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Diabetic Macular Ischemia: Influence of Optical Coherence Tomography Angiography Parameters on Changes in Functional Outcomes Over One Year

PURPOSE: To prospectively evaluate whether diabetic macular ischemia detected with coherence tomography angiography (OCTA) is associated with change in functional outcomes over a period of one year. METHODS: This is a one-year prospective, observational study that included 56 eyes with varying level...

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Autores principales: Tsai, Andrew S. H., Jordan-Yu, Janice Marie, Gan, Alfred T. L., Teo, Kelvin Y. C., Tan, Gavin S. W., Lee, Shu Yen, Chong, Victor, Cheung, Chui Ming Gemmy
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Association for Research in Vision and Ophthalmology 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7794267/
https://www.ncbi.nlm.nih.gov/pubmed/33404598
http://dx.doi.org/10.1167/iovs.62.1.9
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author Tsai, Andrew S. H.
Jordan-Yu, Janice Marie
Gan, Alfred T. L.
Teo, Kelvin Y. C.
Tan, Gavin S. W.
Lee, Shu Yen
Chong, Victor
Cheung, Chui Ming Gemmy
author_facet Tsai, Andrew S. H.
Jordan-Yu, Janice Marie
Gan, Alfred T. L.
Teo, Kelvin Y. C.
Tan, Gavin S. W.
Lee, Shu Yen
Chong, Victor
Cheung, Chui Ming Gemmy
author_sort Tsai, Andrew S. H.
collection PubMed
description PURPOSE: To prospectively evaluate whether diabetic macular ischemia detected with coherence tomography angiography (OCTA) is associated with change in functional outcomes over a period of one year. METHODS: This is a one-year prospective, observational study that included 56 eyes with varying levels of diabetic retinopathy. All participants underwent best corrected visual acuity evaluation, swept-source OCTA and microperimetry at baseline and repeated at one year. Parafoveal vessel densities (VD) and foveal avascular zone (FAZ) areas were generated from OCTA in the superficial and deep vascular plexuses. The influence of baseline and change in OCTA parameters on change in visual acuity and retinal sensitivity over one year was evaluated. RESULTS: Over the one-year follow-up period, 16% (9) of eyes had at least one line worsening in BCVA and 7% (4) of eyes had at least 5% decrease in retinal sensitivity compared to baseline. Diabetic retinopathy progressed in 12.5%. Mean superficial vascular plexus (SVP) FAZ area increased (0.32 ± 0.15 to 0.39 ± 0.18 mm(2), P = 0.003) and parafoveal VD in deep vascular plexus (DVP) decreased (49.8 ± 3.7% to 48.8 ± 2.9%, P = 0.040) at one year compared to baseline. In the multivariate regression analysis, larger baseline DVP FAZ area was associated with worsening of BCVA over one year (β = 0.16 logMAR per mm(2), 95% CI 0.02 to 0.31, P = 0.032). In addition, larger decreases in SVP VD (β = −4.18 db per 10% decrease, 95% CI −6.55 to −1.80, P = 0.002) was associated with worsening of retinal sensitivity over one year. CONCLUSIONS: Progression of parafoveal microvasculature changes over one year can be detected using OCTA. Larger baseline DVP FAZ area on OCTA is predictive of worsening in visual outcomes, and larger decreases in SVP VD were associated with worsening of retinal sensitivity over a course of one year in diabetic individuals.
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spelling pubmed-77942672021-01-26 Diabetic Macular Ischemia: Influence of Optical Coherence Tomography Angiography Parameters on Changes in Functional Outcomes Over One Year Tsai, Andrew S. H. Jordan-Yu, Janice Marie Gan, Alfred T. L. Teo, Kelvin Y. C. Tan, Gavin S. W. Lee, Shu Yen Chong, Victor Cheung, Chui Ming Gemmy Invest Ophthalmol Vis Sci Retina PURPOSE: To prospectively evaluate whether diabetic macular ischemia detected with coherence tomography angiography (OCTA) is associated with change in functional outcomes over a period of one year. METHODS: This is a one-year prospective, observational study that included 56 eyes with varying levels of diabetic retinopathy. All participants underwent best corrected visual acuity evaluation, swept-source OCTA and microperimetry at baseline and repeated at one year. Parafoveal vessel densities (VD) and foveal avascular zone (FAZ) areas were generated from OCTA in the superficial and deep vascular plexuses. The influence of baseline and change in OCTA parameters on change in visual acuity and retinal sensitivity over one year was evaluated. RESULTS: Over the one-year follow-up period, 16% (9) of eyes had at least one line worsening in BCVA and 7% (4) of eyes had at least 5% decrease in retinal sensitivity compared to baseline. Diabetic retinopathy progressed in 12.5%. Mean superficial vascular plexus (SVP) FAZ area increased (0.32 ± 0.15 to 0.39 ± 0.18 mm(2), P = 0.003) and parafoveal VD in deep vascular plexus (DVP) decreased (49.8 ± 3.7% to 48.8 ± 2.9%, P = 0.040) at one year compared to baseline. In the multivariate regression analysis, larger baseline DVP FAZ area was associated with worsening of BCVA over one year (β = 0.16 logMAR per mm(2), 95% CI 0.02 to 0.31, P = 0.032). In addition, larger decreases in SVP VD (β = −4.18 db per 10% decrease, 95% CI −6.55 to −1.80, P = 0.002) was associated with worsening of retinal sensitivity over one year. CONCLUSIONS: Progression of parafoveal microvasculature changes over one year can be detected using OCTA. Larger baseline DVP FAZ area on OCTA is predictive of worsening in visual outcomes, and larger decreases in SVP VD were associated with worsening of retinal sensitivity over a course of one year in diabetic individuals. The Association for Research in Vision and Ophthalmology 2021-01-06 /pmc/articles/PMC7794267/ /pubmed/33404598 http://dx.doi.org/10.1167/iovs.62.1.9 Text en Copyright 2021 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
spellingShingle Retina
Tsai, Andrew S. H.
Jordan-Yu, Janice Marie
Gan, Alfred T. L.
Teo, Kelvin Y. C.
Tan, Gavin S. W.
Lee, Shu Yen
Chong, Victor
Cheung, Chui Ming Gemmy
Diabetic Macular Ischemia: Influence of Optical Coherence Tomography Angiography Parameters on Changes in Functional Outcomes Over One Year
title Diabetic Macular Ischemia: Influence of Optical Coherence Tomography Angiography Parameters on Changes in Functional Outcomes Over One Year
title_full Diabetic Macular Ischemia: Influence of Optical Coherence Tomography Angiography Parameters on Changes in Functional Outcomes Over One Year
title_fullStr Diabetic Macular Ischemia: Influence of Optical Coherence Tomography Angiography Parameters on Changes in Functional Outcomes Over One Year
title_full_unstemmed Diabetic Macular Ischemia: Influence of Optical Coherence Tomography Angiography Parameters on Changes in Functional Outcomes Over One Year
title_short Diabetic Macular Ischemia: Influence of Optical Coherence Tomography Angiography Parameters on Changes in Functional Outcomes Over One Year
title_sort diabetic macular ischemia: influence of optical coherence tomography angiography parameters on changes in functional outcomes over one year
topic Retina
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7794267/
https://www.ncbi.nlm.nih.gov/pubmed/33404598
http://dx.doi.org/10.1167/iovs.62.1.9
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