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. 2020 Apr 23:14:1107-1115.
doi: 10.2147/OPTH.S248881. eCollection 2020.

Correlations Between Optical Coherence Tomography Angiography Parameters and the Visual Acuity in Patients with Diabetic Retinopathy

Marwa Abdelshafy  1 , Ahmed Abdelshafy  1
Affiliations

Correlations Between Optical Coherence Tomography Angiography Parameters and the Visual Acuity in Patients with Diabetic Retinopathy

Marwa Abdelshafy et al. Clin Ophthalmol. .

Abstract

Aim: The aim of this study was to assess the correlation between different optical coherence tomography angiography (OCTA) parameters and the best corrected visual acuity (BCVA) in patients with diabetic retinopathy (DR).

Patients and methods: Sixty eyes of 60 participants were included in this prospective study: 40 diabetic patients [20 with non-proliferative diabetic retinopathy (NPDR group), 20 with proliferative diabetic retinopathy (PDR group)] and 20 age- and gender-matched normal healthy subjects (control group). After full ophthalmological examination and fundus fluorescein angiography, OCTA was performed for all participants. Quantitative OCTA parameters, such as the foveal avascular zone (FAZ) area, the superficial capillary plexus vessel density (%) (SCP-VD) and the deep capillary plexus vessel density (%) (DCP-VD) in, whole and parafoveal areas were measured. Correlations between BCVA and OCTA parameters were analyzed.

Results: There were no statistically significant differences between groups regarding age, gender, refraction, macular thickness or intraocular pressure. The median (IQR) FAZ area was 0.42 (0.39-0.46) mm2 in the NPDR group, 0.54 (0.45-0.65) mm2 in the PDR group and 0.24 (0.21-0.26) mm2 in the control group (P<0.001). The FAZ area increased with increasing severity of DR. SCP-VD and DCP-VD showed significant differences between groups (P<0.001). Vessel density (VD) was decreased in both DCP and SCP as DR progressed. There was a significant positive correlation between BCVA (LogMAR) and FAZ area. There were significant negative correlations between BCVA (LogMAR) and VD in both SCP and DCP. Stepwise multiple linear regression analysis demonstrated that SCP-VD in the whole area and DCP-VD in the parafoveal area were the best predictive factors for BCVA in the NPDR and PDR groups.

Conclusion: With progression of DR, the VD decreased and the FAZ area increased, and both parameters were correlated with poor visual acuity. OCTA is a non-invasive tool which can be used to detect diabetic macular ischemia and help in the prediction of visual prognosis.

Keywords: OCT angiography; diabetic retinopathy; foveal avascular zone; vessel density; visual acuity.

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Conflict of interest statement

The authors report no funding and no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Box plot showing median and IQR of BCVA (LogMAR) and FAZ area among the studied groups.
Figure 2
Figure 2
Foveal avascular zone (FAZ) area: (A) in a healthy subject (B) in a patient with NPDR, and (C) in a patient with PDR. There was widening of the FAZ area as DR progressed.
Figure 3
Figure 3
Box plot showing median and IQR of vessel density in superficial capillary plexus (SCP) and deep capillary plexus (DCP) among the studied groups.
Figure 4
Figure 4
OCTA images (6×6 mm) from SCP and DCP: corresponding color-coded vessel density (VD) mapping with quantitative data. The VD is reduced in eyes with DR in comparison to controls with areas of capillary non-perfusion outside the FAZ. (A) SCP-VD in a healthy subject, (B) SCP-VD in a patient with NPDR, (C) SCP-VD in a patient with PDR, (D) DCP-VD in a healthy subject, (E) DCP-VD in a patient with NPDR, and (F) DCP-VD in a patient with PDR.
See this image and copyright information in PMC

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