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Changes in retinal and choriocapillaris density in diabetic patients receiving anti-vascular endothelial growth factor treatment using optical coherence tomography angiography

Authors
  • Conti, Felipe F.1, 2, 3, 4
  • Song, Weilin2
  • Rodrigues, Eduardo B.4
  • Singh, Rishi P.1, 3
  • 1 Cleveland Clinic Foundation, 2022 E. 105th St, i Building, Cleveland, OH, 44106, USA , Cleveland (United States)
  • 2 Cleveland Clinic Lerner College of Medicine, 9500 Euclid Avenue, NA21, Cleveland, OH, 44195, USA , Cleveland (United States)
  • 3 Cleveland Clinic, 10685 Carnegie Ave, Cleveland, OH, 44106, USA , Cleveland (United States)
  • 4 Federal University of São Paulo, 781 Pedro de Toledo Street, São Paulo, SP, 04039-032, Brazil , São Paulo (Brazil)
Type
Published Article
Journal
International Journal of Retina and Vitreous
Publisher
BioMed Central
Publication Date
Dec 10, 2019
Volume
5
Issue
1
Identifiers
DOI: 10.1186/s40942-019-0192-9
Source
Springer Nature
Keywords
License
Green

Abstract

BackgroundOptical coherence tomography angiography (OCTA) enables detailed, non-invasive assessment of ocular vasculature. This study uses OCTA imaging to evaluate choriocapillaris and retinal capillary perfusion density (CPD) changes in diabetic retinopathy following anti-vascular endothelial growth factor (VEGF) treatment.MethodsRecords of 38 eyes at a single institution were reviewed, grouped as non-diabetic controls (19 eyes), diabetes mellitus patients with diabetic retinopathy (DR, 19 eyes) and macular edema (DME). DR eyes were imaged at baseline, 6-months and 12-months after anti-VEGF treatment. Quantitative analyses assessed CPD of the choriocapillaris and retinal plexus.ResultsDR eyes showed decreased choriocapillaris whole-image CPD (62.6 ± 6.1 vs. 68.4 ± 5.1, p < 0.003), foveal CPD (61.2 ± 7.4 vs. 66.3 ± 9.8, p < 0.014), and parafoveal CPD (61.9 ± 6.6 vs. 68.2 ± 4.8, p < 0.002) at baseline. DR eyes also showed decreased retinal density, including whole-image CPD (46.9 ± 5.1 vs. 50.7 ± 5.6, p < 0.04), foveal CPD (27.6 ± 5.9 vs. 34.1 ± 6.1, p < 0.002), and parafoveal CPD (49.0 ± 5.6 vs. 53.1 ± 6.0, p < 0.011). Following 12 months of anti-VEGF treatment, no changes to retinal or choriocapillaris or CPD were observed. Retinal central subfield thickness decreased (397.1 ± 93.2 µm vs. 294.2 ± 71.5 µm, p < 0.005). Lastly, FAZ area (0.307 ± 0.133 mm2 vs. 0.184 ± 0.058 mm2, p = 0.008) and perimeter (2.415 ± 0.692 mm2 vs. 1.753 ± 0.408 mm2, p = 0.002) were increased in DR eyes at baseline. No changes to FAZ area or perimeter were seen with anti-VEGF treatment in DR eyes.ConclusionsCompared to control, choriocapillaris and retinal CPD are reduced in DR, while FAZ area and perimeter are increased. No retinal capillary or choriocapillaris CPD changes were observed in DR eyes following anti-VEGF treatment.

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