Automated quantification of capillary nonperfusion using optical coherence tomography angiography in diabetic retinopathy

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Abstract

Importance Macular ischemia is a key feature of diabetic retinopathy (DR). Quantification of macular ischemia has potential as a biomarker for DR. OBJECTIVE To assess the feasibility of automated quantification of capillary nonperfusion as a potential sign of macular ischemia using optical coherence tomography (OCT) angiography. DESIGN, SETTING, AND PARTICIPANTS An observational study conducted in a tertiary, subspecialty, academic practice evaluated macular nonperfusion with 6 ∼ 6-mm OCT angiography obtained with commercially available 70-kHz OCT and fluorescein angiography (FA). The study was conducted from January 22 to September 18, 2014. Data analysis was performed from October 1, 2014, to April 7, 2015. Participants included 12 individuals with normal vision serving as controls and 12 patients with various levels of DR. MAIN OUTCOMES AND MEASURES Preplanned primary measureswere parafoveal and perifoveal vessel density, total avascular area, and foveal avascular zone as detected with 6 ∼ 6-mm OCT angiography and analyzed using an automated algorithm. Secondary measures included the agreement of the avascular area between the OCT angiogram and FA. RESULTS Compared with the 12 healthy controls (11 women; mean [SD] age, 54.2 [14.2] years), the 12 participants with DR (4 women; mean [SD] age, 55.1 [12.1] years) had reduced parafoveal and perifoveal vessel density by 12.6%(95%CI, 7.7%-17.5%; P 2 (95%CI, 0.65-0.99mm2; P =.02) and 0.16 mm2 (95%CI, 0.05-0.28mm2; P

Original languageEnglish (US)
Pages (from-to)367-373
Number of pages7
JournalJAMA Ophthalmology
Volume134
Issue number4
DOIs
StatePublished - Apr 1 2016

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Optical Coherence Tomography
Diabetic Retinopathy
Angiography
Ischemia
Fluorescein Angiography
Observational Studies
Biomarkers
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Ophthalmology

Cite this

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title = "Automated quantification of capillary nonperfusion using optical coherence tomography angiography in diabetic retinopathy",
abstract = "Importance Macular ischemia is a key feature of diabetic retinopathy (DR). Quantification of macular ischemia has potential as a biomarker for DR. OBJECTIVE To assess the feasibility of automated quantification of capillary nonperfusion as a potential sign of macular ischemia using optical coherence tomography (OCT) angiography. DESIGN, SETTING, AND PARTICIPANTS An observational study conducted in a tertiary, subspecialty, academic practice evaluated macular nonperfusion with 6 ∼ 6-mm OCT angiography obtained with commercially available 70-kHz OCT and fluorescein angiography (FA). The study was conducted from January 22 to September 18, 2014. Data analysis was performed from October 1, 2014, to April 7, 2015. Participants included 12 individuals with normal vision serving as controls and 12 patients with various levels of DR. MAIN OUTCOMES AND MEASURES Preplanned primary measureswere parafoveal and perifoveal vessel density, total avascular area, and foveal avascular zone as detected with 6 ∼ 6-mm OCT angiography and analyzed using an automated algorithm. Secondary measures included the agreement of the avascular area between the OCT angiogram and FA. RESULTS Compared with the 12 healthy controls (11 women; mean [SD] age, 54.2 [14.2] years), the 12 participants with DR (4 women; mean [SD] age, 55.1 [12.1] years) had reduced parafoveal and perifoveal vessel density by 12.6{\%}(95{\%}CI, 7.7{\%}-17.5{\%}; P 2 (95{\%}CI, 0.65-0.99mm2; P =.02) and 0.16 mm2 (95{\%}CI, 0.05-0.28mm2; P",
author = "Thomas Hwang and Gao, {Simon S.} and Liang Liu and Lauer, {Andreas (Andy)} and Steven Bailey and Christina Flaxel and David Wilson and David Huang and Jia Yali",
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T1 - Automated quantification of capillary nonperfusion using optical coherence tomography angiography in diabetic retinopathy

AU - Hwang, Thomas

AU - Gao, Simon S.

AU - Liu, Liang

AU - Lauer, Andreas (Andy)

AU - Bailey, Steven

AU - Flaxel, Christina

AU - Wilson, David

AU - Huang, David

AU - Yali, Jia

PY - 2016/4/1

Y1 - 2016/4/1

N2 - Importance Macular ischemia is a key feature of diabetic retinopathy (DR). Quantification of macular ischemia has potential as a biomarker for DR. OBJECTIVE To assess the feasibility of automated quantification of capillary nonperfusion as a potential sign of macular ischemia using optical coherence tomography (OCT) angiography. DESIGN, SETTING, AND PARTICIPANTS An observational study conducted in a tertiary, subspecialty, academic practice evaluated macular nonperfusion with 6 ∼ 6-mm OCT angiography obtained with commercially available 70-kHz OCT and fluorescein angiography (FA). The study was conducted from January 22 to September 18, 2014. Data analysis was performed from October 1, 2014, to April 7, 2015. Participants included 12 individuals with normal vision serving as controls and 12 patients with various levels of DR. MAIN OUTCOMES AND MEASURES Preplanned primary measureswere parafoveal and perifoveal vessel density, total avascular area, and foveal avascular zone as detected with 6 ∼ 6-mm OCT angiography and analyzed using an automated algorithm. Secondary measures included the agreement of the avascular area between the OCT angiogram and FA. RESULTS Compared with the 12 healthy controls (11 women; mean [SD] age, 54.2 [14.2] years), the 12 participants with DR (4 women; mean [SD] age, 55.1 [12.1] years) had reduced parafoveal and perifoveal vessel density by 12.6%(95%CI, 7.7%-17.5%; P 2 (95%CI, 0.65-0.99mm2; P =.02) and 0.16 mm2 (95%CI, 0.05-0.28mm2; P

AB - Importance Macular ischemia is a key feature of diabetic retinopathy (DR). Quantification of macular ischemia has potential as a biomarker for DR. OBJECTIVE To assess the feasibility of automated quantification of capillary nonperfusion as a potential sign of macular ischemia using optical coherence tomography (OCT) angiography. DESIGN, SETTING, AND PARTICIPANTS An observational study conducted in a tertiary, subspecialty, academic practice evaluated macular nonperfusion with 6 ∼ 6-mm OCT angiography obtained with commercially available 70-kHz OCT and fluorescein angiography (FA). The study was conducted from January 22 to September 18, 2014. Data analysis was performed from October 1, 2014, to April 7, 2015. Participants included 12 individuals with normal vision serving as controls and 12 patients with various levels of DR. MAIN OUTCOMES AND MEASURES Preplanned primary measureswere parafoveal and perifoveal vessel density, total avascular area, and foveal avascular zone as detected with 6 ∼ 6-mm OCT angiography and analyzed using an automated algorithm. Secondary measures included the agreement of the avascular area between the OCT angiogram and FA. RESULTS Compared with the 12 healthy controls (11 women; mean [SD] age, 54.2 [14.2] years), the 12 participants with DR (4 women; mean [SD] age, 55.1 [12.1] years) had reduced parafoveal and perifoveal vessel density by 12.6%(95%CI, 7.7%-17.5%; P 2 (95%CI, 0.65-0.99mm2; P =.02) and 0.16 mm2 (95%CI, 0.05-0.28mm2; P

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