Disproportion of lamellar capillary non-perfusion in proliferative diabetic retinopathy on optical coherence tomography angiography. Issue 6 (13th September 2019)

• Record Type: Journal Article
• Authors: Uchitomi, Daiki; Murakami, Tomoaki; Dodo, Yoko; Yasukura, Shota; Morino, Kazuya; Uji, Akihito; Yoshitake, Tatsuya; Fujimoto, Masahiro; Tsujikawa, Akitaka
• Is Part Of: British journal of ophthalmology. Volume 104:Issue 6(2020)
• Page Start: 857
• Page End: 862
• Publication Date: 2019-09-13
• Subjects: imaging -- macula -- retina; Ophthalmology -- Periodicals; 617.7
• DOI: 10.1136/bjophthalmol-2019-314743
• Languages: English
• ISSNs: 0007-1161

Abstract

Abstract : Purpose: To characterise the non-perfused areas (NPAs) in the superficial and deep capillary layers (sNPAs and dNPAs, respectively) in the posterior pole in proliferative diabetic retinopathy (PDR) on wide-field optical coherence tomography angiography (OCTA) images. Methods: We retrospectively reviewed 104 eyes of 70 patients with PDR from whom wide-field swept source OCTA images were acquired. sNPAs and dNPAs were manually measured in each quadrant of the inner (1–3 mm diameter), intermediate (3–6 mm), and outer (6–10 mm) rings centred on the fovea. Two qualitative findings, that is, segmented NPAs and periarteriolar NPAs, were also compared. Results: The dNPAs were greater than the sNPAs (p<0.001) in each subfield. The outer ring had higher rates of deep NPAs than did the intermediate ring in the superior, inferior and temporal quadrants (p=0.010, p=0.004 and p<0.001, respectively), whereas no differences were detected in the nasal quadrant (p=1.000). Similarly, sNPA rates were higher in the outer ring than in the intermediate ring in the inferior and temporal subfields (p=0.003 and p<0.001, respectively). In 45 eyes with extensive NPAs, there were modest correlations between the dNPAs in the nasal and temporal quadrants in the intermediate ( ρ =0.341, p=0.026) and outer ( ρ =0324, p=0.032) rings, whereas sNPAs exhibited no associations. Segmented NPAs were delineated more frequently in the superficial layer than in the deep layer (p<0.001). Periarteriolar NPAs were more frequent in the deep layer (p<0.001). Conclusions: Three-dimensional assessment of wide-field OCTA promotes a better understanding of the enigmatic disproportion of lamellar NPAs in the posterior pole in PDR.