Author: Reza Mirshahi (Iran, Islamic Republic of)
Co-authors: Hamid Riazi-Esfahani, Pasha Anvari, Elias Khalili Pour, Parsa Yarmohammadi, Kaveh Fadakar, Khalil Ghasemi Falavarjani
To assess optical coherence tomography angiography (OCTA) metrics of eyes with diabetic macular edema (DME) and compare them with OCTA findings in eyes with diabetic retinopathy (DR) without DME.
Rassoul Akram Hospital, Tehran, Iran
In this retrospective case series, macular optical coherence tomography angiography images were obtained from eyes with DR with and without diabetic macular edema. Foveal avascular zone was delineated using a previously described deep learning approach. In addition to vascular density (VD), different complexity indices including vascular tortuosity index (VTI), fractal dimension (FD), vessel diameter index (VDI), vascular complexity index (VCI) and vessel diameter index (VDI) were measured using an automated method. The area of capillary non-perfusion (CNP) and geometric perfusion deficit (GPD) in superficial capillary plexus (SCP) and deep capillary plexus (DCP) was measured using an automated approach after excluding the foveal avascular zone.
One-hundred-fifty-five eyes of 105 diabetic patients were included in the study; of those 59 eyes (38.1%) had diabetic macular edema. Fifty-two eyes (33.5%) had PDR and the remaining eyes were categorized as NPDR. The mean±SD age of the patients was 60±11.3 years. The mean central foveal thickness (CFT) was 420.1±115.4 and 257.1±31.4 in eyes with DME and without DME, respectively (p value = 0.000). The mean CNP and GPD in both SCP and DCP were significantly higher in eyes with diabetic macular edema than eyes without DME. In multivariate analysis after adjusting for stage of diabetic retinopathy, the presence of diabetic macular edema was associated with GPD in SCP(B= -1.587, p value=0.006), VD of SCP (B= -0.729, p value=0.000), VDI in SCP (B= 16.76, p value=0.000), GPD in SCP (B= 0.839, p value=0.006) and VD of DCP (B= 0.444, p value=0.004). Moreover, in eyes with DME, central foveal thickness was associated with VD ratio(VD in SCP/DCP) (B= 369.53, p value=0.001) and FAZ area (B= -393.49, p value=0.001) after adjusting for stage of diabetic retinopathy.
Eyes with diabetic macular edema have significantly different microvascular changes compared to those without macular edema. DME may be considered a more advanced stage of diabetic retinopathy.
No conflict of interest to report.