Assessment of the foveal avascular zone morphology in healthy subjects using swept-source optical coherence tomography angiography.
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Purpose: To evaluate the vessel density of macula according to analysis area in health subjects using optical coherence tomography angiography (OCTA).Methods: We retrospectively analyzed 30 eyes of 20 healthy people who underwent OCTA.We measured vessel density (VD) according to analysis area and foveal avascular zone (FAZ) size of superficial capillary plexus (SCP) and deep capillary plexus (DCP).The analysis areas were classified as 3 × 3 mm scan area (Box), Box area excluding FAZ (Box-FAZ), fovea centered 3 mm circle area (Circle), Circle area excluding FAZ (Circle-FAZ) and area between fovea centered 1 mm circle and 3 mm circle (Ring).Results: The SCP VDs were Box 34.00 ± 3.97, Box-FAZ 35.37 ± 4.09, Circle 31.70 ± 4.56, Circle-FAZ 33.34 ± 4.72, and Ring 35.22 ± 5.09.The DCP VDs were Box 30.04 ± 3.51, Circle 29.49 ± 3.57, Box-FAZ 31.59 ± 3.65, Circle-FAZ 31.46 ± 3.72, and Ring 32.60 ± 4.00.There was a significant difference according to analysis area from both SCP and DCP (p < 0.001 and p < 0.001, respectively).Comparison of the vessel density between SCP and DCP in the same analysis area were different in all areas (p < 0.001, p = 0.001, p < 0.001, p = 0.005, p = 0.001, respectively).Conclusions: This study shows different results according to analysis area when measuring VD using OCTA.Therefore, when comparing studies related to VD, it is necessary to pay attention to the analysis area in the interpretation of the results.
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To assess the reproducibility and repeatability of foveal avascular zone (FAZ) area measurements using swept-source optical coherence tomography angiography (SS-OCTA) in healthy subjects.Sixty-four eyes of 64 healthy volunteers were randomly subjected to FAZ area measurements using SS-OCTA by 2 examiners in 2 different sessions.The FAZ areas measured by the first and second observer were 0.269 ± 0.092 mm2 and 0.270 ± 0.090 mm2, respectively. Within subjects, the coefficients of variations were 2.44% (95% confidence interval [CI] 1.95% to 2.93%) and 2.66% (95% CI 2.00% to 3.31%) for the first and second observers, respectively. The coefficient of repeatability average measurements of FAZ area were 0.021 mm2 and 0.024 mm2. The intraclass correlation coefficient values were 0.993 (95% CI 0.989 to 0.996) and 0.991 (95% CI 0.986 to 0.995). Interobserver and intraobserver concordance correlation coefficients ranged from 0.998 (95% CI 0.997 to 0.999) to 0.999 (95% CI 0.998 to 0.999) and from 0.989 (95% CI 0.982 to 0.993) to 0.987 (95% CI 0.979 to 0.992), respectively.The FAZ area measurements by means of SS-OCTA showed high reproducibility and repeatability in healthy eyes.
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To analyze foveal avascular zone (FAZ) dimensions and symmetry in patients with diabetic retinopathy (DR) compared to healthy controls using optical coherence tomography angiography (OCT angiography).OCT angiography was performed via an Avanti® RTVue 100 XR OCT system (Optovue, Inc., Fremont, CA, USA) in patients with diabetes mellitus (DM) and healthy adults. A frame centered on the fovea was used for FAZ measurements. The borders of the superficial vascular layer were defined as 3 μm below the internal limiting membrane (ILM) and 15 μm below the inner plexiform layer (IPL), and for the deep vascular layer as15 μm and 70 μm below the IPL, respectively. Angles of maximum FAZ diameter were measured in all eyes by two graders.In healthy eyes (N = 25), the FAZ surrounding vascular arcades were intact, showing a vertical or horizontal oval symmetrical formation with a maximum diameter usually on the horizontal or vertical axis. Diabetic eyes (N = 29) presented with disintegrity of the vascular arcades, resulting in an enlarged FAZ. In the superficial layer, the mean horizontal FAZ diameter was significantly larger in the DR group (753 μm ±272 μm) than in the control group (573 μm ±177 μm, p = 0.029). The difference was even more pronounced in the deep layer, with a mean value of 659 μm ±194 μm in the control group and 1009 μm ±342 μm in the DR group (p = 0.001). Furthermore, in the superficial layer, the angle of the maximum FAZ diameter was 0° (±15°) or 90° (±15°) in 72.0 % of healthy eyes. In eyes with DR, the angle was 0° (±15°) or 90° (±15°) in only 6.9 % of cases, due to the irregular configuration of the FAZ.OCT angiography is capable of imaging retinal vasculature without dye injection. Our data suggest that it can detect disintegrity of the vascular arcades surrounding the FAZ, thus differentiating DM from healthy eyes. Vascular abnormalities were more pronounced in the deep vascular layer.
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To analyze the foveal avascular zone (FAZ) in normal eyes using optical coherence tomography angiography.Prospective noncomparative case series. The parafoveal region of 70 eyes from 67 healthy subjects was imaged using optical coherence tomography angiography to visualize the superficial and deep capillary plexuses and correlated with standard macular volume scans using spectral domain optical coherence tomography to determine foveal morphology.In all 70 eyes imaged, 2 vascular plexuses could be detected within the retina: a superficial plexus within the ganglion cell layer and a deep plexus within the inner nuclear layer. A measurable FAZ was visualized in both plexuses in all imaged eyes. The FAZ area was variable in the study population with a mean of 0.266 mm² ± 0.097 mm² in the superficial plexus (range: 0.071 mm²-0.527 mm²) and a mean of 0.495 mm² ± 0.227 mm² in the deep plexus (range: 0.160 mm²-0.795 mm²). The FAZ area was significantly larger in the deep plexus (P < 0.0001) compared with superficial plexus. The FAZ area in both plexuses correlated inversely with central macular thickness and central macular volume (P < 0.0001). No significant correlation was found between superficial plexus FAZ area and age (P = 0.55) or sex (P = 0.34). In the same manner, no significant correlation was found between deep plexus FAZ area and age (P = 0.13) or sex (P = 0.13).Optical coherence tomography angiography provides a noninvasive method to visualize and measure the superficial and deep plexus FAZ in a normal population. The FAZ can vary in size and shape, with the FAZ area significantly larger in the deep compared with the superficial plexus. Both superficial and deep FAZ area correlate inversely with foveal thickness and volume.
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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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