Value of Fractal Analysis of Optical Coherence Tomography Angiography in Various Stages of Diabetic Retinopathy

Bhardwaj, Suruchi; Tsui, Edmund; Zahid, Sarwar; Young, Emma; Mehta, Nitish; Agemy, Steven; Garcia, Patricia; Rosen, Richard B.; Young, Joshua

doi:10.1097/iae.0000000000001774

Cited by 54 publications

(51 citation statements)

References 18 publications

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“…25 In a 2019 study, Hsiao et al 15 concluded that poor visual acuity in diabetic maculopathy was significantly correlated with decreased DCP-VD, and no correlation was found with SCP-VD. Previous studies also reported significant effects on DCP-VD, more than on SCP-VD, in DR patients, and concluded that DCP-VD may be a useful tool for the prediction of DR severity and identifying subjects at high risk, even in the absence of any signs of DR. 23,[33][34][35] These results disagree with other studies, which stated Abbreviations: S, significant; HS, highly significant; FAZ, foveal avascular zone; SCP-VD, superficial capillary plexus vessel density; DCP-VD, deep capillary plexus vessel density; DM, diabetes mellitus; NPDR, non-proliferative diabetic retinopathy; PDR, proliferative diabetic retinopathy. that DR severity and BCVA were significantly correlated with SCP-VD rather than DCP-VD.…”

Section: Discussioncontrasting

confidence: 58%

“…that DR severity and BCVA were significantly correlated with SCP-VD rather than DCP-VD. [27][28][29][30][31][32][33][34][35][36] We found a significant negative correlation between the BCVA (LogMAR) and vessel density in both DCP and SCP. Our results are comparable to a study by Samara et al; 25 however, no correlation was found between them in another study.…”

Section: Discussionmentioning

confidence: 51%

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<p>Correlations Between Optical Coherence Tomography Angiography Parameters and the Visual Acuity in Patients with Diabetic Retinopathy</p>

Abdelshafy

2020

OPTH

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The aim of this study was to assess the correlation between different optical coherence tomography angiography (OCTA) parameters and the best corrected visual acuity (BCVA) in patients with diabetic retinopathy (DR). Patients and Methods: Sixty eyes of 60 participants were included in this prospective study: 40 diabetic patients [20 with non-proliferative diabetic retinopathy (NPDR group), 20 with proliferative diabetic retinopathy (PDR group)] and 20 age-and gender-matched normal healthy subjects (control group). After full ophthalmological examination and fundus fluorescein angiography, OCTA was performed for all participants. Quantitative OCTA parameters, such as the foveal avascular zone (FAZ) area, the superficial capillary plexus vessel density (%) (SCP-VD) and the deep capillary plexus vessel density (%) (DCP-VD) in, whole and parafoveal areas were measured. Correlations between BCVA and OCTA parameters were analyzed. Results: There were no statistically significant differences between groups regarding age, gender, refraction, macular thickness or intraocular pressure. The median (IQR) FAZ area was 0.42 (0.39-0.46) mm 2 in the NPDR group, 0.54 (0.45-0.65) mm 2 in the PDR group and 0.24 (0.21-0.26) mm 2 in the control group (P<0.001). The FAZ area increased with increasing severity of DR. SCP-VD and DCP-VD showed significant differences between groups (P<0.001). Vessel density (VD) was decreased in both DCP and SCP as DR progressed. There was a significant positive correlation between BCVA (LogMAR) and FAZ area. There were significant negative correlations between BCVA (LogMAR) and VD in both SCP and DCP. Stepwise multiple linear regression analysis demonstrated that SCP-VD in the whole area and DCP-VD in the parafoveal area were the best predictive factors for BCVA in the NPDR and PDR groups. Conclusion: With progression of DR, the VD decreased and the FAZ area increased, and both parameters were correlated with poor visual acuity. OCTA is a non-invasive tool which can be used to detect diabetic macular ischemia and help in the prediction of visual prognosis.

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Section: Discussioncontrasting

confidence: 58%

Section: Discussionmentioning

confidence: 51%

<p>Correlations Between Optical Coherence Tomography Angiography Parameters and the Visual Acuity in Patients with Diabetic Retinopathy</p>

Abdelshafy

2020

OPTH

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“…[ 60 ] FD has been shown to be an early indicator of DR.[ 77 ] FD is reduced in both SCP and DCP in diabetic patients compared to healthy controls,[ 70 77 ] and the reduction may be more pronounced in DCP. [ 78 ] In contrast, some studies found that FD is increased in PDR cases in both SCP and DCP. [ 72 ] FD was found to be correlated with HbA1c and renal impairment.…”

Section: Resultsmentioning

confidence: 98%

“…This has been measured using a novel variable interscan time analysis (VISTA) algorithm utilized in a non-commercial swept source OCTA. [ 78 ]…”

Section: Resultsmentioning

confidence: 99%

An update on optical coherence tomography angiography in diabetic retinopathy

Khadamy¹,

Aghdam²,

Falavarjani³

2018

J Ophthalmic Vis Res

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Optical coherence tomography angiography (OCTA) is a novel non-invasive imaging modality for 3-dimensional visualization of retinal and optic nerve capillary networks. In this article, a comprehensive review of relevant original articles in the PubMed database was performed using the search terms “diabetic retinopathy,” “diabetic macular edema,” “diabetes mellitus,” and “optical coherence tomography angiography.” OCTA was found to detect microvascular changes early in diabetes mellitus, even before they become clinically evident. Morphological and qualitative assessment of vascular changes can help to determine the pathophysiological processes, activity, treatment, and follow-up of diabetic retinopathy (DR). Vessel density and foveal avascular zone are the most investigated quantified indices shown to be early predictors of DR, correlated to DR severity and visual function, and useful in predicting response to treatment. OCTA has shown to be a promising alternative to fluorescein angiography in the management of DR. Further studies are warranted to determine the role of OCTA in the routine clinical management of DR.

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“…The macular nonperfusion area was significantly increased in both superficial and deep vascular layers in patients with NPDR compared to control subjects [14, 22]. Fractal dimension in patients with NPDR was decreased in both retinal vascular layers compared to control subjects [13, 25, 27]. In contrast, another group reported increased fractal dimension in both vascular layers of patients with NPDR compared to control subjects [23].…”

Section: Octa Parameters In the Superficial Deep And/or Intermediatmentioning

confidence: 99%

Implication of Deep-Vascular-Layer Alteration Detected by Optical Coherence Tomography Angiography for the Pathogenesis of Diabetic Retinopathy

Dimitrova¹,

Chihara²

2019

Ophthalmologica

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The aim of this narrative mini review is to analyze optical coherence tomography angiography (OCTA) parameters from reports that involved both superficial and deep vascular layers in patients with diabetes and to assess their relevance for the pathogenesis of diabetic retinopathy (DR). Papers published from January 2015 to August 2018 describing the use of OCTA in diabetes were identified and reviewed through a Medline/PubMed search. OCTA studies suggest that parameters are altered in patients with diabetes in all retinal vascular layers. From all included studies that evaluated both the superficial and the deep vascular layer, a number of studies suggested that the deep vascular layer was affected at an earlier stage of DR. OCTA parameter alterations were more prominent in the deep vascular layer than in the superficial vascular layer in patients with DR, and deep-vascular-layer alterations were most evident in patients with diabetic macular edema. Regarding that retinal venules originate from the deep vascular layer of the retina, alteration of OCTA parameters at the deep vascular layer in diabetic patients may imply a predominant affection of the venous side of the retinal vascular system in the pathogenesis of DR.

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Value of Fractal Analysis of Optical Coherence Tomography Angiography in Various Stages of Diabetic Retinopathy

Cited by 54 publications

References 18 publications

<p>Correlations Between Optical Coherence Tomography Angiography Parameters and the Visual Acuity in Patients with Diabetic Retinopathy</p>

<p>Correlations Between Optical Coherence Tomography Angiography Parameters and the Visual Acuity in Patients with Diabetic Retinopathy</p>

An update on optical coherence tomography angiography in diabetic retinopathy

Implication of Deep-Vascular-Layer Alteration Detected by Optical Coherence Tomography Angiography for the Pathogenesis of Diabetic Retinopathy

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