Age and gender influence on foveal avascular zone in healthy eyes

Gómez‐Ulla, Francisco; Cutrín, Paula; Santos, Paz; Fernández, Melchor Fernández; Abraldes, Maximino; Abalo-Lojo, José Manuel; González, Francisco

doi:10.1016/j.exer.2019.107856

Cited by 50 publications

(38 citation statements)

References 52 publications

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“…Although we did not observe a significant difference in FAZ area between devices, it could be that we were underpowered to detect a small but significant difference. We can, however, say that if there is a significant difference between devices, it does not exceed 0.04 mm 2 .…”

Section: Discussionmentioning

confidence: 89%

“…There were no significant differences in FAZ area (AngioPlex–AngioVue) between devices using either unscaled (paired t -test, average difference: 0.006 mm 2 , P = 0.069) or scaled measurements (paired t -test, average difference: -0.005 mm 2 , P = 0.11). Scaling resulted in decreased average FAZ area (mean ± SD) when using the AngioPlex (unscaled area: 0.281 ± 0.087 mm 2 ; unscaled range: 0.152–0.501 mm 2 ; scaled area: 0.271 ± 0.083 mm 2 ; scaled range: 0.147–0.483 mm 2 ) but increased average FAZ area (mean ± SD) when using the AngioVue (unscaled area: 0.275 ± 0.086 mm 2 ; unscaled range: 0.152–0.496 mm 2 ; scaled area: 0.276 ± 0.085 mm 2 ; scaled range: 0.153 - 0.499 mm 2 ). ( C ) Bland-Altman plot showing interdevice agreement for unscaled average FAZ area.…”

Section: Resultsmentioning

confidence: 99%

“…The widespread availability of this technology has resulted in an enormous growth in the study of retinal vasculature in various systemic and ocular diseases. 1 Of particular interest is the foveal avascular zone (FAZ) and its surrounding microvasculature, which have been shown to be affected by physiologic sex-associated hormonal changes 2 – 4 and diseases, such as diabetic retinopathy, 5 macular degeneration, 6 hypertension, 7 sickle cell disease, 8 macular telangiectasia, 9 retinopathy of prematurity, 10 and albinism. 11 Central to using OCT-A imagery to diagnose and monitor conditions like these is the ability to extract quantitative metrics describing the retinal vasculature.…”

Section: Introductionmentioning

confidence: 99%

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Assessing the Influence of OCT-A Device and Scan Size on Retinal Vascular Metrics

Kraker

Omoba

Cava

et al. 2020

Trans. Vis. Sci. Tech.

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The purpose of this study was to investigate the effect of device and scan size on quantitative optical coherence tomography angiography (OCT-A) metrics. Methods: The 3 × 3 mm scans from Optovue AngioVue and Zeiss AngioPlex systems were included for 18 eyes of 18 subjects without ocular pathology. The foveal avascular zone (FAZ) was segmented manually by two observers, from which estimates of FAZ area (using both the nominal image scale and the axial length corrected image scale) and acircularity were derived. Three scan sizes (3 mm, 6 mm HD, and 8 mm) from the AngioVue system were included for 15 eyes of 15 subjects without ocular pathology. For each subject, larger image sizes were resized to the same resolution as 3 × 3 mm scans, aligned, then cropped to a common area. FAZ area, FAZ acircularity, average and total parafoveal intercapillary area, vessel density, and vessel end points were computed. Results: Between the devices used here, there were no significant differences in FAZ acircularity (P = 0.88) or FAZ area using scaled (P = 0.11) or unscaled images (P = 0.069). Although there was no significant difference in FAZ area across scan sizes (P = 0.30), vessel morphometry metrics were all significantly influenced by scan size. Conclusions: The scan devices and sizes used here do not affect FAZ area measures derived from manual segmentations. In contrast, vessel morphometry metrics are affected by scan size. As individual differences in axial length induce differences in absolute scan size, extreme care should be taken when interpreting metrics of vessel morphometry, both between and within OCT-A devices. Translational Relevance: A better characterization of the confounds surrounding OCT-A retinal vasculature metrics can lead to improved application of these metrics as biomarkers for retinal and systemic diseases.

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Section: Discussionmentioning

confidence: 89%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Assessing the Influence of OCT-A Device and Scan Size on Retinal Vascular Metrics

Kraker

Omoba

Cava

et al. 2020

Trans. Vis. Sci. Tech.

View full text Add to dashboard Cite

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“…Our study also showed significant differences in the FAZs of both the SCP and DCP layers between the NDR group and controls (0.33 ± 0.07 mm 2 vs. 0.26 ± 0.07 mm 2 , 0.51 ± 0.13 mm 2 vs. 0.38 ± 0.12 mm 2 , respectively; all p = 0.002). FAZs can vary between individuals, and so direct comparison may be difficult [ 21 , 22 ]. However, alterations of FAZs may be an important marker to identify early-stage DR, which might be one of the earliest signs of diabetic damage to retinal vasculature.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Foveal and Parafoveal Microvascular Changes Using Optical Coherence Tomography Angiography in Type 2 Diabetes Patients without Clinical Diabetic Retinopathy in South Korea

Park

Kim

Roh

2020

Journal of Diabetes Research

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The aim of this study was to investigate foveal and parafoveal microvascular changes in retinal vascular plexuses in patients with type 2 diabetes mellitus (DM) without clinical diabetic retinopathy (NDR) using optical coherence tomography angiography (OCTA) in South Korea. We included 64 patients in the NDR group and included 48 healthy control subjects for comparison. All subjects underwent ocular examination with visual acuity and wide-field fundus photos. Foveal and parafoveal vessel density and foveal avascular zone (FAZ) area (mm2) in the superficial capillary plexus (SCP) and deep capillary plexus (DCP) were analyzed. Foveal vessel densities in both the SCP and DCP were decreased in the NDR group compared to the controls (p=0.034 and 0.001, respectively). Vessel densities in the superior and inferior parafoveae in the DCP were decreased in the NDR group compared to the controls (p=0.006 and 0.034, respectively). The FAZs of the SCP and DCP were significantly different between the NDR group and the controls (p=0.003 and 0.001, respectively). The average vessel densities of the SCP and DCP were not correlated with HbA1c, serum creatinine, or the duration of DM in the NDR group. We demonstrated that OCTA can identify early-stage DR before the manifestation of clinically apparent retinopathy in diabetic eyes. Diabetic patients without clinical DR have microvascular alterations (foveal vessel density, parts of the parafovea, and enlarged FAZ) in the SCP and DCP. Our results suggest that OCTA might be a promising tool for early detection of eyes with DR.

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“…Earlier studies have reported that the FAZ area size varies significantly among healthy eyes and that it is influenced by age, gender, axial length, spherical equivalent, retinal vascular density, central macular thickness and choroidal thickness (6) (7) (8) (9). Besides, several ischemic pathologies such as diabetic retinopathy and retinal venous occlusion modify its characteristics (10) (11). Glaucoma with central visual field defects has also been reported to cause an enlarged FAZ area (12) (13) (14).…”

Section: Introductionmentioning

confidence: 99%

Automated measurement of the foveal avascular zone in healthy eyes on Heidelberg Spectralis Optical Coherence Tomography Angiography

Gutierrez-Benitez

Palomino

Casas

2020

Preprint

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PURPOSE: To develop and evaluate an automated method to measure the foveal avascular zone (FAZ) area in healthy eyes on Heidelberg Spectralis Optical Coherence Tomography Angiography (HS-OCTA). This method is referred to as the modified Kanno-Saitama macro (mKSM). METHODS: This cross-sectional study included 29 eyes of 25 healthy volunteers who underwent HS-OCTA at the macular area twice at the same time. Regardless of the quality of the images, all of them were included. Macular data on the superficial vascular plexus, intermediate capillary plexus and deep capillary plexus were processed by mKSM. The FAZ area was measured twice automatically using the mKSM and twice manually by two independent examiners. RESULTS: Intrascan intraclass coefficient ranged from 0,948 to 0,993 for manual measurements and was 1 for mKSM method. Interscan intraclass coefficients ranged from 0,925 to 0,973 for manual measurements and from 0,770 to 0,902 for mKSM method. Despite that the difference between human examiners is smaller than between human examiners and mKSM according to Bland-Altman plots, the scatterplots show a strong correlation between human and automatic measurements. The best results are obtained in intermediate capillary plexus. CONCLUSIONS: Automated determination of the FAZ area in HS-OCTA is feasible and less human-dependent by mKSM even if the image is not perfectly centred or has artefacts. The mKSM processing could contribute to our understanding of the three vascular plexuses.

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Age and gender influence on foveal avascular zone in healthy eyes

Cited by 50 publications

References 52 publications

Assessing the Influence of OCT-A Device and Scan Size on Retinal Vascular Metrics

Assessing the Influence of OCT-A Device and Scan Size on Retinal Vascular Metrics

Evaluation of Foveal and Parafoveal Microvascular Changes Using Optical Coherence Tomography Angiography in Type 2 Diabetes Patients without Clinical Diabetic Retinopathy in South Korea

Automated measurement of the foveal avascular zone in healthy eyes on Heidelberg Spectralis Optical Coherence Tomography Angiography

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