TY - JOUR
T1 - Earliest Evidence of Preclinical Diabetic Retinopathy Revealed Using Optical Coherence Tomography Angiography Perfused Capillary Density
AU - Rosen, Richard B.
AU - Andrade Romo, Jorge S.
AU - Krawitz, Brian D.
AU - Mo, Shelley
AU - Fawzi, Amani A.
AU - Linderman, Rachel E.
AU - Carroll, Joseph
AU - Pinhas, Alexander
AU - Chui, Toco Y.P.
N1 - Funding Information:
Funding/Support: Funding support was provided by the National Eye Institute of the National Institutes of Health under award numbers R01EY027301, R01EY024969, and P30EY001931. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Additional funding for this research was provided by the New York Eye and Ear Infirmary Foundation (New York, New York, USA), the Marrus Family Foundation (New York, New York, USA), the Geraldine Violet Foundation (New York, New York, USA), and the Jorge N. Buxton MD Microsurgical Education Foundation (New York, New York, USA). The sponsors and funding organizations had no role in the design or conduct of this research. Financial Disclosures: Richard B. Rosen discloses personal fees from Nano Retina, Inc, personal fees from Astellas Pharma, Inc, personal fees and research support from Optovue, Inc, personal fees from Boehringer-Ingelheim, personal fees from Bayer, and ownership interest from Guardion Health, Opticology, and GlaucoHealth outside the submitted work. Joseph Carroll receives research support from Optovue. The following authors have no financial disclosures: Jorge S. Andrade Romo, Brian D. Krawitz, Shelley Mo, Amani A. Fawzi, Rachel E. Linderman, Alexander Pinhas, and Toco Y.P. Chui. All authors attest that they meet the current ICMJE criteria for authorship.
Funding Information:
Funding/Support: Funding support was provided by the National Eye Institute of the National Institutes of Health under award numbers R01EY027301 , R01EY024969 , and P30EY001931 . The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Additional funding for this research was provided by the New York Eye and Ear Infirmary Foundation (New York, New York, USA), the Marrus Family Foundation (New York, New York, USA) , the Geraldine Violet Foundation (New York, New York, USA) , and the Jorge N. Buxton MD Microsurgical Education Foundation (New York, New York, USA) . The sponsors and funding organizations had no role in the design or conduct of this research. Financial Disclosures: Richard B. Rosen discloses personal fees from Nano Retina, Inc, personal fees from Astellas Pharma, Inc, personal fees and research support from Optovue, Inc, personal fees from Boehringer-Ingelheim, personal fees from Bayer, and ownership interest from Guardion Health, Opticology, and GlaucoHealth outside the submitted work. Joseph Carroll receives research support from Optovue . The following authors have no financial disclosures: Jorge S. Andrade Romo, Brian D. Krawitz, Shelley Mo, Amani A. Fawzi, Rachel E. Linderman, Alexander Pinhas, and Toco Y.P. Chui. All authors attest that they meet the current ICMJE criteria for authorship.
Publisher Copyright:
© 2019
PY - 2019/7
Y1 - 2019/7
N2 - Purpose: To compare perfused capillary density (PCD) in diabetic patients and healthy controls using optical coherence tomography angiography (OCTA). Methods: Forty controls, 36 diabetic subjects without clinical retinopathy (NoDR), 38 with nonproliferative retinopathy (NPDR), and 38 with proliferative retinopathy (PDR) were imaged using spectral-domain optical coherence tomography. A 3 × 3-mm full-thickness parafoveal OCTA scan was obtained from each participant. Following manual delineation of the foveal avascular zone (FAZ), FAZ area, perimeter, and acircularity index were determined. Seven consecutive equidistant 200-μm-wide annular segments were drawn at increasing eccentricities from the FAZ margin. Annular PCD (%) was defined as perfused capillary area divided by the corresponding annulus area after subtraction of noncapillary blood vessel areas. Nonparametric Kruskal-Wallis testing with Bonferroni correction was performed in pairwise comparisons of group PCD values. Results: The NoDR group demonstrated consistently higher PCD compared to the control group in all 7 annuli, reaching statistical significance (36.6% ± 3.30% vs 33.6% ± 3.98%, P = .034) at the innermost annulus (FAZ margin to 200 μm out). The NPDR and PDR groups demonstrated progressively decreasing PCD. Differences in FAZ metrics between the NoDR and control groups did not reach statistical significance. Conclusions: Relative to healthy controls, increased PCD values in the NoDR group likely represent an autoregulatory response to increased metabolic demand, while the decrease in PCD that follows in NPDR and PDR results largely from an incremental loss of capillary segments. These findings, consistent with previous studies, demonstrate the potential of OCTA as a clinical tool for earlier objective detection of preclinical diabetic retinopathy. NOTE: Publication of this article is sponsored by the American Ophthalmological Society.
AB - Purpose: To compare perfused capillary density (PCD) in diabetic patients and healthy controls using optical coherence tomography angiography (OCTA). Methods: Forty controls, 36 diabetic subjects without clinical retinopathy (NoDR), 38 with nonproliferative retinopathy (NPDR), and 38 with proliferative retinopathy (PDR) were imaged using spectral-domain optical coherence tomography. A 3 × 3-mm full-thickness parafoveal OCTA scan was obtained from each participant. Following manual delineation of the foveal avascular zone (FAZ), FAZ area, perimeter, and acircularity index were determined. Seven consecutive equidistant 200-μm-wide annular segments were drawn at increasing eccentricities from the FAZ margin. Annular PCD (%) was defined as perfused capillary area divided by the corresponding annulus area after subtraction of noncapillary blood vessel areas. Nonparametric Kruskal-Wallis testing with Bonferroni correction was performed in pairwise comparisons of group PCD values. Results: The NoDR group demonstrated consistently higher PCD compared to the control group in all 7 annuli, reaching statistical significance (36.6% ± 3.30% vs 33.6% ± 3.98%, P = .034) at the innermost annulus (FAZ margin to 200 μm out). The NPDR and PDR groups demonstrated progressively decreasing PCD. Differences in FAZ metrics between the NoDR and control groups did not reach statistical significance. Conclusions: Relative to healthy controls, increased PCD values in the NoDR group likely represent an autoregulatory response to increased metabolic demand, while the decrease in PCD that follows in NPDR and PDR results largely from an incremental loss of capillary segments. These findings, consistent with previous studies, demonstrate the potential of OCTA as a clinical tool for earlier objective detection of preclinical diabetic retinopathy. NOTE: Publication of this article is sponsored by the American Ophthalmological Society.
UR - http://www.scopus.com/inward/record.url?scp=85064828500&partnerID=8YFLogxK
U2 - 10.1016/j.ajo.2019.01.012
DO - 10.1016/j.ajo.2019.01.012
M3 - Article
C2 - 30689991
AN - SCOPUS:85064828500
SN - 0002-9394
VL - 203
SP - 103
EP - 115
JO - American Journal of Ophthalmology
JF - American Journal of Ophthalmology
ER -