Vascular density of optic nerve head in diabetic retinopathy using optical coherence tomography angiography

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ORIGINAL ARTICLE

International Journal of Retina and Vitreous Open Access

Vascular density of optic nerve head in diabetic retinopathy using optical coherence tomography angiography Fariba Ghassemi1,2*, Sahar Berijani1, Ramak Roohipoor1,2, Masoumeh Mohebbi1,2, Ameneh Babeli1, Alireza Gholizadeh1 and Siamak Sabour3,4,5

Abstract  Purpose:  To measure optic nerve head (ONH) blood perfusion using optical coherence tomography angiography (OCTA) at various stages of diabetic retinopathy (DR). Methods:  One hundred seventy six eyes of 94 patients included in this retrospective single-centre cross-sectional study. The subjects were studied in normal, no diabetic retinopathy (NDR), non-proliferative diabetic retinopathy (NPDR) and proliferative retinopathy (PDR) groups. The eyes were subjected to AngioDisc ONH imaging using OCTA for papillary (Disc) and peripapillary (RPC) vascular density (VD) evaluation. Results:  The mean age of the participants was 56.08 ± 8.87 years and 34 (36.2 percent) were male. With increased DR severity, a statistically significant decrease in peripapillary VD was found. The study showed that only VD of the whole RPC (W-RPC) could be a valid biomarker in the staging assessment. VD of RPC, in all subsections, was considerably different from normal cases in the PDR group. Visual acuity was correlated with whole image ONH VD. The duration of DM, FBS, hyperlipidemia and DME had no effect on the ONH perfusion. Conclusions:  The study showed that only the W-RPC VD could be a reasonable marker in the staging assessment. VDs assessed by OCTA can be useful for assessing and tracking early ONH changes in DR patients. Keywords:  Capillary plexus, Choriocapillaris, Diabetes, Diabetic retinopathy, Optical coherence tomography angiography, Papillary, Peripapillary, Radial peripapillary capillaries, Vascular density Synopsis At the radial peripapillary capillaries, optical coherence tomography angiography basedvascular density is significantly correlated with the severity of diabetic retinopathy anddecreases with its exacerbation.

*Correspondence: [email protected] 1 Eye research center, Farabi Eye Hospital, Tehran University of Medical Sciences, Qazvin Square, Tehran 1336616351, Iran Full list of author information is available at the end of the article

Introduction Diabetic retinopathy (DR) can be a debilitating complication of diabetes mellitus (DM) and is a worldwide leading cause of blindness [1]. Diabetic macular edema (DME) and various forms of optic neuropathy (ONP) are other ocular complications of diabetic patients [2]. Optic neuropathies that can occur in 38.4% of DR patients include optic disc neovascularization (NVD), diabetic papillopathy (DP), non-arteritic anterior ischemic optic neuropathy (AION), and optic atrophy (OA), and some undefined nonspecific diabetic ONP [3]. Although there have been many significant advances in the understanding of the disease over the past few decades, the primary pathogenesis of DR has yet to be identified. Retina perfusion

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