Macular Vessel Density Measured With Optical Coherence Tomography Angiography and Its Associations in a Large Population-Based Study

You, Qi Sheng; Chan, Jonathan C.H.; Ng, Alex; Choy, Bonnie K. N.; Shih, Kendrick Co; Cheung, Janice J. C.; Wong, Jasper Ka Wai; Shum, Jennifer W. H.; Ni, Michael Y.; Lai, Jimmy S. M.; Leung, Gabriel M.; Cheung, Chui Ming Gemmy; Wong, Tien Yin; Wong, Ian Y.

doi:10.1167/iovs.19-28137

Cited by 98 publications

(110 citation statements)

References 30 publications

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“…Even so, SSI still has a more substantial effect on the VD. The result was consistent with previous studies [33,34]. Therefore, the SSI should be taken into consideration when measuring the VD by OCTA.…”

Section: Discussionsupporting

confidence: 92%

Quantitative assessment and determinants of the papillary microvasculature in healthy subjects

et al. 2021

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Background It is critical to monitor the optic disc’s vessel density using Optical coherence tomography angiography (OCTA) and evaluate its determinants. In the current study, we investigate the superficial vessel density (VD) of the papillary microvasculature and its determinants in healthy subjects of Southern China. Methods This was a prospective, cross-sectional study. Superficial VD in healthy individuals’ optic disc region was measured by OCTA. The factors associated with ocular and systemic parameters were analyzed using a generalized estimation equation (GEE) model. Results A total of 510 eyes of 260 healthy subjects were analyzed in the study. The total VD in the optic disc area was 17.21 ± 2.15 mm− 1 (95% CI, 17.02–17.40 mm− 1). The VD in the inner ring and the outer ring of the optic disc were significantly higher compared with the central ring, while the VD of the superior quadrant and inferior quadrant was significantly higher compared with the temporal and nasal quadrant. After adjusting for the ocular factors and systemic factors, AL (β = − 0.4917, P = 0.0003), disc area (β = − 0.3748, P = 0.0143), CMT (β = − 0.0183, P = 0.0003) and SSI (β = 1.0588, P < 0.001) were significantly associated with total VD of the optic disc. Conclusion The mean total VD in the optic disc area was 17.21 ± 2.15 mm− 1 in healthy subjects, and the superior and inferior VD was significantly higher than the temporal and nasal VD. AL, disc area, CMT, and SSI may affect the total VD in the optic disc area and should be considered in clinical practice.

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Section: Discussionsupporting

confidence: 92%

Quantitative assessment and determinants of the papillary microvasculature in healthy subjects

et al. 2021

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“…In the deep retinal layer, VD was also found to be the highest in the superior quadrant followed by nasal, inferior, and temporal quadrants. However, the authors did not report any significant differences between the subsections [33]. Moreover, our findings of reduced vascular density metrics especially in the temporal subsections of the retina are in accordance with current investigations on the metabolic dysfunction in RP.…”

Section: Discussionsupporting

confidence: 92%

Optical coherence tomography angiography findings in patients undergoing transcorneal electrical stimulation for treating retinitis pigmentosa

Zabek

Zuche

Müller

et al. 2020

Graefes Arch Clin Exp Ophthalmol

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Purpose Transcorneal electrical stimulation (TES) is a novel treatment approach for patients with retinitis pigmentosa (RP). The aim of our study was to observe changes in optical coherence tomography angiography (OCTA) that would be attributed to TES treatment. Methods A total of 73 eyes were included: 43 eyes of 22 subjects (11 ♀, 11 ♂) suffering from RP were examined at baseline (BL), after first stimulation (TS), 1 week (1W), and 6 months (6M) after treatment initiation and were compared with 30 control eyes of 15 subjects (8 ♀, 7 ♂). TES was performed simultaneously on both eyes for 30 min weekly. OCTA scans of 9 × 15 mm were recorded with a PLEX Elite 9000 swept-source OCTA device (Carl Zeiss Meditec AG, Jena). Vascular density metrics such as perfusion density (PD) and vessel density (VD) were calculated automatically for the macular area by using standardised extended early treatment diabetic retinopathy study (ETDRS) grids centred around the fovea. In addition, the capillary perfusion density (CPD) and the capillary flux index (CFI) of the peripapillary nerve fibre layer microvasculature in all four quadrants of an annulus centred at the optic disc were measured. All parameters were determined over all retinal layers and separately for the superficial (SCP) and deep capillary plexus (DCP). ANOVA-based linear mixed-effects models were calculated with SPSS®. Results Throughout the course of TES treatment, the macular VD and PD of all retinal layers in all subsections showed a slight decrement without reaching statistical significance, also when analysed separately in the SCP and DCP (p > 0.08). In analogy, the average CPD and CFI also presented with a slight decrement (p > 0.20). However, when compared with controls, most OCTA parameters showed a significant decrement (p < 0.05). When analysed systematically in all subsections of the extended ETDRS grid, the temporal macular subsections within the outer ring (radius 1.5–3 mm) and also of the peripheral C1, C2, and C3 rings (radius 3–7.5 mm) showed lower VD and PD values when compared with the other subsections (p < 0.05). Conclusion Vascular density metrics in the macular region and the peripapillary microvasculature appear to remain unaffected by continuous TES treatment within a period of 6 months.

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“…However, compared with controls, patients with CKD had worse best-corrected visual acuity (BCVA), lower SVP vessel density, lower DVP vessel density, and larger parafoveal SVP flow void area. Due to the wide range of age distribution, the standard deviations (SD) of SVP and DVP vessel densities were slightly higher than expected, but these values were comparable to recent large population-based study 18 .…”

Section: Resultssupporting

confidence: 80%

Impact of blood pressure control on retinal microvasculature in patients with chronic kidney disease

Peng

Lee

et al. 2020

Sci Rep

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Chronic kidney disease (CKD) is an emerging disease worldwide. We investigated the relationship between blood pressure (Bp) control and parafoveal retinal microvascular changes in patients with CKD. This case-control study enrolled 256 patients with CKD (stage 3-5) and 70 age-matched healthy controls. Optical coherence tomography angiography showed lower superficial vascular plexus (SVP) vessel density, lower deep vascular plexus (DVP) vessel density, and larger SVP flow void area in the CKD group. The BP parameters at enrollment and during the year before enrollment were collected in patients with CKD. Partial correlation was used to determine the relationship between BP parameters and microvascular parameters after controlling for age, sex, diabetes mellitus, axial length, and intraocular pressure. The maximum systolic blood pressure (SBP) (p = 0.003) and within-patient standard deviation (SD) of SBP (p = 0.006) in 1 year were negatively correlated with SVP vessel density. The average SBP (p = 0.040), maximum SBP (p = 0.001), within-patient SD of SBP (p < 0.001) and proportion of high BP measurement (p = 0.011) in 1 year were positively correlated with the SVP flow void area. We concluded that long-term SBP was correlated with SVP microvascular injury in patients with CKD. Superficial retinal microvascular changes may be a potential biomarker for prior long-term BP control in these patients. Chronic kidney disease (CKD) is an emerging disease worldwide that is highly prevalent in elderly individuals and in patients with hypertension or diabetes mellitus (DM) 1. Approximately 10-15% of the world's population have CKD 2 , and the prevalence could be as high as 40% among diabetic patients 3. CKD is associated with many systemic vascular complications such as atherosclerosis, cerebrovascular disease, and cardiovascular disease 1. End-stage kidney disease may increase the risk of cardiovascular mortality by 10-30 folds 1. Retinal vasculature, which can be directly visualized using non-invasive tools, has been considered a potential window for systemic vascular complications 4-6. Fundus photography provided a convenient tool for correlating the risk of systemic vascular diseases and retinal vasculature [e.g. the central retinal arteriolar equivalent (CRAE) and the central retinal venular equivalent (CRVE)] 5. However, recent publications showed that systemic diseases may cause retinal capillary alterations preceding any visible pathology in fundus 7-9. Optical coherence tomography angiography (OCTA) technology provides a rapid non-invasive method to quantify microvasculature at the capillary level in the different retinal layers. It could detect early subtle retinal microvascular changes from systemic diseases 8-11. Using OCTA, we had demonstrated decreased parafoveal microvascular vessel densities in both superficial vascular plexus (SVP) and deep vascular plexus (DVP) in patients with CKD 12. eGFR was an independent

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Macular Vessel Density Measured With Optical Coherence Tomography Angiography and Its Associations in a Large Population-Based Study

Cited by 98 publications

References 30 publications

Quantitative assessment and determinants of the papillary microvasculature in healthy subjects

Quantitative assessment and determinants of the papillary microvasculature in healthy subjects

Optical coherence tomography angiography findings in patients undergoing transcorneal electrical stimulation for treating retinitis pigmentosa

Impact of blood pressure control on retinal microvasculature in patients with chronic kidney disease

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