Volume rendered 3D OCTA assessment of macular ischemia in patients with type 1 diabetes and without diabetic retinopathy

• Published in: Scientific reports Vol. 11; no. 1; pp. 19793 - 7
• Main Authors: Borrelli, Enrico, Grosso, Domenico, Parravano, Mariacristina, Costanzo, Eliana, Brambati, Maria, Viganò, Chiara, Sacconi, Riccardo, Querques, Lea, Pina, Adelaide, De Geronimo, Daniele, Bandello, Francesco, Querques, Giuseppe
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 05.10.2021; Nature Publishing Group; Nature Portfolio
• Subjects: 692/308/53; 692/53; Adult; Aged; Angiography; Diabetes; Diabetes mellitus (insulin dependent); Diabetes Mellitus, Type 1 - complications; Diabetic retinopathy; Diabetic Retinopathy - diagnosis; Diabetic Retinopathy - etiology; Female; Humanities and Social Sciences; Humans; Image Processing, Computer-Assisted; Imaging, Three-Dimensional; Ischemia; Ischemia - diagnostic imaging; Ischemia - etiology; Macula Lutea - blood supply; Macula Lutea - diagnostic imaging; Male; Middle Aged; multidisciplinary; Perfusion; Retinal Vessels - diagnostic imaging; Retinal Vessels - physiopathology; Retinopathy; Retrospective Studies; Science; Science (multidisciplinary); Tomography, Optical Coherence - methods; Young Adult
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-021-99297-7

The aim of this study was to measure macular perfusion in patients with type 1 diabetes and no signs of diabetic retinopathy (DR) using volume rendered three-dimensional (3D) optical coherence tomography angiography (OCTA). We collected data from 35 patients with diabetes and no DR who had OCTA obtained. An additional control group of 35 eyes from 35 healthy subjects was included for comparison. OCTA volume data were processed with a previously presented algorithm in order to obtain the 3D vascular volume and 3D perfusion density. In order to weigh the contribution of different plexuses’ impairment to volume rendered vascular perfusion, OCTA en face images were binarized in order to obtain two-dimensional (2D) perfusion density metrics. Mean ± SD age was 27.2 ± 10.2 years [range 19–64 years] in the diabetic group and 31.0 ± 11.4 years [range 19–61 years] in the control group (p = 0.145). The 3D vascular volume was 0.27 ± 0.05 mm 3 in the diabetic group and 0.29 ± 0.04 mm 3 in the control group (p = 0.020). The 3D perfusion density was 9.3 ± 1.6% and 10.3 ± 1.6% in diabetic patients and controls, respectively (p = 0.005). Using a 2D visualization, the perfusion density was lower in diabetic patients, but only at the deep vascular complex (DVC) level (38.9 ± 3.7% in diabetes and 41.0 ± 3.1% in controls, p = 0.001), while no differences were detected at the superficial capillary plexus (SCP) level (34.4 ± 3.1% and 34.3 ± 3.8% in the diabetic and healthy subjects, respectively, p = 0.899). In conclusion, eyes without signs of DR of patients with diabetes have a reduced volume rendered macular perfusion compared to control healthy eyes.