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. 2022 Jan 21;11(3):532.
doi: 10.3390/jcm11030532.

Reduced Vessel Density in the Mid-Periphery and Peripapillary Area of the Superficial Capillary Plexus in Non-Proliferative Diabetic Retinopathy

Amira Chaher  1 , Franck Fajnkuchen  1   2 , Sandrine Tabary  2 , Audrey Giocanti-Aurégan  1
Affiliations

Reduced Vessel Density in the Mid-Periphery and Peripapillary Area of the Superficial Capillary Plexus in Non-Proliferative Diabetic Retinopathy

Amira Chaher et al. J Clin Med. .

Abstract

Our aim in this study was to assess the vessel density (VD) and vessel skeleton density (VSD) in the nasal area of the superficial capillary plexus (SCP) of diabetic subjects without diabetic retinopathy (DR), or in those with a non-proliferative diabetic retinopathy (NPDR), and to evaluate the relationship between the VD and VSD and the severity of DR. In this prospective study, the VD and VSD in the SCP were measured and analyzed on 6 × 6-mm macular and nasal optical coherence tomography angiography scans. The three concentric circles of the Early Treatment of Diabetic Retinopathy Study (ETDRS) grid were used and divided into zones numbered from 1 to 9 in the macular area and from 1 to 8 in the nasal area. The VD was significantly lower in the nasal peripapillary area (p = 0.0028), and both the VD and VSD were significantly lower in the macular area (p = 0.0131 and p = 0.0132, respectively) in patients with more severe DR. The SD was significantly lower in zones 5 (p = 0.0315) and 6 (p = 0.0324) in the nasal grid in patients with more severe DR. We showed a lower superficial capillary flow in the nasal periphery and peripapillary area in patients with more severe DR.

Keywords: diabetic retinopathy; optical coherence tomography angiography; retinal non-perfusion; skeleton density; vessel density.

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Conflict of interest statement

The authors declare no conflict of interest regarding this manuscript.

Figures

Figure 1
Figure 1
Example of a right eye. The 9 areas of the ETDRS (Early Treatment of Diabetic Retinopathy Study) grid were numbered so that area 8 was the most adjacent and area 9 was the most temporal to the optic nerve head.
Figure 2
Figure 2
Example of a left eye. The ETDRS (Early Treatment of Diabetic Retinopathy Study) grid was placed nasally using the optic nerve head as a marker. Zone 4 was the most adjacent to the optic nerve head.
Figure 3
Figure 3
Flow chart of the study.
Figure 4
Figure 4
Mean vessel density with standard deviation for each group (without DR, mild and moderate NPDR, and severe NPDR) in zone 4. ** p < 0.01. DR, diabetic retinopathy; MM NPDR, mild and moderate non-proliferative diabetic retinopathy; S NPDR, severe non-proliferative diabetic retinopathy.
Figure 5
Figure 5
Mean vessel skeleton density with standard deviation for each group (without DR, mild and moderate NPDR, and severe NPDR) in zone 5. * p < 0.05. DR, diabetic retinopathy; MM NPDR, mild and moderate non-proliferative diabetic retinopathy; S NPDR, severe non-proliferative diabetic retinopathy.
Figure 6
Figure 6
Mean vessel skeleton density with standard deviation for each group (without DR, mild and moderate NPDR, and severe NPDR) in zone 6. * p < 0.05. DR, diabetic retinopathy; MM NPDR, mild and moderate non-proliferative diabetic retinopathy; S NPDR, severe non-proliferative diabetic retinopathy.
Figure 7
Figure 7
OCT-A C-scans of the superficial capillary plexus (SCP). From left to right: examples of a patient without DR, a patient with mild NPDR and a patient with severe NPDR. The vessel density in the SCP progressively decreases with DR severity, especially in the most peripheral area. DR, diabetic retinopathy; NPDR, non-proliferative diabetic retinopathy.
Figure 8
Figure 8
OCTA C-scan montage of the superficial capillary plexus (SCP) in a subject with severe non-proliferative diabetic retinopathy. The scale under the image indicates the distance to the fovea in millimeters. The capillary rarefaction predominated at a distance of about 8 mm from the fovea corresponding to zones 6, 7 and 8.
See this image and copyright information in PMC

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