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Retinal Nonperfusion Relationship to Arteries or Veins Observed on Widefield Optical Coherence Tomography Angiography in Diabetic Retinopathy

Author(s)
Ishibazawa, Akihiro; De Pretto, Lucas R.; Alibhai, A. Yasin; Moult, Eric M.; Arya, Malvika; Sorour, Osama; Mehta, Nihaal; Baumal, Caroline R.; Witkin, Andre J.; Yoshida, Akitoshi; Duker, Jay S.; Fujimoto, James G.; Waheed, Nadia K.; ... Show more Show less
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Abstract
Copyright 2019 The Authors PURPOSE. To evaluate whether retinal capillary nonperfusion is found predominantly adjacent to arteries or veins in eyes with diabetic retinopathy (DR). METHODS. Sixty-three eyes from 44 patients with proliferative DR (PDR) or non-PDR (NPDR) were included. Images (12 3 12-mm) foveal-centered optical coherence tomography (OCT) angiography (OCTA) images were taken using the Zeiss Plex Elite 9000. In 37 eyes, widefield montages with five fixation points were also obtained. A semiautomatic algorithm that detects nonperfusion in full-retina OCT slabs was developed, and the percentages of capillary nonperfusion within the total image area were calculated. Retinal arteries and veins were manually traced. Based on the shortest distance, nonperfusion pixels were labeled as either arterial-side or venous-side. Arterial-adjacent and venous-adjacent nonperfusion and the A/V ratio (arterial-adjacent nonperfusion divided by venous-adjacent nonperfusion) were quantified. RESULTS. Twenty-two eyes with moderate NPDR, 16 eyes with severe NPDR, and 25 eyes with PDR were scanned. Total nonperfusion area in PDR (median: 8.93%) was greater than in moderate NPDR (3.49%, P < 0.01). Arterial-adjacent nonperfusion was greater than venous-adjacent nonperfusion for all stages of DR (P < 0.001). The median A/V ratios were 1.93 in moderate NPDR, 1.84 in severe NPDR, and 1.78 in PDR. The A/V ratio was negatively correlated with the total nonperfusion area (r ¼ -0.600, P < 0.0001). The results from the widefield montages showed similar patterns. CONCLUSIONS. OCTA images with arteries and veins traced allowed us to estimate the nonperfusion distribution. In DR, smaller nonperfusion tends to be arterial-adjacent, while larger nonperfusion tends toward veins.
Date issued
2019-10
URI
https://hdl.handle.net/1721.1/128962
Department
Massachusetts Institute of Technology. Department of Electrical Engineering and Computer Science; Massachusetts Institute of Technology. Research Laboratory of Electronics
Journal
Investigative Ophthalmology and Visual Science
Publisher
Association for Research in Vision and Ophthalmology (ARVO)
Citation
Ishibazawa, Akihiro et al. "Retinal Nonperfusion Relationship to Arteries or Veins Observed on Widefield Optical Coherence Tomography Angiography in Diabetic Retinopathy." Investigative Ophthalmology and Visual Science 60, 13 (October 2019): 4310-4318 © 2019 The Authors
Version: Final published version
ISSN
1552-5783

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