Qi Sheng You1, Jie Wang2, Yukun Guo1, Shaohua Pi1, Christina J Flaxel1, Steven T Bailey1, David Huang1, Yali Jia2, Thomas S Hwang3. 1. Casey Eye Institute, Oregon Health and Science University, 515 SW Campus Dr., Portland, Oregon, 97239. 2. Casey Eye Institute, Oregon Health and Science University, 515 SW Campus Dr., Portland, Oregon, 97239; Department of Biomedical Engineering, 3303 SW Bond Ave CH13B, Oregon Health & Science University, Portland, OR, 97239. 3. Casey Eye Institute, Oregon Health and Science University, 515 SW Campus Dr., Portland, Oregon, 97239. Electronic address: hwangt@ohsu.edu.
Abstract
PURPOSE: To assess the association between optical coherence tomography angiography (OCTA) quantified avascular areas (AA) and diabetic retinopathy (DR) severity, progression and treatment requirement in the following year. DESIGN: Prospective cohort study. METHODS: We recruited diabetic patients from tertiary academic retina practice and obtained 3x3-mm macular OCTA scans with AngioVue system and standard 7-field color photographs at baseline and 1-year visit. A masked grader determined the DR severity from the color photographs using the Early Treatment of Diabetic Retinopathy (ETDRS) scale. A custom algorithm detected extrafoveal AA (EAA) excluding the central 1mm circle in projection-resolved superficial vascular complex (SVC), intermediate capillary plexus (ICP), and deep capillary plexus (DCP). RESULTS: Of 138 patients (41 males, age 26-84, mean 59.4 years), 92 completed one-year follow-up. At baseline, EAAs for SVC, ICP and DCP were all significantly correlated with retinopathy severity (p<0.0001). The DCP EAA was significantly associated with worse visual acuity (r=-0.24, P=0.02), but the SVC and ICP EAA were not. At one year, 11 eyes progressed in severity by at least one-step. Multivariate logistic regression analysis demonstrated the progression was significantly associated with baseline SVC EAA (OR=8.73, P=0.04). During the follow up, 33 eyes underwent treatment. Multivariate analysis demonstrated treatment requirement was significantly associated with baseline DCP EAA (OR=3.39, P=0.002). No baseline metric was associated with vision loss at one year. CONCLUSIONS: EAAs detected by OCTA in diabetic eyes are significantly associated with baseline DR severity, disease progression, and treatment requirement over one year.
PURPOSE: To assess the association between optical coherence tomography angiography (OCTA) quantified avascular areas (AA) and diabetic retinopathy (DR) severity, progression and treatment requirement in the following year. DESIGN: Prospective cohort study. METHODS: We recruited diabeticpatients from tertiary academic retina practice and obtained 3x3-mm macular OCTA scans with AngioVue system and standard 7-field color photographs at baseline and 1-year visit. A masked grader determined the DR severity from the color photographs using the Early Treatment of Diabetic Retinopathy (ETDRS) scale. A custom algorithm detected extrafoveal AA (EAA) excluding the central 1mm circle in projection-resolved superficial vascular complex (SVC), intermediate capillary plexus (ICP), and deep capillary plexus (DCP). RESULTS: Of 138 patients (41 males, age 26-84, mean 59.4 years), 92 completed one-year follow-up. At baseline, EAAs for SVC, ICP and DCP were all significantly correlated with retinopathy severity (p<0.0001). The DCP EAA was significantly associated with worse visual acuity (r=-0.24, P=0.02), but the SVC and ICPEAA were not. At one year, 11 eyes progressed in severity by at least one-step. Multivariate logistic regression analysis demonstrated the progression was significantly associated with baseline SVC EAA (OR=8.73, P=0.04). During the follow up, 33 eyes underwent treatment. Multivariate analysis demonstrated treatment requirement was significantly associated with baseline DCP EAA (OR=3.39, P=0.002). No baseline metric was associated with vision loss at one year. CONCLUSIONS: EAAs detected by OCTA in diabetic eyes are significantly associated with baseline DR severity, disease progression, and treatment requirement over one year.
Authors: Inês P Marques; Sophie Kubach; Torcato Santos; Luís Mendes; Maria H Madeira; Luis de Sisternes; Diana Tavares; Ana Rita Santos; Warren Lewis; Conceição Lobo; Mary K Durbin; José Cunha-Vaz Journal: J Clin Med Date: 2021-05-25 Impact factor: 4.241