Visualization of changes in the foveal avascular zone in both observed and treated diabetic macular edema using optical coherence tomography angiography
Abstract Background Central vision loss in diabetic retinopathy is commonly related to diabetic macular edema (DME). The objective of this study was to describe changes between consecutive visits on optical coherence tomography angiography (OCTA) of the foveal avascular zone (FAZ) in eyes with DME....
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2017-06-01
|
| Series: | International Journal of Retina and Vitreous |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s40942-017-0074-y |
| _version_ | 1828963867991998464 |
|---|---|
| author | Aditya Gill Emily D. Cole Eduardo A. Novais Ricardo N. Louzada Talisa de Carlo Jay S. Duker Nadia K. Waheed Caroline R. Baumal Andre J. Witkin |
| author_facet | Aditya Gill Emily D. Cole Eduardo A. Novais Ricardo N. Louzada Talisa de Carlo Jay S. Duker Nadia K. Waheed Caroline R. Baumal Andre J. Witkin |
| author_sort | Aditya Gill |
| collection | DOAJ |
| description | Abstract Background Central vision loss in diabetic retinopathy is commonly related to diabetic macular edema (DME). The objective of this study was to describe changes between consecutive visits on optical coherence tomography angiography (OCTA) of the foveal avascular zone (FAZ) in eyes with DME. Methods 20 eyes from 14 patients with DME were imaged on 2 successive clinic visits separated by at least 1 month. The mean interval between visits was 3.2 months. The only intervention used was intravitreal anti-VEGF in 11 eyes; the others were observed over time without treatment. Two different readers measured FAZ area using a pseudo-automated tool in comparison to a manual tracing tool. Qualitative changes in the appearance of the vasculature surrounding the FAZ were also recorded. The retinal capillary plexus was segmented into deep and superficial plexuses, and FAZ measurements were done on the superficial, deep, and summated plexuses. Results Pseudo-automated and manual measurements of FAZ area decreased significantly (p < 0.05) between visits in the deep, superficial, and summated plexuses. Qualitative analysis of vasculature surrounding the FAZ showed that most of the vascular changes (65%) over time were visible in the deep plexus, compared to 30 and 20% in the superficial and summated plexuses, respectively. Conclusions The most significant differences in FAZ size over time were in the summated plexus (p < 0.001), while changes in FAZ appearance were most prominent in the deep plexus. Absolute decrease in FAZ size over visits was largest in the deep plexus. Our results demonstrate that OCTA can effectively be used to measure FAZ area in patients with DME, visualize qualitative changes in retinal vasculature, and visualize the segmentation levels at which these changes can be best appreciated. However, larger studies are needed to evaluate the reproducibility of manual and pseudo-automated measuring techniques. |
| first_indexed | 2024-12-14T10:37:57Z |
| format | Article |
| id | doaj.art-c10086bb1f73476eafdd6ae6d7c65aeb |
| institution | Directory Open Access Journal |
| issn | 2056-9920 |
| language | English |
| last_indexed | 2024-12-14T10:37:57Z |
| publishDate | 2017-06-01 |
| publisher | BMC |
| record_format | Article |
| series | International Journal of Retina and Vitreous |
| spelling | doaj.art-c10086bb1f73476eafdd6ae6d7c65aeb2022-12-21T23:05:50ZengBMCInternational Journal of Retina and Vitreous2056-99202017-06-013111110.1186/s40942-017-0074-yVisualization of changes in the foveal avascular zone in both observed and treated diabetic macular edema using optical coherence tomography angiographyAditya Gill0Emily D. Cole1Eduardo A. Novais2Ricardo N. Louzada3Talisa de Carlo4Jay S. Duker5Nadia K. Waheed6Caroline R. Baumal7Andre J. Witkin8New England Eye Center, Tufts Medical Center, Tufts UniversityNew England Eye Center, Tufts Medical Center, Tufts UniversityNew England Eye Center, Tufts Medical Center, Tufts UniversityNew England Eye Center, Tufts Medical Center, Tufts UniversityNew England Eye Center, Tufts Medical Center, Tufts UniversityNew England Eye Center, Tufts Medical Center, Tufts UniversityNew England Eye Center, Tufts Medical Center, Tufts UniversityNew England Eye Center, Tufts Medical Center, Tufts UniversityNew England Eye Center, Tufts Medical Center, Tufts UniversityAbstract Background Central vision loss in diabetic retinopathy is commonly related to diabetic macular edema (DME). The objective of this study was to describe changes between consecutive visits on optical coherence tomography angiography (OCTA) of the foveal avascular zone (FAZ) in eyes with DME. Methods 20 eyes from 14 patients with DME were imaged on 2 successive clinic visits separated by at least 1 month. The mean interval between visits was 3.2 months. The only intervention used was intravitreal anti-VEGF in 11 eyes; the others were observed over time without treatment. Two different readers measured FAZ area using a pseudo-automated tool in comparison to a manual tracing tool. Qualitative changes in the appearance of the vasculature surrounding the FAZ were also recorded. The retinal capillary plexus was segmented into deep and superficial plexuses, and FAZ measurements were done on the superficial, deep, and summated plexuses. Results Pseudo-automated and manual measurements of FAZ area decreased significantly (p < 0.05) between visits in the deep, superficial, and summated plexuses. Qualitative analysis of vasculature surrounding the FAZ showed that most of the vascular changes (65%) over time were visible in the deep plexus, compared to 30 and 20% in the superficial and summated plexuses, respectively. Conclusions The most significant differences in FAZ size over time were in the summated plexus (p < 0.001), while changes in FAZ appearance were most prominent in the deep plexus. Absolute decrease in FAZ size over visits was largest in the deep plexus. Our results demonstrate that OCTA can effectively be used to measure FAZ area in patients with DME, visualize qualitative changes in retinal vasculature, and visualize the segmentation levels at which these changes can be best appreciated. However, larger studies are needed to evaluate the reproducibility of manual and pseudo-automated measuring techniques.http://link.springer.com/article/10.1186/s40942-017-0074-yDiabetic macular edema (DME)Foveal avascular zone (FAZ)Optical coherence tomography (OCT)Optical coherence tomography angiography (OCTA) |
| spellingShingle | Aditya Gill Emily D. Cole Eduardo A. Novais Ricardo N. Louzada Talisa de Carlo Jay S. Duker Nadia K. Waheed Caroline R. Baumal Andre J. Witkin Visualization of changes in the foveal avascular zone in both observed and treated diabetic macular edema using optical coherence tomography angiography International Journal of Retina and Vitreous Diabetic macular edema (DME) Foveal avascular zone (FAZ) Optical coherence tomography (OCT) Optical coherence tomography angiography (OCTA) |
| title | Visualization of changes in the foveal avascular zone in both observed and treated diabetic macular edema using optical coherence tomography angiography |
| title_full | Visualization of changes in the foveal avascular zone in both observed and treated diabetic macular edema using optical coherence tomography angiography |
| title_fullStr | Visualization of changes in the foveal avascular zone in both observed and treated diabetic macular edema using optical coherence tomography angiography |
| title_full_unstemmed | Visualization of changes in the foveal avascular zone in both observed and treated diabetic macular edema using optical coherence tomography angiography |
| title_short | Visualization of changes in the foveal avascular zone in both observed and treated diabetic macular edema using optical coherence tomography angiography |
| title_sort | visualization of changes in the foveal avascular zone in both observed and treated diabetic macular edema using optical coherence tomography angiography |
| topic | Diabetic macular edema (DME) Foveal avascular zone (FAZ) Optical coherence tomography (OCT) Optical coherence tomography angiography (OCTA) |
| url | http://link.springer.com/article/10.1186/s40942-017-0074-y |
| work_keys_str_mv | AT adityagill visualizationofchangesinthefovealavascularzoneinbothobservedandtreateddiabeticmacularedemausingopticalcoherencetomographyangiography AT emilydcole visualizationofchangesinthefovealavascularzoneinbothobservedandtreateddiabeticmacularedemausingopticalcoherencetomographyangiography AT eduardoanovais visualizationofchangesinthefovealavascularzoneinbothobservedandtreateddiabeticmacularedemausingopticalcoherencetomographyangiography AT ricardonlouzada visualizationofchangesinthefovealavascularzoneinbothobservedandtreateddiabeticmacularedemausingopticalcoherencetomographyangiography AT talisadecarlo visualizationofchangesinthefovealavascularzoneinbothobservedandtreateddiabeticmacularedemausingopticalcoherencetomographyangiography AT jaysduker visualizationofchangesinthefovealavascularzoneinbothobservedandtreateddiabeticmacularedemausingopticalcoherencetomographyangiography AT nadiakwaheed visualizationofchangesinthefovealavascularzoneinbothobservedandtreateddiabeticmacularedemausingopticalcoherencetomographyangiography AT carolinerbaumal visualizationofchangesinthefovealavascularzoneinbothobservedandtreateddiabeticmacularedemausingopticalcoherencetomographyangiography AT andrejwitkin visualizationofchangesinthefovealavascularzoneinbothobservedandtreateddiabeticmacularedemausingopticalcoherencetomographyangiography |