Multiscale Correlation of Microvascular Changes on Optical Coherence Tomography Angiography With Retinal Sensitivity in Diabetic Retinopathy

Abstract

Purpose: To assess global, zonal, and local correlations between vessel density changes measured by optical coherence tomography angiography and retinal sensitivity measured by microperimetry across diabetic retinopathy severity. Methods: Diabetic patients and nondiabetic controls underwent optical coherence tomography angiography imaging and microperimetry testing. Pearson's correlation was used to assess associations between average sensitivity and skeletonized vessel density (SVD) or foveal avascular zone area centrally. Linear mixed effects modeling was used to assess relationships between local SVD measurements and their spatially corresponding retinal sensitivity measurements. Results: Thirty-nine eyes from 39 participants were imaged. In all slabs, there was a statistically significant positive correlation between retinal sensitivities and SVDs on both global and zonal scales. No statistically significant correlation was found between central retinal sensitivities and the foveal avascular zone areas. Assessment of 1,136 spatially paired retinal sensitivity and SVD measurements revealed a statistically significant local relationship; this seemed to be driven by eyes with proliferative diabetic retinopathy that had reduced retinal sensitivities. Conclusion: This study supports positive correlations between SVD and retinal sensitivity at global and zonal spatial scales in diabetic eyes. However, our analysis did not find evidence of statistically significant correlations between retinal sensitivity and SVD on a local scale until advanced diabetic retinopathy.

The Association of Axial Length with Macular Microvascular Changes in Chinese Diabetic Retinopathy Patients

“…Capillary nonperfusion is an important feature of DR. VLD and VPD can be used as an indicator to observe the changes in DR capillary perfusion, and the changes in the macula vascular are sensitive indicators for the observation of DR. 5 , 15 This study found that compared with the control healthy group, both VLD and VPD in NPDR patients decreased, suggesting that OCTA is a feasible and effective method to detect DR microvascular disease. 6 Our results were consistent with previous report that retinal blood flow, and blood flow rate of diabetes mellitus (DM) patients were lower than those of normal people, and the diameter of blood vessels in the retinal blood vessels of patients with NDR and NPDR was narrower than normal people.…”

“…Optical coherence tomography (OCTA) can show macular vascular morphology quickly and non-invasively in real time. 5 , 6 In addition, OCTA is not affected by traditional contrast fluorescein leakage and masking and drug allergy. Previous study showed that FAZ enlargement was significantly different between diabetic eyes and healthy eyes.…”

Microperimetry in Retinal Diseases

“…Levine and colleagues performed a detailed point-by-point co-localization to evaluate the correlations between the focal retinal sensitivities and the microvascular changes. They reported that significant correlations were only present in eyes with proliferative diabetic retinopathy 80. Interestingly, Mokrane et al81 reported that areas with retinal sensitivity less than 25 dB were always associated with capillary loss, but some areas of capillary loss had a preserved retinal sensitivity.…”

“…Furthermore, the macular function assessed by MP combined with structural OCT angiography (OCTA) metrics and capillary dropout areas showed low sensitivities in eyes with ischemic DME 8. In addition, the retinal sensitivity determined by MP and the vascular density of both the superficial and deep capillary plexuses determined by OCTA were both significantly correlated with the stage of diabetic retinopathy (DR) 9…”

“…8 In addition, the retinal sensitivity determined by MP and the vascular density of both the superficial and deep capillary plexuses determined by OCTA were both significantly correlated with the stage of diabetic retinopathy (DR). 9 We present the results of recent studies of retinal MP that have provided important information on certain macular diseases. The macular diseases studied were age-related macular degeneration (AMD), Stargardt disease, DR, pathologic myopia, 10 and various macular conditions that develop after surgery.…”