Open AccessThree-dimensional structural and angiographic evaluation of foveal ischemia in diabetic retinopathy: method and validation
Author(s) -
Bingjie Wang,
Acner Camino,
Shaohua Pi,
Yukun Guo,
Jie Wang,
David Huang,
Thomas S. Hwang,
Yali Jia
Publication year - 2019
Publication title -
biomedical optics express
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.362
H-Index - 86
ISSN - 2156-7085
DOI - 10.1364/boe.10.003522
Subject(s) - diabetic retinopathy , foveal , medicine , ophthalmology , ischemia , retinopathy , retinal , diabetes mellitus , endocrinology
Optical coherence tomography angiography (OCTA) allows us to noninvasively investigate foveal ischemia, a key feature of diabetic retinopathy (DR). However, the sizes of the foveal avascular zone (FAZ) have a significant variation in normal population, preventing the objective assessment of pathological enlargement of FAZ due to capillary dropout. Based on the relationship between FAZ and ganglion cell complex (GCC) thickness in normal eyes, we defined a theoretical baseline FAZ (tbFAZ) on structural OCT and measured 2D and 3D vessel density in its vicinity on the simultaneously acquired OCTA in normal and diabetic eyes. We found that the structure-based tbFAZ was a reliable reference to identify foveal ischemia and that the 3D vessel density demonstrated ischemia more effectively than the 2D method. The proposed 3D para-FAZ vessel density correlates well with DR severity and potentially is a useful diagnostic biomarker, especially in the early stages of DR.