Vascular and perfusion density in superficial capillary plexus of macula as a biomarker for appearance of diabetic retinopathy

Abstract

Diabetic alteration of the retinal microenvironment causes damage to the retinal vessels. Biomarkers such as vessel density and perfusion density, measured using optical coherence tomography angiography (OCT-A), may help detect early signs of diabetic retinopathy (DR) and track disease progression. In our study, we categorized 212 individuals into 2 groups: Group I (75 healthy individuals) and Group II (137 people with diabetes). All participants underwent comprehensive eye examinations, including OCT-A with AngioPlex™ system. The measurements taken of the superficial retinal capillary plexus included vessel and perfusion density. Our findings showed that vessel and perfusion densities in the central, inner, and outer ETDRS fields, as well as the full macular area, decreased with age. Notably, vessel and perfusion densities in the inner, outer, and full ETDRS macular areas in diabetic patients with mild DR were significantly lower, compared to those in healthy subjects. In conclusion, this study emphasizes the importance of vessel and perfusion densities as biomarkers for early diabetic retinopathy. However, it is important to note that their reduction does not precede clinical signs of diabetic retinopathy.