ObejctiveTo investigate the consistency and reproducibility of macular perfusion parameters in early diabetic retinopathy (DR) using optical coherence tomography angiography (OCTA).MethodsA prospective cross-sectional observational study. Forty-six patients (46 eyes) diagnosed with mild nonproliferative DR were included in this study. There were 24 males and 22 females, with the mean age of 59.16±10.32 years. Two macular scan sizes of 3 mm×3 mm and 6 mm×6 mm were performed by the same operator, and the same test was performed by another operator. The superficial retinal layer (SRL) and deep retinal layer (DRL) in the foveal avascular zone (FAZ) and vessel density (VD) were quantified. The consistency of the two scan sizes and the reproducibility of the same scan size were also evaluated. The consistency was determined by the intraclass correlation coefficient (ICC). If the intraclass correlation coefficient (ICC)＞0.80, consistency was good; if 0.4≤ICC＜0.8, consistency was general; if ICC＜0.40, consistency was poor.ResultsIn the 3 mm×3 mm and 6 mm×6 mm scanning sizes, the mean results of the two examiners were calculated. The FAZ of SRL were 0.39±0.13 mm2 and 0.42±0.15 mm2, FAZ of DRL were 0.74±0.22 mm2 and 0.89±0.23 mm2. The VD of SRL were (32.23±2.86)% and (31.91±3.01)%, VD of DRL were (43.73±4.64)% and (45.12±5.49)%. The consistency analysis showed that the ICC of SRL-FAZ and DRL-FAZ were 0.920 and 0.812, respectively; the ICC of VD were 0.833 and 0.830, respectively. The consistency was good. The reproducibility analysis of different examiners in the same scan size was better in the consistency of SRL FAZ and VD.ConclusionOCTA in two scanning sizes to measure FAZ and VD of early DR has good consistency and reproducibility.
ObjectiveTo investigate macular microvascular abnormalities in eyes with subfoveal fibrotic nodules secondary to Coats' disease. MethodsA cross-sectional study. From January 1, 2018 to July 30, 2021, 45 eyes of 45 patients diagnosed with Coats' disease with or without subfoveal fibrotic nodules in Eye and ENT Hospital, Shanghai Medical College of Fudan University were included in this study. There were 40 eyes in 40 males and 5 eyes in 5 females. All were under 21 years old. According to the presence or absence of subfoveal fiber nodules, the patients were divided into fibrotic group (26 cases, 26 eyes) and non-fibrotic group (19 cases, 19 eyes). Optical coherence tomography angiography was used to scan 3 mm×3 mm or 6 mm×6 mm macular area of both eyes. The software of the device automatically processed the images. The presence of FAZ edge anastomotic vascular arch ring breakage and abnormal microvascular branch (AMB) in the foveal avascular zone (FAZ) were observed. ResultsIn 26 eyes of fibrosis group, AMB originating from the parafoveal retinal capillary network was observed, which grew into and destroyed the integrity of the vascular arch ring at the edge of FAZ. AMB was crisscrossing and winding, and its curvature expands. B-scan images showed the blood flow signal in the subfoveal fiber nodule, and the blood flow signal traversed between the inner retina and the fiber nodule in 23 eyes (88.46%, 23/26). In the non-fibrosis group, all the vascular abnormalities were characterized by capillary dilation and defect, and no breakage of FAZ anastomotic vascular arch ring or AMB was observed. ConclusionsIn Coats' disease with subfoveal fiber nodules, staggered and dilated AMBs emerge from the parafoveal vascular network, grow into and destroy the integrity of the vascular arch ring at the edge of FAZ, and grow down longitudinally into the fiber nodules.
ObjectiveTo observe and analyze the superficial retinal blood flow density and its related influencing factors in the macular area of adolescents with different types of non-pathological high myopia (HM). MethodsA retrospective clinical study. From March to August 2022, 117 eyes of 117 adolescents who were admitted to Liaocheng Aier Eye Hospital due to myopia were included in the study. According to equivalent spherical degree (SE) and corneal curvature, subjects were divided into mild myopia or emmetropia group (control group), HM group, occult HM (OHM) group, and super HM (SHM) group, with 30 eyes, 28 eyes, 35 eyes, and 24 eyes, respectively. All subjects underwent medical optometry, intraocular pressure, optical coherence tomography (OCT), OCT angiography (OCTA), axial length (AL) and corneal curvature measurements. The diopter was SE. OCTA instrument was used to scan the macular region in the range of 6 mm×6 mm, and the software automatically divided it into three concentric circles centered on the fovea of the macular, namely, the central area with a diameter of 1 mm, the inner ring area with a diameter of 1-3 mm, and the outer ring area with a diameter of 3-6 mm. The superficial retinal vascular density (SRVD), vascular perfusion density (SBPD), the area, perimeter (PERIM), avascular index (AI) of foveal avascular area (FAZ) and retinal thickness were measured in the macular region as a whole and in different regions. One-way analysis of variance was used to compare the data among groups, and the least significant difference t-test was used to compare the data among groups. The correlation of AL, corneal curvature and intraocular pressure with SRVD and SBPD in macula was analyzed by Pearson correlation analysis. ResultsThere were significant differences in SRVD and SBPD in the central, inner and outer regions of macula in control group, HM group, OHM group and SHM group (P＜0.05). There were statistically significant differences in the thickness of the retina above, below and on the temporal side of the central and outer ring regions (P＜0.05). However, no statistically significant difference was in the thickness of the retina on the nasal side (P＞0.05). There was no significant difference in PERIM (P＞0.05). There were significant differences in FAZ area and AI (P＜0.05). Correlation analysis showed that AL was negatively correlated with SRVD and SBPD in macular whole and central, inner and outer ring regions (P＜0.05). Corneal curvature and SE were positively correlated with the SRVD and SBPD of macular whole, central area and outer ring area (P＜0.05). AL was negatively correlated with retinal thickness in the outer ring region (P＜0.05). SE was positively correlated with the thickness of the retina above, below and temporally in the outer ring region (P＜0.05). AL was negatively correlated with FAZ area and AI (P＜0.05). SE was positively correlated with FAZ area and PERIM (P＜0.05). Retinal thickness was positively correlated with SRVD and SBPD (P＜0.05). ConclusionsThe SRVD and SBPD of different types of HM in adolescents decreases to different degrees. The thickness of the retina in the central region is thicker, and the retina in the outer ring region is thinner. With the decrease of SRVD, the retinal thickness gradually is thinner.
ObjectiveTo observe the correlation between retinal capillary density and retinal thickness in the macula and spherical equivalent (SE) in school-age children. MethodsA cross-sectional study. From May to December 2022, 182 school-age children who visited the ophthalmology department of the First Affiliated Hospital of Zhengzhou University were included . There were 95 males and 87 females. The age ranged from 6 to 12 years, and the spherical equivalent (SE) was +0.50 to －6.00 D. They were divided into three groups based on the SE of the right eyes: 54 eyes in emmetropia group (+0.50≤SE＜－0.50 D), 71 eyes in low myopia group (－0.50≤SE＜－3.00 D), and 57 eyes in moderate myopia group (－3.00≤SE≤－6.00 D). The macular area of 6 mm×6 mm was scanned using swept-source optical coherence tomography angiography and was divided into three concentric rings centered on the fovea, including the macular central fovea (0-1 mm diameter), inner ring (1-3 mm diameter) and outer ring (3-6 mm diameter). The retinal thickness and blood flow density of superficial vascular plexus (SVP) and deep vascular plexus (DVP) in different zones within 6 mm of the macular area were measured. The relationships between SE and SVP, DVP and retinal thickness in each ring region were investigated by univariate and multivariate linear regression analyses, smooth curve fitting, and threshold effects. ResultsThere were significant differences in the SVP (F=6.64, 26.06, 22.69) and DVP (F=7.97, 25.01, 5.09) of macular central fovea, inner ring and outer ring among the emmetropia, low myopia and moderate myopia groups (P＜0.05). Univariate linear regression analysis showed that the SVP (β=－0.56, －1.17, －0.79) and DVP (β=－1.03, －0.93, －0.45) of the three regions were positively correlated with SE (P＜0.05). After smooth curve fitting, threshold effect analysis and multivariate linear regression analysis, the SVP and DVP in the macular central fovea were linearly positively correlated with SE (β=－0.91, －1.40; P＜0.05), and SVP and DVP in the inner ring and outer ring showed an inverted U-shaped curve relationship with SE with the inflection (＜3.00 D). When the SE was less than ＜3.00 D, the SVP and DVP in the inner ring and outer ring were positively correlated with SE (P＜0.05). When the SE was higher than －3.00 D, except for the DVP in the inner ring region, the other parameters were negatively correlated with SE (P＜0.05). There were significant differences in retinal thickness of the inner ring and outer ring (F=5.47, 16.36; P＜0.05), and no significant difference in the macular central fovea among the emmetropia, low and moderate myopia groups (F=2.16, P＞0.05). By using univariate and multivariate linear regression analyses, the retinal thickness in the inner ring and outer ring were negatively correlated with SE (β =1.99, 3.05; P＜0.05). However, no correlation was found between retinal thickness and SE in the macular central fovea (β=－1.65, P＞0.05). ConclusionsIn school-age children with SE between +0.50 D and －6.00 D, the retinal capillaries density of the macular central fovea gradually increase, and increase first and then decrease in the inner ring and outer ring with increasing SE. The retinal thickness of inner ring and outer ring gradually decrease and not change significantly in the macular central fovea.
ObjectiveTo observe alterations in center retinal thickness (CRT) in patients diagnosed with central retinal artery occlusion (CRAO) before and after undergoing superselective arterial thrombolysis (IAT) treatment. MethodsA retrospective clinical study. From August 2022 to September 2023, 12 patients (12 eyes) diagnosed with CRAO and treated with IAT at the ophthalmology department of Shenzhen Second People's Hospital. Among these patients, there were 8 males (8 eyes) and 4 females (4 eyes), all experiencing unilateral onset. The mean age was (47.00±15.06) years. The mean duration from onset to thrombolysis was (30.00±30.42) h. All eyes underwent best corrected visual acuity (BCVA) and optical coherence tomography (OCT) assessments; additionally, 6 eyes underwent Fluorescein fundus angiography (FFA). BCVA assessments were conducted using a standard logarithmic chart and transformed into logarithm of the minimum angle of resolution (logMAR) values for statistical analysis. The OCT measured CRT at various locations around the macular fovea (M), including upper (S1, S3), lower (I1, I3), nasal (N1, N3), and temporal (T1, T3) areas at 1 mm and 3 mm distances from the fovea. CRT was defined as the vertical distance between the inner retinal boundary membrane and the inner interface of the retinal pigment epithelial layer. Pre- and post-IAT examinations were performed using the same equipment and methodologies within a 24-hour interval. Changes in CRT at different macular points were compared and observed, while arterial imaging time changes were assessed in 6 eyes that underwent FFA. Paired t-tests were utilized to analyze logMAR BCVA, CRT at different locations, and arterial imaging time pre- and post-treatment. ResultsPrior to IAT treatment, the logMAR BCVA for the affected eye was 3.48±1.42, while the arterial imaging time for the 6 eyes undergoing FFA examination was (27.50±5.47) s. After 24 hours, the logMAR BCVA had improved to 2.35±1.59 for the affected eye, with 9 eyes showing varying degrees of BCVA improvement. The arterial imaging time was (24.17±7.28) s post-treatment. The differences in logMAR BCVA and arterial imaging time before and after treatment were found to be statistically significant (t=2.489, 3.262; P＜0.05). Additionally, the comparison of CRT at S3 (t=2.871), I1 (t=2.325), and T3 (t=3.446) before and after treatment yielded statistically significant differences (P＜0.05). Conversely, the comparison of CRT at S1 (t=1.879), I3 (t=1.915), N1 (t=2.001), N3 (t=1.987), T1 (t=2.180), and M (t=－0.490) showed no statistically significant differences (P＞0.05). ConclusionsIAT treatment for CRAO has been shown to be effective in achieving therapeutic effects by reducing CRT in the macular area. However, the short-term improvement in retinal edema in the macular area is limited.
ObjectiveTo investigate the correlation of retinal blood vessel density with blood pressure and retinal thickness in the macular region of glaucoma. MethodsA retrospective study. From March 2019 to March 2022, 100 glaucoma patients of 100 eyes (glaucoma group) and 100 healthy people of 100 eyes (control group) diagnosed in Department of Ophthalmology of Luoyang First People's Hospital were included in the study. The patients in the glaucoma group were subdivided into the early, intermediate, and late groups based on the average visual field defect value, which were 38, 32, and 30 cases, respectively. Optical coherence tomography angiography was used to scan the macular area of the examined eyes in a 3 mm×3 mm area. The software automatically divided the retina within 3 mm of the macular central concavity into 2 concentric circles centered on the macular central concavity, which were the central concave area with a diameter of 1 mm and the paracentral concave area with a diameter of 1-3 mm. The blood flow density and retinal thickness of the superficial retinal capillary plexus in the nasal, temporal, inferior, and superior quadrants of the retina within 3 mm of the macula were measured. Blood pressure was measured at the brachial artery using an electronic sphygmomanometer. Comparisons between two groups were made by independent samples t test, and comparisons between multiple groups were made by one-way analysis of variance. Correlations between retinal blood flow density and blood pressure and retinal thickness were analyzed by Spearman's correlation analysis. ResultsThe retinal blood vessel density in the central fovea, parafoveal, inferior, and superior macular areas in the glaucoma group were lower than that in the control group, and with the aggravation of the disease, the retinal blood vessel density in the central fovea, parafoveal, inferior and superior macular areas gradually decreased; the retinal thicknesses in the foveal, parafoveal, inferior, and superior macular areas in the glaucoma group were lower than those in the control group, and with the aggravation of the disease, the retinal thicknesses in the foveal, parafoveal, inferior, and superior macular areas gradually decreased, the differences were statistically significant (P＜0.05). Systolic and diastolic blood pressure were higher in the glaucoma group than in the control group, and they increased gradually as the disease worsened (P＜0.05). Spearman's correlation analyses showed that in glaucoma patients, the density of retinal blood vessels in the macular central plexus, paracentral plexus, and inferior and superior retinas was positively correlated with retinal thickness in the corresponding areas and negatively correlated with blood pressure (P＜0.05). ConclusionThe density of retinal blood vessels in the macular central plexus, paracentral plexus, and inferior and superior retinas are positively correlated with retinal thickness in the corresponding areas and negatively correlated with blood pressure.