Jay C Wang1, Inês Laíns2, Joana Providência3, Grayson W Armstrong1, Ana R Santos4, Pedro Gil3, João Gil3, Katherine E Talcott5, João H Marques6, João Figueira7, Demetrios G Vavvas5, Ivana K Kim5, Joan W Miller5, Deeba Husain5, Rufino Silva7, John B Miller8. 1. Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts. 2. Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts; Retina Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts; Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Coimbra University Hospital, Coimbra, Portugal; Association for Innovation and Biomedical Research on Light, Coimbra, Portugal. 3. Coimbra University Hospital, Coimbra, Portugal; Association for Innovation and Biomedical Research on Light, Coimbra, Portugal. 4. Association for Innovation and Biomedical Research on Light, Coimbra, Portugal; School of Allied Health Technologies, Polytechnic Institute of Porto, Porto, Portugal. 5. Retina Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts. 6. Faculty of Medicine, University of Coimbra, Coimbra, Portugal. 7. Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Coimbra University Hospital, Coimbra, Portugal; Association for Innovation and Biomedical Research on Light, Coimbra, Portugal. 8. Retina Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts. Electronic address: john_miller@meei.harvard.edu.
Abstract
PURPOSE: To compare choroidal vascular density (CVD) and volume (CVV) in diabetic eyes and controls, using en face swept-source optical coherence tomography (SS-OCT). DESIGN: Prospective cross-sectional study. METHODS: Setting: Multicenter. PATIENT POPULATION: Total of 143 diabetic eyes-27 with no diabetic retinopathy (DR), 47 with nonproliferative DR (NPDR), 51 with NPDR and diabetic macular edema (DME), and 18 with proliferative DR (PDR)-and 64 age-matched nondiabetic control eyes. OBSERVATION PROCEDURES: Complete ophthalmologic examination and SS-OCT imaging. En face SS-OCT images of the choroidal vasculature were binarized. MAIN OUTCOME MEASURES: CVD, calculated as the percent area occupied by choroidal vessels in the central macular region (6-mm-diameter circle centered on the fovea), and throughout the posterior pole (12 × 9 mm). The central macular CVV was calculated by multiplying the average CVD by macular area and choroidal thickness (obtained with SS-OCT automated software). Multilevel mixed linear models were performed for analyses. RESULTS: Compared to controls (0.31 ± 0.07), central macular CVD was significantly decreased by 9% in eyes with NPDR + DME (0.28 ± 0.06; ß = -0.03, P = .02) and by 15% in PDR (0.26 ± 0.05; ß = -0.04, P = .01). The central macular CVV was significantly decreased by 19% in eyes with PDR (0.020 ± 0.005 mm3, ß = -0.01, P = .01) compared to controls (0.025 ± 0.01 mm3). CONCLUSIONS: Choroidal vascular density and volume are significantly reduced in more advanced stages of diabetic retinopathy. New imaging modalities should allow further exploration of the contributions of choroidal vessel disease to diabetic eye disease pathogenesis, prognosis, and treatment response.
PURPOSE: To compare choroidal vascular density (CVD) and volume (CVV) in diabetic eyes and controls, using en face swept-source optical coherence tomography (SS-OCT). DESIGN: Prospective cross-sectional study. METHODS: Setting: Multicenter. PATIENT POPULATION: Total of 143 diabetic eyes-27 with no diabetic retinopathy (DR), 47 with nonproliferative DR (NPDR), 51 with NPDR and diabetic macular edema (DME), and 18 with proliferative DR (PDR)-and 64 age-matched nondiabetic control eyes. OBSERVATION PROCEDURES: Complete ophthalmologic examination and SS-OCT imaging. En face SS-OCT images of the choroidal vasculature were binarized. MAIN OUTCOME MEASURES: CVD, calculated as the percent area occupied by choroidal vessels in the central macular region (6-mm-diameter circle centered on the fovea), and throughout the posterior pole (12 × 9 mm). The central macular CVV was calculated by multiplying the average CVD by macular area and choroidal thickness (obtained with SS-OCT automated software). Multilevel mixed linear models were performed for analyses. RESULTS: Compared to controls (0.31 ± 0.07), central macular CVD was significantly decreased by 9% in eyes with NPDR + DME (0.28 ± 0.06; ß = -0.03, P = .02) and by 15% in PDR (0.26 ± 0.05; ß = -0.04, P = .01). The central macular CVV was significantly decreased by 19% in eyes with PDR (0.020 ± 0.005 mm3, ß = -0.01, P = .01) compared to controls (0.025 ± 0.01 mm3). CONCLUSIONS: Choroidal vascular density and volume are significantly reduced in more advanced stages of diabetic retinopathy. New imaging modalities should allow further exploration of the contributions of choroidal vessel disease to diabetic eye disease pathogenesis, prognosis, and treatment response.
Authors: Hao Zhou; Yining Dai; Yingying Shi; Jonathan F Russell; Cancan Lyu; Jila Noorikolouri; William J Feuer; Zhongdi Chu; Qinqin Zhang; Luis de Sisternes; Mary K Durbin; Giovanni Gregori; Philip J Rosenfeld; Ruikang K Wang Journal: Ophthalmol Retina Date: 2019-10-01
Authors: Jonathan F Russell; Yingying Shi; John W Hinkle; Nathan L Scott; Kenneth C Fan; Cancan Lyu; Giovanni Gregori; Philip J Rosenfeld Journal: Ophthalmol Retina Date: 2018-11-24