Enlargement of the foveal avascular zone detected by optical coherence tomography angiography in diabetic children without diabetic retinopathy

Niestrata-Ortiz, Magdalena; Fichna, Piotr; Stankiewicz, Witold; Stopa, Marcin

doi:10.1007/s00417-019-04264-8

Cited by 48 publications

(34 citation statements)

References 24 publications

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“…25 The largest series in type 1 DM have been described in children, and they interestingly have shown controversial results. [26][27][28][29][30] Golebiewska et al reported that no differences were seen in the VD or FAZ area in any of the studied plexuses between patients with type 1 DM and controls (n = 188 vs. 60); however, Niestrata-Ortiz et al described that FAZ area was different between diabetic and healthy children (n = 112 vs. 30). 27,28 In this last paper, a greater FAZ area was also associated with a longer duration of the disease.…”

Section: Discussionmentioning

confidence: 92%

“…[26][27][28][29][30] Golebiewska et al reported that no differences were seen in the VD or FAZ area in any of the studied plexuses between patients with type 1 DM and controls (n = 188 vs. 60); however, Niestrata-Ortiz et al described that FAZ area was different between diabetic and healthy children (n = 112 vs. 30). 27,28 In this last paper, a greater FAZ area was also associated with a longer duration of the disease. Obviously, the mean age of the study cohorts in these pediatric series (15.3 and 13.8 years, respectively) needs to be considered when interpreting these results, in order to allow meaningful comparisons with adult populations.…”

Section: Discussionmentioning

confidence: 92%

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Optical Coherence Tomography Angiography in Type 1 Diabetes Mellitus. Report 1: Diabetic Retinopathy

Barraso

Alé-Chilet

Hernandez

et al. 2020

Trans. Vis. Sci. Tech.

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The purpose of this study was to evaluate specifically in type 1 diabetes mellitus (DM) individuals the relationship between perifoveal superficial capillary plexus (SCP) parameters assessed by optical coherence tomography angiography (OCTA) and diabetic retinopathy (DR) grade. Methods: Cross-sectional analysis of a large scale prospective OCTA trial cohort (Clini-calTrials.gov NCT03422965). A total of 1186 eyes (593 individuals), 956 type 1 DM eyes (478 patients), and 230 control eyes (115 healthy volunteers) were included in this study. DR stage was graded according to the International Classification. OCTA imaging was performed with a commercially available device (Cirrus HD-OCT). Vessel density (VD), perfusion density (PD), and foveal avascular zone (FAZ) area, perimeter and circularity measurements were quantified in the SCP and receiver operating characteristic (ROC) curves were constructed for each OCTA parameter. Results: VD and PD (in both 3 × 3 and 6 × 6 mm captures) were inversely associated with DR stage (P < 0.001 in all cases) in a multiple regression analysis after controlling by age, gender, signal strength index, axial length, and DM duration. Greater FAZ area and perimeter and conversely lower circularity measurements were observed as DR severity increased in both scanning protocols (P < 0.05 in all cases). Conclusions: In type 1 DM individuals, OCTA provides an objective, continuous, and reliable method for accurate quantification of VD, PD, and FAZ parameters in the SCP, which ultimately correlate with DR stages. Translational Relevance: Objective OCTA measurements of the retinal microvasculature could substitute the clinical DR classification in patients with type 1 DM, identify patients at risk of DR progression, and inform treatment decisions to modify the evolution of the disease.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 92%

Optical Coherence Tomography Angiography in Type 1 Diabetes Mellitus. Report 1: Diabetic Retinopathy

Barraso

Alé-Chilet

Hernandez

et al. 2020

Trans. Vis. Sci. Tech.

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“…There have been a number of excellent studies that have highlighted the potential power of OCT-A in discriminating diabetic status. [17][18][19][20][21] In particular, pioneering work by Durbin et al 7 demonstrated the ability of measuring retinal microvasculature to distinguish diabetic status in patients. In their albeit small cohort they demonstrated highest area under the ROC curve (i.e., AUC) of 0.893 for measures of the vessel density in the superficial capillary network.…”

Section: Discussionmentioning

confidence: 99%

Differentiation of Diabetic Status Using Statistical and Machine Learning Techniques on Optical Coherence Tomography Angiography Images

Aslam

Hoyle

Puri

et al. 2020

Trans. Vis. Sci. Tech.

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Purpose To investigate the potential of statistical and machine learning approaches to determine the diabetic status of patients from optical coherence tomography angiography (OCT-A) images. Methods This was a retrospective cross-sectional observational study based at Manchester Royal Eye Hospital, United Kingdom. OCT-A scans were sequentially selected from one eye of each of 182 patients who were either not diabetic, diabetic without retinopathy, or diabetic with retinopathy requiring hospital follow-up. Eligible images were analyzed by expert purpose-built automated algorithms to calculate clinically relevant outcome measures. These were used in turn as inputs to machine learning and statistical procedures to derive algorithms to perform clinically relevant classifications of patient images into the clinical groups. Receiver operating characteristic curves for the classifiers were evaluated and predictive accuracy assessed using area under curve (AUC). Results For distinguishing diabetic patients from those without diabetes, the Random Forest classifier provided the highest AUC (0.8). For distinguishing diabetic patients with significant retinopathy from those with no retinopathy, the highest AUC was represented by logistic regression (0.91). Conclusions The study demonstrates the potential of novel techniques using automated analysis of OCT-A scans to diagnose patients with diabetes, or when diabetic status is known, to automatically determine those that require hospital input. Translational Relevance This work advances the concept of a rapid and noninvasive clinical screening tool using OCT-A to determine a patient's diabetic status.

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“…Although significant FAZ size variability has been reported, 34,35 FAZ outline was the parameter of choice in this pilot study, as it is obtained in all OCTA machines, can be readily evaluated for artifacts, and does not carry the burden of the various vascularity indices that vary widely across different manufacturers. [36][37][38] SCP and DCP are fundamentally different. DCP represents an area of slow circulation and relatively low intravascular hydrostatic pressure, more susceptible to ischemia and oxidative stress.…”

Section: Discussionmentioning

confidence: 99%

A Pilot Optical Coherence Tomography Angiography Study on Superficial and Deep Capillary Plexus Foveal Avascular Zone in Patients With Beta-Thalassemia Major

Georgalas

Makris

Papaconstantinou

et al. 2019

Invest. Ophthalmol. Vis. Sci.

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Enlargement of the foveal avascular zone detected by optical coherence tomography angiography in diabetic children without diabetic retinopathy

Cited by 48 publications

References 24 publications

Optical Coherence Tomography Angiography in Type 1 Diabetes Mellitus. Report 1: Diabetic Retinopathy

Optical Coherence Tomography Angiography in Type 1 Diabetes Mellitus. Report 1: Diabetic Retinopathy

Differentiation of Diabetic Status Using Statistical and Machine Learning Techniques on Optical Coherence Tomography Angiography Images

A Pilot Optical Coherence Tomography Angiography Study on Superficial and Deep Capillary Plexus Foveal Avascular Zone in Patients With Beta-Thalassemia Major

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