Automated Quantification of Capillary Nonperfusion Using Optical Coherence Tomography Angiography in Diabetic Retinopathy

作者：Thomas S. Hwang, Simon S. Gao, Liang Liu, Andreas Lauer, Steven T. Bailey, Christina J. Flaxel, David J. Wilson, David Huang, Yali Jia · 发表于：JAMA Ophthalmology · 年份：2016 · DOI：10.1001/jamaophthalmol.2015.5658 · 被引用次数：394 · 研究领域：Retinal Diseases and Treatments、Retinal Imaging and Analysis、Optical Coherence Tomography Applications

IMPORTANCE: Macular ischemia is a key feature of diabetic retinopathy (DR). Quantification of macular ischemia has potential as a biomarker for DR. OBJECTIVE: To assess the feasibility of automated quantification of capillary nonperfusion as a potential sign of macular ischemia using optical coherence tomography (OCT) angiography. DESIGN, SETTING, AND PARTICIPANTS: An observational study conducted in a tertiary, subspecialty, academic practice evaluated macular nonperfusion with 6 × 6-mm OCT angiography obtained with commercially available 70-kHz OCT and fluorescein angiography (FA). The study was conducted from January 22 to September 18, 2014. Data analysis was performed from October 1, 2014, to April 7, 2015. Participants included 12 individuals with normal vision serving as controls and 12 patients with various levels of DR. MAIN OUTCOMES AND MEASURES: Preplanned primary measures were parafoveal and perifoveal vessel density, total avascular area, and foveal avascular zone as detected with 6 × 6-mm OCT angiography and analyzed using an automated algorithm. Secondary measures included the agreement of the avascular area between the OCT angiogram and FA. RESULTS: Compared with the 12 healthy controls (11 women; mean [SD] age, 54.2 [14.2] years), the 12 participants with DR (4 women; mean [SD] age, 55.1 [12.1] years) had reduced parafoveal and perifoveal vessel density by 12.6% (95% CI, 7.7%-17.5%; P < .001) and 10.4% (95% CI, 6.8%-14.1%; P < .001), respectively. Total avasc...