Diabetic Neuroglial Changes in the Superficial and Deep Nonperfused Areas on Optical Coherence Tomography Angiography.
Dodo Yoko, Murakami Tomoaki, Suzuma Kiyoshi, Yoshitake Shin, Yoshitake Tatsuya, Ishihara Kenji, Fujimoto Masahiro, Miwa Yuko, Tsujikawa Akitaka
AI Summary
This study found specific neuroglial damage on OCT corresponds to superficial and deep capillary nonperfusion areas in diabetic retinopathy, enabling layer-by-layer assessment of retinal health.
Abstract
Purpose
To evaluate the relationship between lamellar capillary nonperfusion on optical coherence tomography angiography (OCTA) images and neuroglial changes on structural optical coherence tomography (OCT) images in diabetic retinopathy (DR).
Methods
We retrospectively reviewed 101 consecutive eyes of 69 patients with DR. OCTA and OCT images within a 3 × 3-mm square centered on the fovea were acquired simultaneously. The nonperfused areas (NPAs) in the superficial capillary layer (sNPA) (from the nerve fiber layer [NFL] to the inner plexiform layer [IPL]), the deep layer (dNPA) (corresponding mainly to the inner nuclear layer [INL]), or both layers (bNPA) were measured individually along 10 transverse lines. The corresponding lamellar neuroglial changes also were evaluated on OCT images.
Results
The transverse lengths of the sNPA, dNPA, and bNPA were 2.34% (interquartile range, 0.81-5.55), 0.61% (0-1.99), and 5.96% (4.02-10.88), respectively. The length of the sNPA was correlated significantly with the lengths of no boundary between the NFL and ganglion cell layer (GCL)/IPL and the spots with inverted OCT reflectivity in the sNPA. The transverse length of the dNPA was associated with the length of cystoid spaces in the INL or Henle's fiber layer (HFL) in the dNPA. There was a significant correlation between the transverse lengths of the bNPA and no boundary between the NFL and GCL/IPL within the bNPA.
Conclusions
Systematic evaluation of the OCTA-OCT association showed structural changes in the neuroglial tissues corresponding to the lamellar NPAs and suggested the feasibility of layer-by-layer evaluation of the capillary nonperfusion in DR.
MeSH Terms
Shields Classification
Key Concepts6
The transverse length of the superficial capillary nonperfused area (sNPA) in diabetic retinopathy, measured from the nerve fiber layer (NFL) to the inner plexiform layer (IPL) on optical coherence tomography angiography (OCTA) images, was 2.34% (interquartile range, 0.81-5.55) in 101 eyes of 69 patients with diabetic retinopathy.
The transverse length of the deep nonperfused area (dNPA) in diabetic retinopathy, corresponding mainly to the inner nuclear layer (INL) on optical coherence tomography angiography (OCTA) images, was 0.61% (interquartile range, 0-1.99) in 101 eyes of 69 patients with diabetic retinopathy.
The transverse length of the combined superficial and deep nonperfused area (bNPA) in diabetic retinopathy on optical coherence tomography angiography (OCTA) images, was 5.96% (interquartile range, 4.02-10.88) in 101 eyes of 69 patients with diabetic retinopathy.
The transverse length of the superficial nonperfused area (sNPA) in diabetic retinopathy was significantly correlated with the lengths of no boundary between the nerve fiber layer (NFL) and ganglion cell layer (GCL)/inner plexiform layer (IPL) and the spots with inverted OCT reflectivity within the sNPA, as observed in 101 eyes of 69 patients with diabetic retinopathy.
The transverse length of the deep nonperfused area (dNPA) in diabetic retinopathy was associated with the length of cystoid spaces in the inner nuclear layer (INL) or Henle's fiber layer (HFL) within the dNPA, as observed in 101 eyes of 69 patients with diabetic retinopathy.
There was a significant correlation between the transverse lengths of the combined superficial and deep nonperfused area (bNPA) and no boundary between the nerve fiber layer (NFL) and ganglion cell layer (GCL)/inner plexiform layer (IPL) within the bNPA in diabetic retinopathy, as observed in 101 eyes of 69 patients with diabetic retinopathy.
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