The use of optical coherence tomography angiography and optical coherence tomography to predict visual acuity in diabetic retinopathy.
Journal
Eye (London, England)
ISSN: 1476-5454
Titre abrégé: Eye (Lond)
Pays: England
ID NLM: 8703986
Informations de publication
Date de publication:
05 2020
05 2020
Historique:
received:
20
10
2018
accepted:
13
09
2019
revised:
02
06
2019
pubmed:
9
10
2019
medline:
22
6
2021
entrez:
9
10
2019
Statut:
ppublish
Résumé
Diabetic macular ischaemia (DMI) is associated with reduced visual acuity. Limitations exist in assessing the ischaemic component of diabetic retinopathy. Optical coherence tomography angiography (OCTA) is a non-invasive imaging technique to distinguish retinal capillary layers and allow microvascular assessment. Evaluation of DMI is of prognostic significance when planning treatment regimens for diabetic maculopathy. The aims of this study were to evaluate OCTA to assess DMI and correlate findings with structural optical coherence tomography (OCT) features to predict visual acuity. Cross sectional study of fifty-seven eyes (n = 57) of thirty-seven subjects with diabetic retinopathy. 26/57 (46%) eyes had diabetic macular cysts. OCT and OCTA data from a single visit were analysed. Central retinal thickness, the presence of intraretinal cysts, ellipsoid zone (EZ) disruption, disorganisation of the retinal inner layers (DRIL), foveal avascular zone (FAZ) area, FAZ acircularity, and level of DMI in the superficial capillary plexus were graded according to ETDRS protocols. The deep vascular plexus was also graded for ischaemia. Correlations between measures and visual acuity were explored using regression models. Median age was 55 years. Multiple regression analysis showed EZ disruption (p < 0.05), horizontal DRIL length (p < 0.01), DMI grade, and FAZ area (p < 0.1) correlated with visual acuity. Central retinal thickness and the presence of intraretinal cysts did not predict visual acuity in this study. FAZ area, DMI grade, EZ disruption, and DRIL length correlate with visual acuity and could be incorporated into longitudinal clinical assessment of individual patients with diabetic retinopathy.
Identifiants
pubmed: 31591506
doi: 10.1038/s41433-019-0606-9
pii: 10.1038/s41433-019-0606-9
pmc: PMC7182553
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
942-947Références
Klein BE. Overview of epidemiologic studies of diabetic retinopathy. Ophthalmic Epidemiol. 2007;14:179–83.
doi: 10.1080/09286580701396720
Yau JW, Rogers SL, Kawasaki R, Lamoureux EL, Kowalski JW, Bek T, et al. Global prevalence and major risk factors of diabetic retinopathy. Diabetes Care. 2012;35:556–64.
doi: 10.2337/dc11-1909
Sim DA, Keane PA, Zarranz-Ventura J, et al. Predictive factors for the progression of diabetic macular ischaemia. Am J Ophthalmol. 2013;156:684–92.
doi: 10.1016/j.ajo.2013.05.033
Classification of diabetic retinopathy from fluorescein angiograms. ETDRS report number 11. Early treatment Diabetic Retinopathy Study Research Group. Ophthalmology. 1991;98:807–22.
doi: 10.1016/S0161-6420(13)38013-0
Jonas JB, Schneider U, Naumann GO. Count and density of human retinal photoreceptors. Graefes Arch Clin Exp Ophthalmol. 1992;230:505–10.
doi: 10.1007/BF00181769
Samara WA, Say EA, Khoo CT, et al. Correlation of foveal avascular zone size with foveal morphology in normal eyes using optical coherence tomography angiography. Retina. 2015;35:2188–95.
doi: 10.1097/IAE.0000000000000847
Magrath GN, Say EAT, Sioufi K, et al. Variability in foveal avascular zone and capillary density using optical coherence tomography angiography machines in healthy eyes. Retina. 2017;37:2102–11.
doi: 10.1097/IAE.0000000000001458
Laatikainen L, Larinkari J. Capillary-free area of the fovea with advancing age. Investig Ophthalmol Vis Sci. 1977;16:1154–7.
Balaratnasingam C, Inoue M, Ahn S, McCann J, Dhrami-Gavazi E, Yannuzzi LA, et al. Visual acuity is correlated with the area of the foveal avascular zone in diabetic retinopathy and retinal vein occlusion. Ophthalmology. 2016;123:2352–67.
doi: 10.1016/j.ophtha.2016.07.008
Tan CS, Lim LW, Chow VS, Chay IW, Tan S, Cheong KX, et al. Optical coherence tomography angiography evaluation of the parafoveal vasculature and its relationship with ocular factors. Investig Ophthalmol. 2016;57:224–34.
doi: 10.1167/iovs.15-18869
Bresnick GH, Condit R, Syrjala S, Palta M, Groo A, Korth K. Abnormalities of the foveal avascular zone in diabetic retinopathy. Arch Ophthalmol. 1984;102:1286–93.
doi: 10.1001/archopht.1984.01040031036019
Samara WA, Shahlaee A, Adam MK, Khan MA, Chiang A, Maguire JI, et al. Quantification of diabetic macular ischaemia using optical coherence tomography angiography and its relationship with visual acuity. Ophthalmology. 2017;124:235–44.
doi: 10.1016/j.ophtha.2016.10.008
Tam J, Dhamdhere KP, Tiruveedhula P, Manzanera S, Barez S, Bearse MA Jr, et al. Disruption of the retinal parafoveal capillary network in type 2 diabetes before the onset of diabetic retinopathy. Investig Ophthalmol. 2011;52:9257–66.
doi: 10.1167/iovs.11-8481
Krawitz BD, Mo S, Geyman LS, Agemy SA, Scripsema NK, Garcia PM, et al. Acircularity index and axis ratio of the foveal avascular zone in diabetic eyes and healthy controls measured by optical coherence tomography. Vis Res. 2017;139:177–86.
doi: 10.1016/j.visres.2016.09.019
Dupas B, Minvielle W, Bonnin S, Couturier A, Erginay A, Massin P, et al. Association between vessel density and visual acuity in patients with diabetic retinopathy and poorly controlled type 1 diabetes. JAMA Ophthalmol. 2018;136:721–8. https://doi.org/10.1001/jamaophthalmol.2018.1319 .
Salz DA, de Carlo TE, Adhi M, et al. Select features of diabetic retinopathy on swept source optical coherence tomographic angiography compared with fluorescein angiography and normal eyes. JAMA Ophthalmol. 2016;134:644–50.
doi: 10.1001/jamaophthalmol.2016.0600
Schottenhamml J, Moult EM, Ploner S, et al. An automatic, intercapillary area-based algorithm for quantifying diabetes related capillary dropout using optical coherence tomography angiography. Retina. 2016;36:593–S101.
doi: 10.1097/IAE.0000000000001288
Tang F, Sun Z, Wong R, Lok J, Lam A, Tham CC, et al. Relationship of intercapillary area with visual acuity in diabetes mellitus: an optical coherence tomography angiography study. Br J Ophthalmol. 2018. https://doi.org/10.1136/bjophthalmol-2018-312010 .
Tzekov R, Arden GB. The electroretinogram in diabetic retinopathy. Surv Ophthalmol. 1999;44:53–60.
doi: 10.1016/S0039-6257(99)00063-6
Laron M, Bearse MA, Bronson-Castain K, et al. Interocular symmetry of abnormal multifocal electroretingrams in adolescents with diabetes and no retinopathy. Investig Ophthalmol Vis Sci. 2012;53:316–21.
doi: 10.1167/iovs.11-8825
Shin HJ, Lee SH, Chung H, Kim HC. Association between photoreceptor integrity and visual outcome in diabetic macular oedema. Graefes Arch Clin Exp Ophthalmol. 2012;250:61–70.
doi: 10.1007/s00417-011-1774-x
Ghazi NG, Scruggs RT, Batchelet AR, et al. Diabetic macular oedema. Ophthalmology. 2012;119:2643.e1.
pubmed: 23207021
Sun JK, Lin MM, Lammer J, et al. Disorganisation of the retinal inner layers as a predictor of visual acuity in eyes with center-involve diabetic macular oedema. JAMA Ophthalmol. 2014;132:1309–16.
doi: 10.1001/jamaophthalmol.2014.2350
Radwan SH, Soliman AZ, Tokarev J, Zhang L, van Kuijk FJ, Koozekanani DD. Association of disorganisation of retinal inner layers with vision after resolution of center-involved diabetic macular oedema. JAMA Ophthalmol. 2015;133:820–5.
doi: 10.1001/jamaophthalmol.2015.0972
Tranos PG, Tsaousis KT, Vakalis AN, Asteriades S, Pavesio CE. Long term follow up of inflammatory cystoid macular oedema. Retina. 2012;32:1624–8.
doi: 10.1097/IAE.0b013e3182483348
Browning DJ, Glassman AR, Aiello LP, et al. Diabetic Retinopathy Clinical Research Network. Relationship between optical coherence tomography- measured central retinal thickness and visual acuity in diabetic macular oedema. Ophthalmology. 2007;114:525–36.
doi: 10.1016/j.ophtha.2007.03.057
Sun JK, Radwan SH, Soliman AZ, Lammer J, Lin MM, Prager SG, et al. Neuronal retinal disorganisation as a robust marker of visual acuity in current and resolved diabetic macular edema. Diabetes. 2015;64:2560–70.
doi: 10.2337/db14-0782
Pelosini L, Hull CC, Boyce JF, McHugh D, Stanford MR, Marshall J. Optical coherence tomography may be used to predict visual acuity in patients with macular edema. Investig Ophthalmol Vis Sci. 2011;52:2741–8.
doi: 10.1167/iovs.09-4493
Maheshwary AS, Oster SF, Yuson RM, Cheng L, Mojana F, Freeman WR. The association between percent disruption of the photoreceptor inner segment-outer segment junction and visual acuity in diabetic macular edema. Am J Ophthalmol. 2010;150:63–7.
doi: 10.1016/j.ajo.2010.01.039
Otani T, Yamaguchi Y, Kishi S. Correlation between visual acuity and foveal microstructural changes in diabetic macular oedema. Retina. 2010;30:774–80.
doi: 10.1097/IAE.0b013e3181c2e0d6
Pelosini L, Hull CC, Boyce JF, McHugh D, Stanford MR, Marshall J. Author response: Predictors of visual acuity in Macular oedema. Investig Ophthalmol Vis Sci. 2012;53:924.
doi: 10.1167/iovs.11-9278
Kim AY, Chu Z, Shahidzadeh A, Wang RK, Puliafito CA, Kashani AH. Quantifying microvascular density and morphology in diabetic retinopathy using spectral-domain optical coherence tomography angiography. Investig Ophthalmol Vis Sci. 2016;57:362–70.
doi: 10.1167/iovs.15-18904
Bradley PD, Sim DA, Keane PA, Cardoso J, Agrawal R, Tufail A, et al. The Evaluation of diabetic macular ischaemia using optical coherence tomography angiography. Investig Ophthalmol Vis Sci. 2016;57:626–31.
doi: 10.1167/iovs.15-18034
Sampson DM, Gong P, An D, Menghini M, Hansen A, Mackey DA, et al. Axial length variation impacts on superficial retinal vessel density and foveal avascular zone area measurements using optical coherence tomography angiography. Investig Ophthalmol Vis Sci. 2017;58:3065–72.
doi: 10.1167/iovs.17-21551