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

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.

Association of Neuroretinal Thinning and Microvascular Changes with Hypertension in an Older Population in Southern Italy

“…Peripapillary vessels originate from two systems, the central retinal artery and the short posterior ciliary arteries, whereas macular vessels originate only from the central retinal artery [45]. The posterior ciliary arteries might suffer more severe damage than the retinal vascular system in glaucoma [46], diabetic retinopathy [15], and obstructive sleep apnea syndrome [45], because they are probably more prone to structural alterations due to high intraocular pressure, microangiopathy and hypercapnia, respectively. Therefore, the different origins and sizes of the vessels between the peripapillary and parafoveal areas might explain our findings, suggesting different damage to the vessels in different vascular systems attributable to hypertension.…”

“…However, the optic nerve head (ONH) and radial peripapillary capillary (RPC) plexi at the peripapillary site have a key role in the vascular supply of inner neuroretinal layers, including the ganglion cell layer (GCL) and RNFL [12,13]. In recent OCT-A studies, RPC plexus impairment was more evident in older subjects [14], diabetic patients with and without diabetic retinopathy [15], and hypertensive patients with and without retinopathy [8,10].…”

Superficial Retinal Vessel Density and Foveal Avascular Zone in Myopic Anisometropia: An OCTA‐Based Study in Young Chinese Children

“…Superficial retinal vessel density (SRVLD) was defined as the area occupied by vessel lumens following binary reconstruction of images [ 11 ]. Perfusion density (PD) was expressed as the ratio between the measured vessel pixels and the total scan area after subtracting the FAZ area, thus being a dimensionless quantity [ 12 ]. The Cirrus HD-OCT review software program automatically calculates the vessel density and PD of the superficial capillary plexus inside these circles and in different sectors (temporal, superior, nasal, and inferior) of the foveal and parafoveal areas ( Figure 1 ).…”

Evaluation of peripapillary vascular flow in patients with Thyroid-Associated Ophthalmopathy (TAO) by OCT Angiography

“…Optical coherence tomography (OCT) is a rapid and noninvasive technique that allows detailed structural visualization of retina and choroid; moreover, OCT angiography (OCTA) studies retinal and choroidal vascularization by producing three-dimensional microcirculation vascular maps without the use of dye [ 6 ]. Through the en face presentation of the volumetric angiogram, it is possible to measure areas of interest and to quantity density of vessels in the macula or blood flow in specific areas of the retina [ 7 ] .…”