Relationship between macular perfusion and lesion distribution 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:
09 May 2024
Historique:
received: 08 02 2023
accepted: 19 04 2024
revised: 17 03 2024
medline: 10 5 2024
pubmed: 10 5 2024
entrez: 9 5 2024
Statut: aheadofprint

Résumé

To assess the relationship between macular vessel density metrics and foveal avascular zone (FAZ) characteristics on optical coherence tomography angiography (OCTA) and lesion distribution in eyes with diabetic retinopathy (DR). Patients with DR who underwent both Optos ultrawidefield (UWF) pseudocolor imaging and macular OCTA (Cirrus Angioplex, 6 × 6 mm) were included in this cross-sectional observational study. The distribution of DR lesions was assessed by comparing each of the peripheral ETDRS extended fields (3-7) against their corresponding ETDRS field, hence eyes were defined as either having predominantly peripheral lesions (PPL) or predominantly central lesions (PCL). En face OCTA images from the superficial and deep capillary plexuses (SCP and DCP) were then analysed using Image J software. Perfusion density (PD), vessel length density (VLD), and fractal dimensions (FD) were calculated following binarization and skeletonization of the images. Out of 344 eyes, 116 (33.72%) eyes had PPL and 228 (66.28%) eyes had PCL. For all DRSS levels, VLD, PD, and FD were not significantly different between eyes with PPL and PCL. The FAZ in eyes with PPL, however, was found to be more circular in shape compared to eyes with PCL (p = 0.037). Although the presence of PPL has been associated with a higher risk for diabetic retinopathy progression, the macular perfusion is similar in eyes with PPL and PCL. The FAZ is more circular in eyes with PPL, but the clinical relevance of this difference remains to be defined.

Sections du résumé

BACKGROUND/OBJECTIVES OBJECTIVE
To assess the relationship between macular vessel density metrics and foveal avascular zone (FAZ) characteristics on optical coherence tomography angiography (OCTA) and lesion distribution in eyes with diabetic retinopathy (DR).
SUBJECTS/METHODS METHODS
Patients with DR who underwent both Optos ultrawidefield (UWF) pseudocolor imaging and macular OCTA (Cirrus Angioplex, 6 × 6 mm) were included in this cross-sectional observational study. The distribution of DR lesions was assessed by comparing each of the peripheral ETDRS extended fields (3-7) against their corresponding ETDRS field, hence eyes were defined as either having predominantly peripheral lesions (PPL) or predominantly central lesions (PCL). En face OCTA images from the superficial and deep capillary plexuses (SCP and DCP) were then analysed using Image J software. Perfusion density (PD), vessel length density (VLD), and fractal dimensions (FD) were calculated following binarization and skeletonization of the images.
RESULTS RESULTS
Out of 344 eyes, 116 (33.72%) eyes had PPL and 228 (66.28%) eyes had PCL. For all DRSS levels, VLD, PD, and FD were not significantly different between eyes with PPL and PCL. The FAZ in eyes with PPL, however, was found to be more circular in shape compared to eyes with PCL (p = 0.037).
CONCLUSION CONCLUSIONS
Although the presence of PPL has been associated with a higher risk for diabetic retinopathy progression, the macular perfusion is similar in eyes with PPL and PCL. The FAZ is more circular in eyes with PPL, but the clinical relevance of this difference remains to be defined.

Identifiants

pubmed: 38724702
doi: 10.1038/s41433-024-03105-1
pii: 10.1038/s41433-024-03105-1
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024. The Author(s).

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Auteurs

Navid Manafi (N)

Doheny Eye Institute, Pasadena, CA, USA.
Department of Ophthalmology, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA.

Deniz Oncel (D)

Loyola University, Chicago, Stritch School of Medicine, Chicago, IL, 60153, USA.

Aditya Verma (A)

Doheny Eye Institute, Pasadena, CA, USA.
Department of Ophthalmology and Visual Sciences, University of Louisville, Louisville, KY, USA.

Giulia Corradetti (G)

Doheny Eye Institute, Pasadena, CA, USA.
Department of Ophthalmology, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA.

Shin Kadomoto (S)

Doheny Eye Institute, Pasadena, CA, USA.
Department of Ophthalmology, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA.

Alireza Mahmoudi (A)

Doheny Eye Institute, Pasadena, CA, USA.
Department of Ophthalmology, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA.

Ahmed Roshdy Alagorie (AR)

Doheny Eye Institute, Pasadena, CA, USA.
Department of Ophthalmology, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA.
Department of Ophthalmology, Faculty of Medicine, Tanta University, Tanta, Egypt.

Naresh Kumar Yadav (NK)

Smt. Kanuri Santhamma Centre for Vitreo-Retinal Diseases, L. V. Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, 500034, India.

Rajeev R Pappuru (RR)

Smt. Kanuri Santhamma Centre for Vitreo-Retinal Diseases, L. V. Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, 500034, India.

Adnan Tufail (A)

Moorfields Eye Hospital NHS Foundation Trust, London, London, UK.

Houri Esmaeilkhanian (H)

Doheny Eye Institute, Pasadena, CA, USA.
Department of Ophthalmology, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA.

Muneeswar G Nittala (MG)

Doheny Eye Institute, Pasadena, CA, USA.
Department of Ophthalmology, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA.

Rajiv Raman (R)

Shri Bhagwan Mahavir Vitreoretinal Services, Medical Research Foundation, Sankara Nethralaya, Chennai, India.

Srinivas Sadda (S)

Doheny Eye Institute, Pasadena, CA, USA. ssadda@doheny.org.
Department of Ophthalmology, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA. ssadda@doheny.org.

Classifications MeSH