Superficial and deep foveal avascular zone size and characteristics evaluated using optical coherence tomography angiography
Isaac W. ChayLouis Wei Yi LimVernon S. ChowShoun TanKai Xiong CheongGabriel TanSrinivas R. SaddaColin S. Tan
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Purpose: The purpose of this article is to evaluate long-term change of the foveal avascular zone (FAZ) area in diabetic eyes using optical coherence tomography angiography (OCTA) (AngioVue, Avanti OCT, Optovue). Methods: A retrospective chart review was conducted of patients who had undergone OCTA fundus examinations with at least 12 months of follow-up. Eyes with previous laser photocoagulation and antivascular endothelial growth factor treatments were excluded. ImageJ software was used to evaluate the FAZ area in the superficial capillary plexus (SCP) and deep capillary plexus (DCP). Results: Forty eyes were analyzed in this study and divided into 3 groups: healthy controls (13 eyes), diabetic patients without diabetic retinopathy (DR) (14 eyes), and diabetic patients with DR (13 eyes). During the 22 months of follow-up, the FAZ area of eyes with DR in the DCP enlarged from 0.64 ± 0.20 mm 2 to 0.70 ± 0.20 mm 2 ( P = .021), which was a 10.1% increase from baseline (5.1% per year). No significant changes were observed during the study period for FAZ areas in the DCP of controls and diabetic patients without DR. Enlargement of FAZ in the DCP was significantly greater in eyes with DR progression vs those without progression (19.2% and 1.2%, respectively, P = .013). Conclusions: Our data suggest FAZ enlargement in the DCP is associated with DR progression. Assessment of the FAZ by OCTA might be useful for the evaluation of microcirculation abnormalities in DR and the onset of DR progression.
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To evaluate the repeatability of vessel density and superficial and deep foveal avascular zone measurements using optical coherence tomography angiography, and to specify a diurnal change range.Forty-six eyes of 25 healthy individuals were included. Optical coherence tomography angiography measurements were planned for three consecutive sessions, with 3 hours in between them. AngioVue software of the RTVue XR Avanti was used. Superficial and deep retinal layer vessel density values, including the whole retina, fovea, and each parafoveal zone, were obtained from the software. The intraclass correlation, coefficient of variation, and coefficient of repeatability were calculated for each parameter.The whole image intraclass correlation value was 0.81 for the superficial and 0.86 for the deep layer among the three consecutive sessions. The smallest real difference (coefficient of repeatability) value of whole image measurements was 7.72% for the superficial and 9.84% for the deep retinal layer. Foveal avascular zone area intraclass correlation value was 0.97 for the superficial and 0.83 for the deep retinal layer.The optical coherence tomography angiography analysis provides quantitative data about the retinal microvasculature, which could be used to distinguish between normal and pathology. Changes in superficial vessel density >8% and deep vessel density >10% may be considered as real clinical change rather than variation.
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To provide normative data of foveal avascular zone (FAZ) and thickness.In this cross-sectional study both eyes of each normal subject were scanned with optical coherence tomography angiography (OCTA) for foveal superficial and deep avascular zone (FAZ) and central foveal thickness (CFT) and parafoveal thickness (PFT).Out of a total of 224 eyes of 112 volunteers with a mean age of 37.03 (12-67) years, the mean superficial FAZ area was 0.27 mm2, and deep FAZ area was 0.35 mm2 (P < 0.001), with no difference between both eyes. Females had a larger superficial (0.32 ± 0.11 mm2 versus 0.23 ± 0.09 mm2) and deep FAZ (0.40 ± 0.14 mm2 versus 0.31 ± 0.10 mm2) (P < 0.001) than males. By multivariate linear regression analysis, in normal eyes, superficial FAZ area varied significantly with the gender, CFT, and deep FAZ. Deep FAZ varied with the gender and CFT.The gender and CFT influence the size of normal superficial and deep FAZ of capillary network.
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목적 빛간섭단층혈관조영술을 이용하여 백내장수술 전후 망막중심오목무혈관부위의 변화에 대하여 알아보고자 하였다. 대상과 방법 2019년 4월부터 2019년 6월까지 본원에서 백내장수술을 받은 39명 39안의 의무기록을 후향적으로 조사하였다. 술 전, 술 후 1주일, 술 후 1개월에 빛간섭단층촬영을 이용하여 중심황반두께 및 중심와밑 맥락막두께를 측정하였으며 빛간섭단층혈관조영술을 이용하여 표층혈관총과 심층혈관총에서의 망막중심오목무혈관부위의 면적을 측정하였다. ê²°ê³¼ 총 39안 중 낭포황반부종이 발생한 5안을 제외한 34안의 중심황반두께는 시간에 따른 유의한 변화가 있었으며(p<0.0001) 술 후 1개월에 술 전보다 유의하게 증가하였다(p=0.005). 중심와밑 맥락막두께는 시간에 따른 유의한 변화가 있었으며(p<0.0001) 술 후 1주일, 술 후 1개월에 술 전보다 증가하였다(p<0.0001, p=0.004). 표층혈관총과 심층혈관총의 망막중심오목무혈관부위의 면적 역시 시간에 따른 유의한 변화가 있었으며(p<0.0001), 술 후 1주일에 술 전보다 감소한 소견을 보였다(p<0.0001, p=0.007). 낭포황반부종이 발생한 5안에서 망막중심오목무혈관부위의 면적은 심층혈관총에서 시간에 따른 유의한 변화를 보였으며(p=0.028) 술 후 1개월에 술 전보다 증가하는 양상을 보였다. ê²°ë¡ 백내장수술 후 표층 및 심층혈관총에서 중심오목무혈관부위의 감소 소견이 관찰되었다. 이는 백내장수술 후 회복 과정에서 황반 중심와의 관류에 변화가 있을 수 있음을 시사한다. Keywords: Cataract surgery, Foveal avascular zone, Optical coherence tomography angiography, Retinal vasculature
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Purpose: To investigate the Foveal Avascular Zone (FAZ) area in patients with arterial hypertension using optical coherence tomography angiography (OCT-A).Material and methods: The study was permormed at the School Clinic of UNIFACISA and at the Eye Care Center. It was included 21 hypertensive patients (study group) and 19 individuals without hypertension (control group). It was excluded patientes with diabetes or glaucoma. The measurement of the FAZ areas was performed by the DRI OCT-1Triton/Plus. For the quantitative variables, the results were expressed by their means and standard deviations. Qualitative variables were expressed by their absolute and relative frequencies. Student’s t-test was used to verify differences between means and Fisher’s exact test for differences between frequencies. For evaluating the correlation between the superficial and deep plexus areas, the Pearson correlation test was used. P value ≤ 0.05, rejected the null hypothesis. The research was approved by the Ethics Committee of the Medical School from Campina Grande -UNIFACISA and all individuals signed the free and informed consent form.Results: The means of the superficial FAZ of both eyes was significantly higher in the study group (right eye 410.7 ± 160.7 μm2 - 319.1 ± 108.2 μm2 - p = 0.0433); (left eye: 405.4 ± 144.8 μm2 versus 309.4 ± 87.7 μm2- p = 0.0174). The means of the deep FAZ areas of the right and left eyes were similar between the study and control groups (right eye: 559.6 ± 253.28 μm2 versus 605.1 ± 226.8 μm2 - p = 0.5548); (left eye: 673.2 ± 170.8 μm2 versus 585.6 ± 171.2 μm2 - p = 0.1142). The relationships between the superficial and deep plexus areas of both eyes showed a weak correlation between the two plexuses. (r = 0.4734), left eye (r = 0.2287), study group - right eye: (r = 0.4374), left eye (r = 0.3580).Conclusion: The area of superficial FAZ of the right and left eyes was significantly higher in the hypertensive patients. The deep FAZ area of both eyes, however showed similar mean areas between the study and control groups.
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