysis of foveal avascular zone (FAZ) width and vascular density (VD) changes before and after intravitreal dexamethasone implant (IDI) treatment in diabetic macular edema (DME) patients resistant to anti-VEGF treatment. In this retrospective study, patients who were regularly treated with at least 5 doses of intravitreal Anti-VEGF (bevacizumab, ranibizumab or aflibercept) for DME and whose DME continued were considered resistant to Anti-VEGF and were treated with IDI for the first time. Thirty-four eyes of 34 patients were included in the study. FAZ and VD values of optical coherence tomography angiography (OCT-A) scans at 0, 1 and 3months were examined. In OCT-A measurements, the pre-IDI superficial plexus FAZ (SFAZ) area (0.350 ± 0.120 mm2) was decreased at 1 (0.292 ± 0.132 mm2, p < 0.001) and at 3months (0.311 ± 0.153 mm2, p = 0.017). Pre-IDI deep plexus FAZ (DFAZ) area (0.651 ± 0.313 mm2) was decreased at 1-month post-IDI (0.481 ± 0.247 mm2, p < 0.001) while no significant change was observed at 3months (0.575 ± 0.259 mm2, p = 0.197). There was no significant change in the mean post-IDI total VD rate in both superficial (pre 39.2% ± 2.4; 1st month 39.2% ± 2.6%; 3rd month 39.5% ± 3.4%) and deep retinal plexus (pre 43.3% ± 2.6%; 1st month 43.5 ± 2.8%; 3rd month 43.6% ± 4.6%) (p = 0.408 and p = 0.607, respectively). The study showed that IDI caused a significant decrease in the FAZ area without any change in VD in patients with DME resistant to the anti-VEGF agents. IDI might be related to a decrease in the macular ischemia secondary to diabetic retinopathy.

Retinal Microvascular Changes in Patients with Multiple Myeloma: A Study Based on Optical Coherence Tomography Angiography

Purpose: Ocular microvascular networks and variables were analyzed using optical coherence tomography angiography (OCTA) in patients with multiple myeloma (MM) who had no pathological findings in their routine ophthalmologic examinations. Methods: The study included 31 patients with a diagnosis of MM and 30 healthy controls. The ophthalmologic examination findings and OCTA measurements of the participants were prospectively analyzed. We evaluated the superficial capillary plexus (SCP) vessel density (VD) and deep capillary plexus (DCP) VD in macular region, radial peripapillary capillary (RPC) VD, optic nerve head (ONH) VD and the foveal avascular zone (FAZ) area. Results: The samples were gender-balanced, and there were no significant differences in age or gender between the MM and control groups. From the OCTA, all the ONH-VD measurements, except for the peripapillary and superotemporal parameters, were found to be significantly lower in MM patients than in the control group; the same was found for the whole image, inferonasal, superonasal, and superotemporal RPC-VD values; for all the SCP-VD values, except for the inferior hemi and temporal; and for all the DCP-VD values. It was also observed that the deep FAZ area was wider in the MM group than in the control group. Conclusions: We detected decreased VD in deep and superficial macular retinal areas, papillary, peripapillary regions, suggesting decreased blood flow and possible ischemia in MM patients. Therefore, obtaining information on ischemia by using a noninvasive and easily measurable method such as OCTA, may be beneficial in terms of follow-up and treatment but this needs to be supported by further, larger studies.

Evaluation of radiation maculopathy after treatment of choroidal melanoma with ruthenium-106 using optical coherence tomography angiography

BackgroundTo assess the impact of brachytherapy on macular microvasculature utilizing optical coherence tomography angiography (OCTA) in treated choroidal melanoma.MethodsIn this retrospective observational case series, we reviewed the recorded data of the patients with unilateral extramacular choroidal melanoma treated with ruthenium − 106 (106Ru) plaque radiotherapy with a follow-up period of more than 6 months. Automatically measured OCTA retinal parameters were analysed after image processing.ResultsThirty-one eyes of 31 patients with the mean age of 51.1 years were recruited. Six eyes had no radiation maculopathy (RM). From 25 eyes with RM, nine eyes (36%) revealed a burnout macular microvasculature with imperceptible vascular details. Twenty-one non-irradiated fellow eyes from the enrolled patients were considered as the control group. Foveal and optic disc radiation dose had the highest value to predict the burnout pattern (ROC, AUC: 0.763, 0.727). Superficial and deep foveal avascular zone (FAZ) were larger in irradiated eyes in comparison to non-irradiated fellow eyes (1629 μm2 vs. 428 μm2, P = 0.005; 1837 μm2 vs 268 μm2, P = 0.021; respectively). Foveal and parafoveal vascular area density (VAD) and vascular skeleton density (VSD) in both superficial and deep capillary plexus (SCP and DCP) were decreased in all irradiated eyes in comparison with non-irradiated fellow eyes (P < 0.001). Compared with non-irradiated fellow eyes, irradiated eyes without RM had significantly lower VAD and VSD at foveal and parafoveal DCP (all P < 0.02). However, these differences at SCP were not statistically significant.ConclusionThe OCTA is a valuable tool for evaluating RM. Initial subclinical microvascular insult after 106Ru brachytherapy is more likely to occur in DCP. The deep FAZ area was identified as a more critical biomarker of BCVA than superficial FAZ in these patients.

Optical coherence tomography angiography in healthy children: A comparison of macular structure.

The purpose of the present study was to investigate the perfusion density (PD) of macular superficial (SCP) and deep capillary plexus (DCP), the size of foveal avascular zone (FAZ) and central macular thickness (CMT) in healthy children using optical coherence tomography angiography (OCT-A). About 206 eyes of 111 children were analyzed. The correlation of gestational age (GA), birth weight (BW), age, sex, refractive errors, and visual acuity (VA) with OCT-A parameters were investigated. The mean PD of the fovea and the mean FAZ area of SCP were 17.1% (DS: 4.26) and 234.47 (DS: 106.39) µm2. The mean PD of the fovea and the mean FAZ area of DCP were 13.5% (DS: 5.23) and 298.32 (DS: 112.37) µm2. Superficial and deep FAZ areas were not correlated with sex, age, BW, refractive errors, or VA. FAZ area of SCP was correlated with foveal PD (r = -0.76) and with CMT (r = -0.68). FAZ area of DCP was correlated with foveal's PD (r = -0.61). There was no correlation between CMT and refractive errors. OCT-A may provide a non-invasive and reliable approach to evaluate macular perfusion in children. As the FAZ area, PD, and CMT change during the growth period, we performed established a reference range for different ages.

Macular density alterations in myopic choroidal neovascularization and the effect of anti-VEGF on it.

To analyse macular microvascular alterations in myopic choroidal neovascularization (mCNV) and the efficiency of anti-vascular endothelial growth factor (anti-VEGF) therapy for mCNV by optical coherence tomography angiography (OCTA). A total of 123 patients were included in this retrospective study, divided into mCNV group, high myopia (HM) group, and normal group at the Affiliated Eye Hospital of Wenzhou Medical University from January 2017 to January 2019. Superficial vessel density, deep capillary density, foveal avascular zone (FAZ) area, A-circularity index (AI) and vessel density around the 300 µm width of the FAZ region density (FD) and the area of choroidal neovascularization (CNV) lesion (only for mCNV group) were measured on 3×3 mm2 OCTA images. FAZ area was corrected for axial length. Central macular thickness (CMT) was measured on OCT in mCNV group. Compared the parameters on OCTA of 3 groups and pre-anti-VEGF and post-anti-VEGF at 1, 2, 3, and 6mo follow-up in mCNV group. There were significant differences among 3 groups in superficial vessel density, deep capillary density and FD (P<0.05). FAZ area in HM group was smaller than normal group (P<0.05), but there was no significant difference between mCNV group and the other two group. AI increased in mCNV group (P<0.05). The mean CMT, area and flow area of CNV lesion decreased after treatment (P<0.05), while vessel density and FAZ didn't change. The mean CMT, area and flow area of CNV lesion statistically decreased after anti-VEGF treatment in mCNV group (P<0.05), while superficial vessel density, deep capillary density and FAZ area, AI and FD didn't change. The mean reduction ratio of lesions was 50.32% (7.07% to 100%). Lesion regression 100% was observed in 2 cases (4.88%). There was a negative correlation between the CNV lesion area and reduction ratio (r=-0.380, P=0.042) and the flow lesion area and reduction ratio (r=-0.402, P=0.030). Macular vessel density decreases, FAZ turns smaller and more irregular in mCNV eyes. Anti-VEGF therapy is efficient for mCNV without affecting vessel density and FAZ, but it is unable to completely eliminate CNV lesions in most cases. The bigger mCNV lesions have lower reduction ratio.

Evaluation of the Foveal Avascular Zone in Familial Exudative Vitreoretinopathy Using Optical Coherence Tomography Angiography.

PurposeTo evaluate the foveal avascular zone (FAZ) and retinal structure in familial exudative vitreoretinopathy (FEVR).Patients and MethodsEighteen eyes with stage 1 or 2 FEVR and 20 control eyes were evaluated. The central retinal thickness (CRT), foveal inner retinal thickness (IRT), surface retinal vessel density (SRVD), and deep retinal vessel density (DRVD) were measured using optical coherence tomography. The FAZ area was calculated using ImageJ software. The equivalent spherical value (SE) and axial length (AL) were measured.ResultsThe CRT (232.5±3.086 vs 211±12.6325 μm; p=0.003) and foveal IRT (15.83±13.95 vs 0.9±4.02 μm; p=0.002) were thicker in the FEVR group than in the control group. The surface FAZ area (0.265±0.08 vs 0.364±0.09 mm2; p=0.004) and the deep FAZ area (0.364±0.1 vs 0.484±0.11 mm2; p=0.03) were smaller in the FEVR group than in the control group. The SRVD values did not differ among the sectors, but the DRVD was higher in the FEVR group except for the inferior sector (superior, p=0.027; inferior, p=0.88; temporal, p=0.035; nasal, p=0.027). The SE and AL did not differ between the two groups. There were no correlations between the surface and deep layer FAZ area and age, CRT, SE, and AL. The surface, deep FAZ area, and foveal IRT were correlated negatively (surface, r = −0.47, p=0.033; deep layer FAZ area, r = −0.46, p=0.037).ConclusionEyes with FEVR have a smaller FAZ because the vascular structure in the inner retina remained in the fovea.

Peripapillary Vessel Density in Eyes with Rhegmatogenous Retinal Detachment after Pars Plana Vitrectomy.

Purpose To investigate the vascular density of the optic nerve head (ONH) and macula using optical coherence tomography angiography (OCTA) in patients undergoing vitrectomy for rhegmatogenous retinal detachment (RRD) and to evaluate associations with visual outcomes. Methods Patients with RRD, successfully treated with a pars plana vitrectomy (PPV) and a minimum three-month follow-up were included in this study. The vessel density (VD) of the ONH and peripapillary regions, foveal avascular zone (FAZ), foveal flow density (FFD), and parafoveal flow density (PFD) were evaluated using OCTA and compared to the fellow eye. Multivariate linear regression analysis was performed to determine correlations with visual outcomes. Results Thirty-one patients with macula-off RRD were included in the study. Compared with the fellow eyes, eyes after RRD surgery had a lower peripapillary VD (P < 0.01). No significant difference in superficial and deep FFD, PFD, and FAZ area was found compared to the fellow eyes. Postoperative peripapillary VD and baseline BCVA were significantly associated with BCVA three months after PPV (P < 0.05). Conclusion Rhegmatogenous retinal detachment eyes successfully treated with PPV had lower peripapillary vessel density than fellow healthy eyes. Postoperative BCVA was related to postoperative peripapillary VD.

Changes in the Foveal Avascular Zone Area and Retinal Vessel Density after Anti-VEGF Therapy for Neovascular Age-Related Macular Degeneration

ABSTRACT Purpose To investigate changes in the foveal avascular zone (FAZ) area and retinal vessel density (VD) in the macula of patients receiving multiple anti-vascular endothelial growth factor (VEGF) therapy for neovascular age-related macular degeneration (N-AMD). Methods This study included 54 eyes of 54 treatment-naïve N-AMD patients. Thirty-three eyes were treated with intravitreal aflibercept injections, and 21 eyes were treated with intravitreal ranibizumab injections. Unaffected fellow eyes (54 eyes) were used as controls. All image scans were acquired after the macular architecture had recovered with drying up of the subretinal fluid/hemorrhage after treatment. Results Both the superficial and deep FAZ areas were significantly larger in the aflibercept group than in the control group. The VD was also significantly reduced in the aflibercept group. Conclusions Prolonged and repeated anti-VEGF therapy may cause an increase in the FAZ area and a decrease in the VD in patients with N-AMD, indicating ischemic damage.

Evaluation of Ocular Hypoperfusion in Patients with Acromegaly by Using Optical Coherence Tomography Angiography

ABSTRACT Purpose This study aimed to evaluate the retinal blood vessel parameters and the foveal avascular zone (FAZ) area using optical coherence tomography angiography (OCTA) in patients with acromegaly in comparison with healthy controls. Methods A total of 45 patients with acromegaly and 45 healthy controls were included in this study. In all patients, the vessel density (VD) of the deep and superficial macular vascular networks and the foveal avascular zone (FAZ) were measured using OCTA. The correlation of insulin-like growth factor 1 (IGF-1) level and disease duration with deep macular VD and FAZ values was analyzed. All parameters were registered. Results were assessed and compared between the two groups. Results Deep macular plexus VD values were lower in patients with acromegaly compared to the control group. No significant differences in VD values in the superficial segment, except for that in the inferior parafovea (P = .01) were found between the two groups. Furthermore, patients with acromegaly showed enlargement in the superficial (P = .30) and deep FAZ areas (P < .001). IGF-1 level and disease duration showed a significant negative correlation with the deep whole image (R = −0.216, P = .041, R = −0.339, P = .001, respectively), deep parafovea (R = −0.271, P = .01; R = −0.372, P < .001, respectively), deep parafovea superior hemi (R = −0.342, P = .001; R = −0.350, P = .001, respectively), deep parafovea temporal (R = −0.224, P = .034; R = −0.234, P = .026, respectively), deep parafovea nasal (R = −0.320, P = .002; R = −0.361, P < .001, respectively), and deep parafovea superior VD values (R = −0.293, P = .005; R = −0.307, P = .003, respectively) and a significant positive correlation with the deep FAZ area values (R = 0.244, P = .02; R = 0.329, P = .002, respectively). Conclusion VD values in the deep macular capillary plexus were lower in patients with acromegaly, and the superficial and deep FAZ area enlarged. Patients with acromegaly may have an increased risk of developing ocular vascular complications. OCTA can be used to evaluate retinal blood VD in patients with acromegaly.

Comparison between two multimodal imaging platforms: Nidek Mirante and Heidelberg Spectralis.

To investigate the reliability and comparability of retinal measurements obtained with spectral-domain optical coherence tomography (OCT), optical coherence tomography angiography (OCTA), confocal scanning laser ophthalmoscopy (cSLO) colour images, and fundus autofluorescence (FAF) between two multimodal imaging platforms in eyes with macular pathology and normal, healthy volunteers. This cross-sectional, multi-centre, instrument validation study recruited 94 consecutive subjects. All participants underwent a dilated examination and were scanned consecutively on the Heidelberg Spectralis (Heidelberg Engineering, Heidelberg, Germany) and Nidek Mirante (Nidek Co. Ltd., Gamagori, Japan) devices. Agreement between device images were evaluated from measures of the central retinal thickness (CRT), presence of segmentation and fixation imaging artefacts (IA), foveal avascular zone (FAZ) measurements; as well as sensitivity and specificity values from the detection of atrophy on fundus autofluorescence (FAF), drusen, subretinal drusenoid deposits, geographic atrophy, epiretinal membrane, fibrosis and haemorrhage on multicolour imaging, and agreement between devices and groups. Compared with reference clinical examination, sensitivity values for the identification of retinal features using sole device images ranged from 100% for epiretinal membranes to 66.7% for subretinal drusenoid deposits (SSD). Mean absolute difference for CRT between OCT devices was 3.78μm (95% confidence interval [CI]: - 21.39 to 28.95, P = 0.809). Differences in the superficial and deep capillary plexus FAZ area on OCTA between devices were not statistically significant (P = 0.881 and P = 0.595, respectively). IAs were significantly increased in the presence of macular pathology. Comparison of retinal measurements between the OCT devices did not differ significantly. Common ultrastructural biomarkers of multiple macular pathologies were identified with high sensitivities and specificities, with good agreement between graders, indicating that they can be identified with comparable confidence in retinal imaging between the two devices.

Evaluation of Macular Microcirculation in Healthy Children Using Optical Coherence Tomography Angiography.

Objectives:This study was designed to evaluate macular perfusion in a healthy pediatric population using optical coherence tomography angiography (OCTA).Methods:Fifty-three eyes of 30 healthy children (20 boys and 10 girls) were included in this prospective, cross-sectional study. Age, gender, foveal thickness (FT), superficial foveal avascular zone area (FAZs), deep foveal avascular zone area (FAZd), superficial capillary plexus flow area (SCP), deep capillary plexus flow area (DCP), choriocapillaris flow area (CC), vascular density in the SCP (VDs), vascular density in the DCP (VDd), and subfoveal choroidal thickness (SFCT) were evaluated.Results:The mean age was 12.0±4.0 years (range: 6-15 years). Gender did not have a statistically significant influence on the FAZs or FAZd. However, there was a positive correlation between the CC and age (r=0.31; p=0.025). The FAZs and FAZd were negatively correlated with the FT (p<0.001). The VDd was positively correlated with the FT (p=0.03) and was negatively correlated with the FAZd (p=0.019).Conclusion:The present study determined normative data of OCTA parameters in healthy children and provides useful insight into the relationship between age, macular microvascular networks, and the FAZ.

Obese Foveal Avascular Zone Assessed by Optical Coherence Tomography Angiography of the Retina: Is There a Relation to Comorbities?

Purpose: To investigate the foveal avascular zone (FAZ) in obese by optical coherence tomography angiography (OCT-A) and to evaluate the findings of structural optical coherence tomography (OCT) and their relations with comorbidities. Methods: It was included 35 obese (study group) and 30 normal individuals (control group). Patients with retinal diseases and retinal treatments were excluded. The images were obtained using the Topcon®;. Results: The mean areas of FAZ in superficial plexus (FAZ-SP) and deep plexus (FAZ-DP) were significantly greater in the study group: FAZ-SP was 405.0 ± 136.4 μm2 in the obese group and 307.3 ± 78.6 μm2 in the control group and in the left eye (LE) 477.1 ± 124.4 μm2 in the obese group and 384.0 ± 88.7 μm2 in the control group. This difference was statistically significant (RE: p = 0.0014 and LE: p = 0.0012). The mean area of the FAZ-DP was 491.0 ± 124.4 μm2 (Right eye—RE) in the obese group and 384.4 ± 88.7 μm2 in the control group and in the left eye (LE) was 497.9 ± 124.1 μm2 in the obese group and 484.9 ± 92.7 μm2 in the control group. There were no correlations regarding FAZ-SP and FAZ-DP in both eyes with fasting blood glucose, glycated hemoglobin, total cholesterol and fractions and triglycerides. A significant association between enlargement of FAZ-DP and type 2 diabetes mellitus (p = 0.0160) was observed. Conclusion: The FAZ areas in superficial and deep plexus achieved significantly greater values in the study group. There was a significant association between a larger deep FAZ area and type 2 diabetes mellitus. It is necessary an evaluation with a larger sample size to corroborate the findings.

Superficial and Deep Foveal Avascular Zone Area Measurement in Healthy Subjects Using Two Different Spectral Domain Optical Coherence Tomography Angiography Devices.

PurposeTo compare the area of the foveal avascular zone (FAZ) in the superficial and deep retinal layers using two different spectral-domain optical coherence tomography angiography (OCTA) devices.MethodsA cross-sectional comparative study was conducted to obtain macular OCTA images from healthy subjects using Optovue RTVue XR Avanti (Optovue, Inc, Fremont, CA) and Spectralis HRA+OCTA (Heidelberg Engineering, Heidelberg, Germany). Two independent trained graders measured the FAZ area using automated slab segmentation. The FAZ area in the superficial and deep retinal layers were compared.ResultsTwenty-three eyes of 23 subjects were included. The graders agreement was excellent (0.86) for all measurements. The mean FAZ area was significantly larger at the superficial retinal layer as compared to the deep retinal layer on both devices (0.31 0.08 mm vs 0.26 0.08 mm in Optovue and 0.55 0.16 mm vs 0.36 0.13 mm in Spectralis, both P 0.001). The mean FAZ area was significantly greater in the superficial and deep retinal layers using Spectralis as compared to Optovue measurements (P 0.001 for both comparisons).ConclusionIn contrast to previous reports, the FAZ area was larger in the superficial retina as compared to deep retinal layers using updated software versions. Measurements from different devices cannot be used interchangeably.