Retinal Nonperfusion Relationship to Arteries or Veins Observed on Widefield Optical Coherence Tomography Angiography in Diabetic Retinopathy

Ishibazawa, Akihiro; Pretto, Lucas Ramos De; Alibhai, A. Yasin; Moult, Eric M.; Arya, Malvika; Sorour, Osama; Mehta, Nihaal; Baumal, Caroline R.; Witkin, André J.; Yoshida, Akitoshi; Duker, Jay S.; Fujimoto, James G.; Waheed, Nadia K.

doi:10.1167/iovs.19-26653

Cited by 27 publications

(27 citation statements)

References 41 publications

(59 reference statements)

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“…We used a custom MATLAB software (MathWorks, Natick, MA, USA) similar to prior work to identify vascular density within a defined radius (0.2 mm) surrounding SCP arterioles and venules on the OCTA images, set to maximize intervessel capillary space and minimize arteriovenular capillary zone overlap. 11 Figures 1 and 2 illustrate our methods for manual vessel isolation and automatic quantification of arteriovenous vascular density in healthy and MacTel eyes, respectively.…”

Section: Methodsmentioning

confidence: 99%

Section: Quantification Of Vascular Densitymentioning

confidence: 99%

“…11 In the healthy retina, vascular densities are much lower surrounding arterioles than venules, 12 so to detect subtle relative arteriovenous changes in diabetic retinopathy, the authors proposed the concept of an arteriovenous ratio, representing arteriolaradjacent nonperfusion divided by venular-adjacent nonperfusion. 11 In diabetic retinopathy, arteriolaradjacent nonperfusion has been shown to be the greatest contributor to overall nonperfusion, with venular-adjacent nonperfusion playing a larger role as disease progresses. 11 The presence of peculiar yet characteristic rightangle venules 3,13 offers reason to believe arteriovenous (A/V) differences exist in MacTel.…”

Section: Introductionmentioning

confidence: 99%

“…11 In diabetic retinopathy, arteriolaradjacent nonperfusion has been shown to be the greatest contributor to overall nonperfusion, with venular-adjacent nonperfusion playing a larger role as disease progresses. 11 The presence of peculiar yet characteristic rightangle venules 3,13 offers reason to believe arteriovenous (A/V) differences exist in MacTel. We have recently shown that there is an intricate relationship between photoreceptor loss and markers of vascular change, such as DCP telangiectasia.…”

Section: Introductionmentioning

confidence: 99%

“… 11 In diabetic retinopathy, arteriolar-adjacent nonperfusion has been shown to be the greatest contributor to overall nonperfusion, with venular-adjacent nonperfusion playing a larger role as disease progresses. 11 …”

Section: Introductionmentioning

confidence: 99%

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Perivenular Capillary Loss: An Early, Quantifiable Change in Macular Telangiectasia Type 2

Micevych

Soetikno

Fawzi

2020

Trans. Vis. Sci. Tech.

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To evaluate differences in parafoveal vascular density surrounding arterioles and venules in type 2 macular telangiectasia (MacTel). Methods: Thirty-seven eyes (20 subjects) diagnosed with MacTel and 16 healthy eyes (10 subjects) were imaged with optical coherence tomography angiography between March 2016 and June 2019 in this single-center, observational, cross-sectional study. Arterioles and venules were manually identified, and perivascular density was generated using a custom MATLAB code. The primary outcome measure was the ratio of periarteriolar to perivenular vascular density (arteriovenous [A/V] capillary ratio) in the superficial and deep capillary plexuses across MacTel stages. The main secondary outcome measures were overall parafoveal vascular density (VD), periarteriolar VD, and perivenular VD. Results: In the superficial capillary plexus (SCP), the A/V capillary ratio was significantly higher in MacTel subjects than controls (0.914 vs. 0.892; P = 0.0044). The greatest differences occurred between controls and nonproliferative MacTel subjects without optical coherence tomography evidence of disease (P = 0.0055). A/V capillary ratios progressed in a nonlinear fashion with MacTel severity, increasing from nonproliferative disease (0.912) to intraretinal proliferative disease (0.931), then decreasing in subretinal proliferative disease (0.905). Parafoveal VD in the SCP was lower in MacTel subjects than controls only in subretinal proliferative disease (P = 0.0130). Conclusions: The A/V capillary ratio of the SCP is a quantifiable metric of vascular pathology in MacTel that occurs earlier than decline in parafoveal VD. Elevated A/V capillary ratios in MacTel are consistent with an early, disproportionately perivenular disruption in the SCP. Translational Relevance: Findings inform MacTel pathogenesis through revealing early perivenular capillary loss and offer a new quantitative metric for earliest stage MacTel.

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Section: Methodsmentioning

confidence: 99%

Section: Quantification Of Vascular Densitymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Perivenular Capillary Loss: An Early, Quantifiable Change in Macular Telangiectasia Type 2

Micevych

Soetikno

Fawzi

2020

Trans. Vis. Sci. Tech.

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New Vessels on the Optic Disc and Elsewhere in the Retina

Gupta,

Bansal,

Sharma

et al. 2023

Ophthalmic Signs in Practice of Medicine

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Relationship between nonperfusion area from widefield optical coherence tomography angiography and macular vascular parameters in diabetic retinopathy

Konno,

Ishibazawa,

De Pretto

et al. 2023

Int Ophthalmol

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Purpose To evaluate the relationship between the nonperfusion area (NPA) from widefield optical coherence tomography angiography (OCTA) and macular vascular parameters in diabetic retinopathy (DR). Methods In total, 51 eyes from 51 patients with proliferative DR (PDR) or moderate/severe non-PDR were included. Widefield OCTA using the Zeiss Plex Elite 9000 was performed. A semi-automatic algorithm calculated the percentages of the NPA within the total image. Macular OCTA (3 × 3 mm and 6 × 6 mm area) was scanned using the RTVue-XR Avanti. Vessel density (VD) was automatically separated into the superficial (SCP) and deep capillary plexus (DCP), and foveal avascular zone (FAZ) measurements were computed according to the parafoveal (1–3 mm) and perifoveal (3–6 mm) regions. Results A negative correlation was found between the average VD of the SCP and DCP obtained 3 × 3 mm and 6 × 6 mm area and the NPA. Multiple regression analysis revealed that the temporal–perifoveal region most negatively correlated with the NPA (r = − 0.55, p < 0.0001). No correlation was found between FAZ measurements and DR severity (area, p = 0.07; perimeter, p = 0.13). Conclusion Diabetic macular nonperfusion was significantly associated with the NPA from widefield OCTA. In particular, the temporal–perifoveal DCP disorder may be a sensitive indicator of wide NPA.

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Retinal Nonperfusion Relationship to Arteries or Veins Observed on Widefield Optical Coherence Tomography Angiography in Diabetic Retinopathy

Cited by 27 publications

References 41 publications

Perivenular Capillary Loss: An Early, Quantifiable Change in Macular Telangiectasia Type 2

Perivenular Capillary Loss: An Early, Quantifiable Change in Macular Telangiectasia Type 2

New Vessels on the Optic Disc and Elsewhere in the Retina

Relationship between nonperfusion area from widefield optical coherence tomography angiography and macular vascular parameters in diabetic retinopathy

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