J.ophthalmol.(Ukraine).2019;2:7-13.
http://doi.org/10.31288/oftalmolzh20192713
Received: !2 November 2019; Published-online: 23 April 2019
Assessing OCTA changes in morphology and structure of retinal microvascular bed in patients with exudative AMD
N.S. Lutsenko, Dr Sc (Med), Prof.; O.A. Rudycheva, Cand Sc (Med); O.A. Isakova, Cand Sc (Med); T.S. Kyrylova, Resident
Zaporizhzhia Medical Academy of Post-Graduate Education; Zaporizhzhia (Ukraine)
E-mail: tetianakyrylova@gmail.com
TO CITE THIS ARTICLE: Lutsenko NS, Rudycheva OA, Isakova OA, Kyrylova TS. Assessing OCTA changes in morphology and structure of retinal microvascular bed in patients with exudative AMD. J.ophthalmol.(Ukraine).2019;2:7-13. http://doi.org/10.31288/oftalmolzh20192713
Background: Optical coherence tomography angiography (OCTA) enables measuring characteristics of the retinal microvascular bed such as vascular plexus density and foveal avascular zone (FAZ) area.
Purpose: To assess the OCTA changes in morphology and structural characteristics of the retinal microvascular bed in patients with exudative age-related macular degeneration (AMD).
Materials and Methods: Forty seven patients with exudative AMD (51 eyes) and 13 healthy controls (22 eyes) were included in the study. OCTA was used to measure superficial plexus FAZ area (SPFA), deep plexus FAZ area (DPFA), vessel density and retinal thickness. Patients were divided into three groups based on the ratio of SPFA to DPFA: Group 1 (SPFA/DPFA < 0.6; 15 eyes), Group 2 (0.6 ≤ SPFA/DPFA < 0.8; 17 eyes), and Group 3 (SPFA/DPFA ≥ 0.8; 19 eyes).
Results: Deep plexus FAZ area in all groups of patients was increased and superficial plexus FAZ area in Group 3 was significantly increased compared to controls. Patients in Group 1 exhibited mostly apparent signs of retinal edema and minimal alterations in the retinal microvascular bed. Patients in Group 2 had greater retinal thickness, but moderately lower plexus vessel density compared to controls. Patients in Group 3 had substantially lower superficial plexus vessel density and insubstantially altered retinal thickness compared to controls.
Conclusion: OCTA enables assessing the changes in morphology and structure of the retinal microvascular bed, measuring FAZ area and vessel density in patients with exudative AMD.
Keywords: optical coherence tomography angiography, age-related macular degeneration, foveal avascular zone, vessel density
References
1.Wong WL, Su X, Li X, Cheung CM, Klein R, Cheng CY, Wong TY. Global prevalence of age-related macular degeneration and disease burden projection for 2020 and 2040: a systematic review and meta-analysis. Lancet Global Health. 2014 Feb;2(2):e106-16.
2.Sulzbacher F, Kiss C, Munk M, Deak G, Sacu S, Schmidt-Erfurth U. Diagnostic evaluation of type 2 (classic) choroidal neovascularization: optical coherence tomography, indocyanine green angiography, an fluorescein angiography. Am J Ophthalmol. 2011 Nov;152(5):799-806.e1.
3.Lumbroso B, Huang D, Jia Y, Fujimoto JG, Rispoli M. Clinical guide to Angio-OCT: non invasive, dyeless OCT angiography. 1st ed. New Delhi: Jaypee Brothers Medical Publisher (P) Ltd; 2015.
4.Jia Y, Tan O, Tokayer J, Potsaid B, Wang Y, Liu JJ, Kraus MF, Subhash H, Fujimoto JG, Hornegger J, Huang D. Split-spectrum amplitude-decorrelation angiography with optical coherence tomography. Opt Express. 2012 Feb 13;20(4):4710-25.
5.Jia Y, Bailey ST, Wilson DJ, Tan O, Klein ML, Flaxel CJ, Potsaid B, Liu JJ, Lu CD, Kraus MF, Fujimoto JG, Huang D. Quantitative optical coherenсе tomography angiography of choroidal neovascularization in age-related macular degeneration. Ophthalmology. 2014 Jul;121(7):1435-44.
6.Jia Y, Bailey ST, Hwang TS, McClintic SM, Gao SS, Pennesi ME, Flaxel CJ, Lauer AK, Wilson DJ, Hornegger J, Fujimoto JG, Huang D. Quantitative optical coherence tomography angiography of vascular abnormalities in the living human eye. Proc Natl Acad Sci USA. 2015 May 5;112(18):E2395-402.
7.Savastano MC, Lumbroso B, Rispoli M. In vivo characterization of retinal vascularization morphology using optical coherence tomography angiography. Retina. 2015 Nov;35(11):2196-203.
8.Tultseva SN, Astakhov YS, Rukhovets AG, Titarenko AI. [Informative value of OCT-angiography in combination with regional hemodynamic studies in retinal vein occlusion]. Oftalmologicheskie Vedomosti. 2017;10(2):40-48. Russian.
9.Nesper PL, Roberts PK, Onishi AC, Chai H, Liu L, Jampol LM, Fawzi AA. Quantifying microvascular abnormalities with increasing severity of diabetic retinopathy using optical coherence tomography angiography. Invest Ophthalmol Vis Sci. 2017 May 1;58(6):BIO307-BIO315.
10.Samara WA, Say EAT, Khoo CTL, Higgins TP, Magrath G, Ferenczy S, Shields CL. Correlation of foveal avascular zone size with foveal morphology in normal eyes using optical coherence tomography angiography. Retina. 2015 Nov;35(11):2188-95.
11.Carpineto P, Mastropasqua R, Marchini G, Toto L, Di Nicola M, Di Antonio L. Reproducibility and repeatability of foveal avascular zone measurements in healthy subjects by optical coherence tomography angiography. Br J Ophthalmol. 016 May;100(5):671-6.
12.Balaratnasingam C, Inoue M, Ahn S, McCann J, Dhrami-Gavazi E, Yannuzzi LA, Freund KB. Visual acuity is correlated with the area of the foveal avascular zone in diabetic retinopathy and retinal vein occlusion. Ophthalmology. 2016 Nov;123(11):2352-2367.
13.Al-Sheikh M, Akil H, Pfau M, Sadda SR. Swept-source OCT angiography imaging of the foveal avascular zone and macular capillary network density in diabetic retinopathy. Invest Ophthalmol Vis Sci. 2016 Jul 1;57(8):3907-13.
14.Takase N, Nozaki M, Kato A, Ozeki H, Yoshida M, Ogura Y. Enlargement of foveal avascular zone in diabetic eyes evaluated by en face optical coherence tomography angiography. Retina. 2015 Nov;35(11):2377-83.
15.Freiberg FJ, Pfau M, Wons J, Wirth MA, Becker MD, Michels S. Optical coherence tomography angiography of the foveal avascular zone in diabetic retinopathy. Graefes Arch Clin Exp Ophthalmol. 2016 Jun;254(6):1051-8.
16.Krawitz BD, Mo S, Geyman LS, Agemy SA, Scripsema NK, Garcia PM, Chui TYP, Rosen RB. Acircularity index and axis ratio of the foveal avascular zone in diabetic eyes and healthy-controls measured by optical coherence tomography angiography. Vision Res. 2017 Oct;139:177-186.
17.Miotto S, Zemella N, Gusson E, Panozzo G, Saviano S, Scarpa G, Boschi G, Piermarocchi S. Morphologic criteria of lesion activity in neovascular age-related macular degeneration: a consensus article. J Ocul Pharmacol Ther. 2018 Apr;34(3):298-308.
18.Matsunaga D, Puliafito CA, Kashani AH. OCT angiography in healthy human subjects. Ophthalmic Surg Lasers Imaging Retina. 2014 Nov-Dec;45(6):510-5.
19.Lumbroso B, Huang D, Chen CJ, Jia Y, Rispoli M, Romano A, Waheed NK. Clinical OCT angiography atlas. 1st ed. New Delhi: Jaypee Brothers Medical Publisher (P) Ltd; 2015.
20.Al-Sheikh M, Tepelus TC, Nazikyan T, Sadda SVR. Repeatability of automated vessel density measurements using optical coherence tomography angiography. Br J Ophthalmol. 2017 Apr;101(4):449-452.
21.Tan CS, Lim LW, Chow VS, Chay IW, Tan S, Cheong KX, Tan GT, Sadda SR. Optical coherence tomography angiography evaluation of the parafoveal vasculature and its relationship with ocular factors. Invest Ophthalmol Vis Sci. 2016 Jul 1;57(9):OCT224-34.
22.Adhi M, Filho MA, Louzada RN, Kuehlewein L, de Carlo TE, Baumal CR, Witkin AJ, Sadda SR, Sarraf D, Reichel E, Duker JS, Waheed NK. Retinal Capillary Network and Foveal Avascular Zone in Eyes with Vein Occlusion and Fellow Eyes Analyzed With Optical Coherence Tomography Angiography. Invest Ophthalmol Vis Sci. 2016 Jul 1;57(9):OCT486-94.
23.Kashani AH, Lee SY, Moshfeghi A, Durbin MK, Puliafito CA. Optical coherence tomography angiography of retinal venous occlusion. Retina. 2015 Nov;35(11):2323-31.
24.Stavrev V, Sivkova N, Koleva-Georgieva D. Quantitative assessment of foveal avascular zone in patients with early and intermediate nonexudative age-related macular degeneration using optical coherence tomography-angiography. Open Journal of Ophthalmology. 2018;8(3):133-9.
The authors certify that they have no conflicts of interest in the subject matter or materials discussed in this manuscript.