Optical coherence tomography angiography in diabetes: A review

Battista, Marco; Borrelli, Enrico; Sacconi, Riccardo; Bandello, Francesco; Querques, Giuseppe

doi:10.1177/1120672119899901

Cited by 31 publications

(23 citation statements)

References 42 publications

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“…Recent technical advances in ocular imaging techniques, most importantly the introduction of optical coherence tomography angiography (OCT-A), allow for the non-invasive visualization and quantification of retinal microvascular changes [ 36 ]. OCT-A provides depth-resolved images of the retinal and choroidal vasculature approaching almost histological resolution, which has considerably increased our understanding of microvascular alterations in patients with diabetes [ 37 ]. Furthermore, OCT-A allows for the quantification of vascular density in different layers of the retinal vascular tissue and might, therefore, be a suitable tool to monitor disease progression.…”

Section: Microvascular Changes In Patients With Diabetesmentioning

confidence: 99%

Retinal Neurovascular Coupling in Diabetes

Garhöfer

Chua

Tan

et al. 2020

JCM

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Neurovascular coupling, also termed functional hyperemia, is one of the physiological key mechanisms to adjust blood flow in a neural tissue in response to functional activity. In the retina, increased neural activity, such as that induced by visual stimulation, leads to the dilatation of retinal arterioles, which is accompanied by an immediate increase in retinal and optic nerve head blood flow. According to the current scientific view, functional hyperemia ensures the adequate supply of nutrients and metabolites in response to the increased metabolic demand of the neural tissue. Although the molecular mechanisms behind neurovascular coupling are not yet fully elucidated, there is compelling evidence that this regulation is impaired in a wide variety of neurodegenerative and vascular diseases. In particular, it has been shown that the breakdown of the functional hyperemic response is an early event in patients with diabetes. There is compelling evidence that alterations in neurovascular coupling precede visible signs of diabetic retinopathy. Based on these observations, it has been hypothesized that a breakdown of functional hyperemia may contribute to the retinal complications of diabetes such as diabetic retinopathy or macular edema. The present review summarizes the current evidence of impaired neurovascular coupling in patients with diabetes. In this context, the molecular mechanisms of functional hyperemia in health and disease will be covered. Finally, we will also discuss how neurovascular coupling may in future be used to monitor disease progression or risk stratification.

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Section: Microvascular Changes In Patients With Diabetesmentioning

confidence: 99%

Retinal Neurovascular Coupling in Diabetes

Garhöfer

Chua

Tan

et al. 2020

JCM

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“…OCTA analysis was also revealed to be useful in characterizing retinal alterations in diabetic eyes [18][19][20][21]. Overall, these studies demonstrated early retinal perfusion changes in these eyes.…”

Section: Introductionmentioning

confidence: 71%

“…Several studies have used 2D OCTA to demonstrate that retinal perfusion is affected in diabetic eyes [18][19][20][21]. In patients affected by type 2 diabetes and DR, 2D perfusion and vessel length densities-that are based on the area of thresholded vessels and on a map with vessels of 1-pixel width, respectively-were proved to be reduced in eyes with non-proliferative DR.…”

Section: Discussionmentioning

confidence: 99%

Quantification of diabetic macular ischemia using novel three‐dimensional optical coherence tomography angiography metrics

Borrelli

Sacconi

Querques

et al. 2020

Journal of Biophotonics

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We applied three-dimensional (3D) analysis to optical coherence tomography angiography (OCTA) to measure macular ischemia in eyes affected by non-proliferative diabetic retinopathy (DR). A previously validated algorithm was applied to OCTA data in order to obtain 3D visualization of the retinal vasculature. Successively, a global thresholding algorithm was applied and two novel quantitative metrics were introduced: 3D vascular volume and 3D perfusion density. Two-dimensional (2D) OCTA metrics were also obtained with different binarization thresholds for comparison. Of the 30 patients included, 15 were diagnosed with DR and 15 were controls. The 3D vascular volume and 3D perfusion density were reduced in DR eyes (P < .0001). The 2D variables also significantly differ between groups. The 3D perfusion density had the highest area under the receiver operating characteristic curve (0.964) among tested variables. Assessing quantitative perfusion using 3D analysis is reliable and promising, and with an elevated diagnostic efficacy in identifying DR eyes.

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“…26 Capillary vascular density and visual acuity reduce in proportion to disease severity in systemic diseases involving impairments to the blood-retinal barrier and retinal blood flow, such as diabetes. 27,28…”

Section: Discussionmentioning

confidence: 99%

The effect of religious fasting and dehydration at Ramadan on choroidal thickness and Retinal vessel densities, measured with optical coherence tomography angiography

Gökmen

Ozgur

2020

European Journal of Ophthalmology

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Aim: To investigate the effect of religious fasting and dehydration at Ramadan on choroidal thickness and vessel density in the superficial and deep vascular plexuses with OCTA. Methods: The choroidal thickness, and superficial and deep vessel density indices of fasting healthy subjects were measured with an OCTA device, and compared with non-fasting measurements. Results: The study included 70 eyes of 35 healthy subjects with a mean age of 42.86 ± 8.3 years. The measured choroidal thickness, superficial vessel density index and deep vessel density index were 288.89 ± 67 µm, 40.56% and 41.43%, respectively when measured in the fasting period, compared to 284.62 ± 65 µm, 40.41% and 41.41%, respectively when measured in the non-fasting period. The choroidal thickness under the fovea center was found to be significantly higher in the fasting period than in the non-fasting period ( p = 0.014). The mean total choroidal thickness was found to be reduced in the non-fasting period, although not to a statistically significant degree ( p > 0.05). An analysis of the mean total superficial and deep vascular plexuses revealed no statistically significant difference ( p = 0.368, p = 0.938 respectively). Conclusion: Although a significant increase was noted in central choroidal thickness in the fasting period, no significant change due to fasting was observed in the superficial and deep capillary plexuses. The choroidal layer may vary in thickness due to fasting-related metabolic factors, while retinal vessels are more stable against such effects.

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Optical coherence tomography angiography in diabetes: A review

Cited by 31 publications

References 42 publications

Retinal Neurovascular Coupling in Diabetes

Retinal Neurovascular Coupling in Diabetes

Quantification of diabetic macular ischemia using novel three‐dimensional optical coherence tomography angiography metrics

The effect of religious fasting and dehydration at Ramadan on choroidal thickness and Retinal vessel densities, measured with optical coherence tomography angiography

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