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Vessel Density around Foveal Avascular Zone as a Potential Imaging Biomarker for Detecting Preclinical Diabetic Retinopathy: An Optical Coherence Tomography Angiography Study.
Semin Ophthalmol. 2020 Aug 17; 35(5-6):316-323.SO

Abstract

Purpose: The purpose of this study was to investigate the changes of optical coherence tomography angiography (OCTA) parameters in diabetic retinopathy (DR) using an updated software with 3D projection artifact removal. Methods: In this cross-sectional observational study, 192 eyes of 111 patients with diabetes mellitus (DM) and 55 eyes of 34 age-matched healthy subjects were included. Diabetic patients were divided into three subgroups: without DR, with mild non-proliferative DR, and with moderate-to-severe non-proliferative DR. All eyes underwent dilated fundoscopy along with 3x3mm and 6x6mm OCTA image acquisition. Vessel density (VD), retinal thickness and foveal avascular zone (FAZ) parameters were analyzed. Correlation analyses between OCTA parameters and DR severity were also performed. Results: There was a statistically significant difference in all OCTA parameters among groups, except for superficial foveal VD in 6x6mm scan and whole image retinal thickness in both 3x3mm and 6x6mm scans, while 3x3mm scan parameters were found to be diagnostically superior to the corresponding ones of 6x6mm scan. As the DR stage progressed, the mean VD values decreased. FD-300, which is the VD of a 300-μm width annulus surrounding FAZ, demonstrated the strongest inverse correlation with DR severity (r = -0.590/rs = -0.562, p < .001) and showed the highest area under the ROC curve (AUROC = 0.833 ± 0.030, p < .001) in scan 3 × 3. Conclusion: OCTA shows progressive decrease of VD parameters with increasing DR severity. Foveal VD, FAZ area, and perimeter are not very useful indexes due to the high interindividual variability of FAZ size. OCTA and specifically FD-300 may serve as a promising DR screening tool for detecting preclinical microvascular alterations.

Authors+Show Affiliations

Department of Ophthalmology, "Korgialenio-Benakio" Red Cross Hospital , Athens, Greece. 2nd Department of Ophthalmology, National and Kapodistrian University of Athens , Athens, Greece.Eye Institute of Thrace, Democritus University of Thrace , Alexandroupolis, Greece.Department of Ophthalmology, "Korgialenio-Benakio" Red Cross Hospital , Athens, Greece.Department of Ophthalmology, "Korgialenio-Benakio" Red Cross Hospital , Athens, Greece.Department of Ophthalmology, "Korgialenio-Benakio" Red Cross Hospital , Athens, Greece.Department of Neurology, Democritus University of Thrace , Alexandroupolis, Greece.2nd Department of Ophthalmology, National and Kapodistrian University of Athens , Athens, Greece.

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

33258720

Citation

Ragkousis, Antonios, et al. "Vessel Density Around Foveal Avascular Zone as a Potential Imaging Biomarker for Detecting Preclinical Diabetic Retinopathy: an Optical Coherence Tomography Angiography Study." Seminars in Ophthalmology, vol. 35, no. 5-6, 2020, pp. 316-323.
Ragkousis A, Kozobolis V, Kabanarou S, et al. Vessel Density around Foveal Avascular Zone as a Potential Imaging Biomarker for Detecting Preclinical Diabetic Retinopathy: An Optical Coherence Tomography Angiography Study. Semin Ophthalmol. 2020;35(5-6):316-323.
Ragkousis, A., Kozobolis, V., Kabanarou, S., Bontzos, G., Mangouritsas, G., Heliopoulos, I., & Chatziralli, I. (2020). Vessel Density around Foveal Avascular Zone as a Potential Imaging Biomarker for Detecting Preclinical Diabetic Retinopathy: An Optical Coherence Tomography Angiography Study. Seminars in Ophthalmology, 35(5-6), 316-323. https://doi.org/10.1080/08820538.2020.1845386
Ragkousis A, et al. Vessel Density Around Foveal Avascular Zone as a Potential Imaging Biomarker for Detecting Preclinical Diabetic Retinopathy: an Optical Coherence Tomography Angiography Study. Semin Ophthalmol. 2020 Aug 17;35(5-6):316-323. PubMed PMID: 33258720.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Vessel Density around Foveal Avascular Zone as a Potential Imaging Biomarker for Detecting Preclinical Diabetic Retinopathy: An Optical Coherence Tomography Angiography Study. AU - Ragkousis,Antonios, AU - Kozobolis,Vassilios, AU - Kabanarou,Stamatina, AU - Bontzos,Georgios, AU - Mangouritsas,George, AU - Heliopoulos,Ioannis, AU - Chatziralli,Irini, Y1 - 2020/12/01/ PY - 2020/12/2/pubmed PY - 2021/8/12/medline PY - 2020/12/1/entrez KW - FD-300 KW - OCT Angiography KW - diabetic retinopathy KW - preclinical diabetic retinopathy KW - vessel density SP - 316 EP - 323 JF - Seminars in ophthalmology JO - Semin Ophthalmol VL - 35 IS - 5-6 N2 - Purpose: The purpose of this study was to investigate the changes of optical coherence tomography angiography (OCTA) parameters in diabetic retinopathy (DR) using an updated software with 3D projection artifact removal. Methods: In this cross-sectional observational study, 192 eyes of 111 patients with diabetes mellitus (DM) and 55 eyes of 34 age-matched healthy subjects were included. Diabetic patients were divided into three subgroups: without DR, with mild non-proliferative DR, and with moderate-to-severe non-proliferative DR. All eyes underwent dilated fundoscopy along with 3x3mm and 6x6mm OCTA image acquisition. Vessel density (VD), retinal thickness and foveal avascular zone (FAZ) parameters were analyzed. Correlation analyses between OCTA parameters and DR severity were also performed. Results: There was a statistically significant difference in all OCTA parameters among groups, except for superficial foveal VD in 6x6mm scan and whole image retinal thickness in both 3x3mm and 6x6mm scans, while 3x3mm scan parameters were found to be diagnostically superior to the corresponding ones of 6x6mm scan. As the DR stage progressed, the mean VD values decreased. FD-300, which is the VD of a 300-μm width annulus surrounding FAZ, demonstrated the strongest inverse correlation with DR severity (r = -0.590/rs = -0.562, p < .001) and showed the highest area under the ROC curve (AUROC = 0.833 ± 0.030, p < .001) in scan 3 × 3. Conclusion: OCTA shows progressive decrease of VD parameters with increasing DR severity. Foveal VD, FAZ area, and perimeter are not very useful indexes due to the high interindividual variability of FAZ size. OCTA and specifically FD-300 may serve as a promising DR screening tool for detecting preclinical microvascular alterations. SN - 1744-5205 UR - https://www.unboundmedicine.com/medline/citation/33258720/Vessel_Density_around_Foveal_Avascular_Zone_as_a_Potential_Imaging_Biomarker_for_Detecting_Preclinical_Diabetic_Retinopathy:_An_Optical_Coherence_Tomography_Angiography_Study_ L2 - https://www.tandfonline.com/doi/full/10.1080/08820538.2020.1845386 DB - PRIME DP - Unbound Medicine ER -