TY - JOUR
T1 - Deep Retinal Capillary Nonperfusion Is Associated with Photoreceptor Disruption in Diabetic Macular Ischemia
AU - Scarinci, Fabio
AU - Nesper, Peter L.
AU - Fawzi, Amani A.
N1 - Funding Information:
Funding/Support: This work was funded in part by National Institutes of Health study 1DP3DK108248 (A.A.F.) and research instrument support by Optovue, Inc, Fremont, California, USA. The funders had no role in study design, data collection and analysis, data interpretation, decision to publish, or preparation of the manuscript. The following authors have no financial disclosures: Fabio Scarinci, Peter L. Nesper, and Amani A. Fawzi. All authors attest that they meet the current ICMJE criteria for authorship.
PY - 2016/8/1
Y1 - 2016/8/1
N2 - Purpose To report outer retinal structural changes associated with macular capillary nonperfusion at the level of deep capillary plexus (DCP) in diabetic patients. Design Prospective observational cross-sectional study. Methods The study included 14 eyes of 10 patients who were diagnosed as having diabetic retinopathy. To study the outer retina and localize areas of capillary nonperfusion at the superficial (SCP) or DCP, we used the spectral-domain optical coherence tomography (SDOCT) device (RTVue-XR Avanti; Optovue Inc, Fremont, California, USA) with split-spectrum amplitude-decorrelation angiography (SSADA) software for optical coherence tomography angiography (OCTA). Two independent masked graders (F.S. and A.A.F.) qualitatively evaluated SDOCT scans as either normal or having outer retina disruption. The angiographic images were examined to define the presence and location of capillary nonperfusion. Results Eight eyes showed outer retinal disruption on SDOCT that co-localized to areas of enlarged foveal avascular zone, areas of no flow between capillaries, and capillary nonperfusion of the DCP. Six eyes without outer retinal changes on SDOCT showed robust perfusion of the DCP. Conclusions Using OCTA, this study shows that macular photoreceptor disruption on SDOCT in patients with diabetic retinopathy corresponds to areas of capillary nonperfusion at the level of the DCP. This is important in highlighting the contribution of the DCP to the oxygen requirements of the photoreceptors as well as the outer retina in diabetic macular ischemia.
AB - Purpose To report outer retinal structural changes associated with macular capillary nonperfusion at the level of deep capillary plexus (DCP) in diabetic patients. Design Prospective observational cross-sectional study. Methods The study included 14 eyes of 10 patients who were diagnosed as having diabetic retinopathy. To study the outer retina and localize areas of capillary nonperfusion at the superficial (SCP) or DCP, we used the spectral-domain optical coherence tomography (SDOCT) device (RTVue-XR Avanti; Optovue Inc, Fremont, California, USA) with split-spectrum amplitude-decorrelation angiography (SSADA) software for optical coherence tomography angiography (OCTA). Two independent masked graders (F.S. and A.A.F.) qualitatively evaluated SDOCT scans as either normal or having outer retina disruption. The angiographic images were examined to define the presence and location of capillary nonperfusion. Results Eight eyes showed outer retinal disruption on SDOCT that co-localized to areas of enlarged foveal avascular zone, areas of no flow between capillaries, and capillary nonperfusion of the DCP. Six eyes without outer retinal changes on SDOCT showed robust perfusion of the DCP. Conclusions Using OCTA, this study shows that macular photoreceptor disruption on SDOCT in patients with diabetic retinopathy corresponds to areas of capillary nonperfusion at the level of the DCP. This is important in highlighting the contribution of the DCP to the oxygen requirements of the photoreceptors as well as the outer retina in diabetic macular ischemia.
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U2 - 10.1016/j.ajo.2016.05.002
DO - 10.1016/j.ajo.2016.05.002
M3 - Article
C2 - 27173374
AN - SCOPUS:84973561119
VL - 168
SP - 129
EP - 138
JO - American Journal of Ophthalmology
JF - American Journal of Ophthalmology
SN - 0002-9394
ER -