Skip to main content
Top
Published in: Graefe's Archive for Clinical and Experimental Ophthalmology 7/2019

01-07-2019 | Angiography | Retinal Disorders

Optical coherence tomography angiography analysis of the choriocapillary layer in treatment-naïve diabetic eyes

Authors: Jingyuan Yang, Erqian Wang, Xinyu Zhao, Song Xia, Mingzhen Yuan, Huan Chen, Xiao Zhang, Youxin Chen

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 7/2019

Login to get access

Abstract

Purpose

To evaluate the capillary flow density (CFD) of choriocapillary (CC) microvasculature using optical coherence tomography angiography (OCT-A) in diabetic eyes and the association of CFD and systemic and metabolic factors.

Methods

Cross-sectional study. This study enrolled 282 eyes of 146 subjects, including 43 healthy control eyes, 56 diabetic eyes without diabetic retinopathy (DR), 43 eyes with mild nonproliferative DR (NPDR), 54 eyes with moderate NPDR, 38 eyes with severe NPDR, and 48 eyes with proliferative DR (PDR). CFD was measured in the CC layer. Clinical data were collected. Multiple linear regression analyses were performed to identify associated clinical variables.

Results

CFD in the CC layer presented a downward trend with DR progression. Comparisons of CFD in the CC layer between adjacent stages of DR revealed significant differences between severe NPDR and PDR using both 3-mm and 6-mm scan patterns (P = 0.003, P = 0.001). CFD in the CC layer in DR with diabetic macular edema (DME) was less than that in DR without DME using both 3-mm and 6-mm scan patterns (P < 0.001, P < 0.001). Coronary artery disease and atherosclerosis in other locations, estimated glomerular filtration rate, and increased HbA1c were associated with CFD in the CC layer using both 3-mm and 6-mm scan patterns (all P values < 0.05).

Conclusions

OCT-A revealed decreased CFD in the CC layer in the PDR stage and the presence of DME. Diabetic patients with apparently decreased CFD should be assessed carefully under general conditions.
Literature
1.
go back to reference Yau JW, Rogers SL, Kawasaki R, Lamoureux EL, Kowalski JW, Bek T, Chen SJ, Dekker JM, Fletcher A, Grauslund J, Haffner S, Hamman RF, Ikram MK, Kayama T, Klein BE, Klein R, Krishnaiah S, Mayurasakorn K, O'Hare JP, Orchard TJ, Porta M, Rema M, Roy MS, Sharma T, Shaw J, Taylor H, Tielsch JM, Varma R, Wang JJ, Wang N, West S, Xu L, Yasuda M, Zhang X, Mitchell P, Wong TY (2012) Global prevalence and major risk factors of diabetic retinopathy. Diabetes Care 35:556–564. https://doi.org/10.2337/dc11-1909 CrossRefPubMedPubMedCentral Yau JW, Rogers SL, Kawasaki R, Lamoureux EL, Kowalski JW, Bek T, Chen SJ, Dekker JM, Fletcher A, Grauslund J, Haffner S, Hamman RF, Ikram MK, Kayama T, Klein BE, Klein R, Krishnaiah S, Mayurasakorn K, O'Hare JP, Orchard TJ, Porta M, Rema M, Roy MS, Sharma T, Shaw J, Taylor H, Tielsch JM, Varma R, Wang JJ, Wang N, West S, Xu L, Yasuda M, Zhang X, Mitchell P, Wong TY (2012) Global prevalence and major risk factors of diabetic retinopathy. Diabetes Care 35:556–564. https://​doi.​org/​10.​2337/​dc11-1909 CrossRefPubMedPubMedCentral
3.
go back to reference Hayreh SS (2001) Blood flow in the optic nerve head and factors that may influence it. Prog Retin Eye Res 20:595–624CrossRefPubMed Hayreh SS (2001) Blood flow in the optic nerve head and factors that may influence it. Prog Retin Eye Res 20:595–624CrossRefPubMed
4.
go back to reference McLeod DS, Lutty GA (1994) High-resolution histologic analysis of the human choroidal vasculature. Invest Ophthalmol Vis Sci 35:3799–3811PubMed McLeod DS, Lutty GA (1994) High-resolution histologic analysis of the human choroidal vasculature. Invest Ophthalmol Vis Sci 35:3799–3811PubMed
9.
go back to reference Choi W, Waheed NK, Moult EM, Adhi M, Lee B, De Carlo T, Jayaraman V, Baumal CR, Duker JS, Fujimoto JG (2017) Ultrahigh speed swept source optical coherence tomography angiography of retinal and choriocapillaris alterations in diabetic patients with and without retinopathy. Retina (Philadelphia, Pa) 37:11–21. https://doi.org/10.1097/iae.0000000000001250 CrossRef Choi W, Waheed NK, Moult EM, Adhi M, Lee B, De Carlo T, Jayaraman V, Baumal CR, Duker JS, Fujimoto JG (2017) Ultrahigh speed swept source optical coherence tomography angiography of retinal and choriocapillaris alterations in diabetic patients with and without retinopathy. Retina (Philadelphia, Pa) 37:11–21. https://​doi.​org/​10.​1097/​iae.​0000000000001250​ CrossRef
10.
go back to reference Conti FF, Qin VL, Rodrigues EB, Sharma S, Rachitskaya AV, Ehlers JP, Singh RP (2018) Choriocapillaris and retinal vascular plexus density of diabetic eyes using split-spectrum amplitude decorrelation spectral-domain optical coherence tomography angiography. Br J Ophthalmol 103:452–456. https://doi.org/10.1136/bjophthalmol-2018-311903 Conti FF, Qin VL, Rodrigues EB, Sharma S, Rachitskaya AV, Ehlers JP, Singh RP (2018) Choriocapillaris and retinal vascular plexus density of diabetic eyes using split-spectrum amplitude decorrelation spectral-domain optical coherence tomography angiography. Br J Ophthalmol 103:452–456. https://​doi.​org/​10.​1136/​bjophthalmol-2018-311903
12.
go back to reference Carnevali A, Sacconi R, Corbelli E, Tomasso L, Querques L, Zerbini G, Scorcia V, Bandello F, Querques G (2017) Optical coherence tomography angiography analysis of retinal vascular plexuses and choriocapillaris in patients with type 1 diabetes without diabetic retinopathy. Acta Diabetol 54:695–702. https://doi.org/10.1007/s00592-017-0996-8 CrossRefPubMed Carnevali A, Sacconi R, Corbelli E, Tomasso L, Querques L, Zerbini G, Scorcia V, Bandello F, Querques G (2017) Optical coherence tomography angiography analysis of retinal vascular plexuses and choriocapillaris in patients with type 1 diabetes without diabetic retinopathy. Acta Diabetol 54:695–702. https://​doi.​org/​10.​1007/​s00592-017-0996-8 CrossRefPubMed
14.
go back to reference Levey AS, Stevens LA, Schmid CH, Zhang YL, Castro AF 3rd, Feldman HI, Kusek JW, Eggers P, Van Lente F, Greene T, Coresh J (2009) A new equation to estimate glomerular filtration rate. Ann Intern Med 150:604–612CrossRefPubMedPubMedCentral Levey AS, Stevens LA, Schmid CH, Zhang YL, Castro AF 3rd, Feldman HI, Kusek JW, Eggers P, Van Lente F, Greene T, Coresh J (2009) A new equation to estimate glomerular filtration rate. Ann Intern Med 150:604–612CrossRefPubMedPubMedCentral
16.
go back to reference Fukushima I, McLeod DS, Lutty GA (1997) Intrachoroidal microvascular abnormality: a previously unrecognized form of choroidal neovascularization. Am J Ophthalmol 124:473–487CrossRefPubMed Fukushima I, McLeod DS, Lutty GA (1997) Intrachoroidal microvascular abnormality: a previously unrecognized form of choroidal neovascularization. Am J Ophthalmol 124:473–487CrossRefPubMed
17.
go back to reference Funatsu H, Yamashita H, Ikeda T, Nakanishi Y, Kitano S, Hori S (2002) Angiotensin II and vascular endothelial growth factor in the vitreous fluid of patients with diabetic macular edema and other retinal disorders. Am J Ophthalmol 133:537–543CrossRefPubMed Funatsu H, Yamashita H, Ikeda T, Nakanishi Y, Kitano S, Hori S (2002) Angiotensin II and vascular endothelial growth factor in the vitreous fluid of patients with diabetic macular edema and other retinal disorders. Am J Ophthalmol 133:537–543CrossRefPubMed
19.
go back to reference Paine SK, Mondal LK, Borah PK, Bhattacharya CK, Mahanta J (2017) Pro- and antiangiogenic VEGF and its receptor status for the severity of diabetic retinopathy. Mol Vis 23:356–363PubMedPubMedCentral Paine SK, Mondal LK, Borah PK, Bhattacharya CK, Mahanta J (2017) Pro- and antiangiogenic VEGF and its receptor status for the severity of diabetic retinopathy. Mol Vis 23:356–363PubMedPubMedCentral
22.
go back to reference Van Belle E, Rivard A, Chen D, Silver M, Bunting S, Ferrara N, Symes JF, Bauters C, Isner JM (1997) Hypercholesterolemia attenuates angiogenesis but does not preclude augmentation by angiogenic cytokines. Circulation 96:2667–2674CrossRefPubMed Van Belle E, Rivard A, Chen D, Silver M, Bunting S, Ferrara N, Symes JF, Bauters C, Isner JM (1997) Hypercholesterolemia attenuates angiogenesis but does not preclude augmentation by angiogenic cytokines. Circulation 96:2667–2674CrossRefPubMed
28.
go back to reference Sas KM, Kayampilly P, Byun J, Nair V, Hinder LM, Hur J, Zhang H, Lin C, Qi NR, Michailidis G, Groop PH, Nelson RG, Darshi M, Sharma K, Schelling JR, Sedor JR, Pop-Busui R, Weinberg JM, Soleimanpour SA, Abcouwer SF, Gardner TW, Burant CF, Feldman EL, Kretzler M, Brosius FC 3rd, Pennathur S (2016) Tissue-specific metabolic reprogramming drives nutrient flux in diabetic complications. JCI Insight 1:e86976. https://doi.org/10.1172/jci.insight.86976 CrossRefPubMedPubMedCentral Sas KM, Kayampilly P, Byun J, Nair V, Hinder LM, Hur J, Zhang H, Lin C, Qi NR, Michailidis G, Groop PH, Nelson RG, Darshi M, Sharma K, Schelling JR, Sedor JR, Pop-Busui R, Weinberg JM, Soleimanpour SA, Abcouwer SF, Gardner TW, Burant CF, Feldman EL, Kretzler M, Brosius FC 3rd, Pennathur S (2016) Tissue-specific metabolic reprogramming drives nutrient flux in diabetic complications. JCI Insight 1:e86976. https://​doi.​org/​10.​1172/​jci.​insight.​86976 CrossRefPubMedPubMedCentral
29.
go back to reference Suzuma I, Hata Y, Clermont A, Pokras F, Rook SL, Suzuma K, Feener EP, Aiello LP (2001) Cyclic stretch and hypertension induce retinal expression of vascular endothelial growth factor and vascular endothelial growth factor receptor-2: potential mechanisms for exacerbation of diabetic retinopathy by hypertension. Diabetes 50:444–454CrossRefPubMed Suzuma I, Hata Y, Clermont A, Pokras F, Rook SL, Suzuma K, Feener EP, Aiello LP (2001) Cyclic stretch and hypertension induce retinal expression of vascular endothelial growth factor and vascular endothelial growth factor receptor-2: potential mechanisms for exacerbation of diabetic retinopathy by hypertension. Diabetes 50:444–454CrossRefPubMed
Metadata
Title
Optical coherence tomography angiography analysis of the choriocapillary layer in treatment-naïve diabetic eyes
Authors
Jingyuan Yang
Erqian Wang
Xinyu Zhao
Song Xia
Mingzhen Yuan
Huan Chen
Xiao Zhang
Youxin Chen
Publication date
01-07-2019
Publisher
Springer Berlin Heidelberg
Published in
Graefe's Archive for Clinical and Experimental Ophthalmology / Issue 7/2019
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI
https://doi.org/10.1007/s00417-019-04326-x

Other articles of this Issue 7/2019

Graefe's Archive for Clinical and Experimental Ophthalmology 7/2019 Go to the issue