TY - JOUR
T1 - Optical Coherence Tomography Angiography Avascular Area Association With 1-Year Treatment Requirement and Disease Progression in Diabetic Retinopathy
AU - You, Qi Sheng
AU - Wang, Jie
AU - Guo, Yukun
AU - Pi, Shaohua
AU - Flaxel, Christina J.
AU - Bailey, Steven T.
AU - Huang, David
AU - Jia, Yali
AU - Hwang, Thomas S.
N1 - Funding Information:
All authors have completed and submitted the ICMJE form for disclosure of potential conflicts of interest. Funding/Support: Supported by National Eye Institute grants R01 EY024544, R01 EY027833, and P30 EY010572, an unrestricted departmental funding grant, and the William and Mary Greve Special Scholar Award from Research to Prevent Blindness, New York, New York, USA. Financial Disclosures: Drs Jia, Bailey, and Huang have a significant financial interest in Optovue Inc. The other authors have no financial conflict of interest. We thank Dongseok Choi from Oregon Health and Science University and the Portland State University School of Public Health for his help with logistic regression analysis. Investigation (Q.S.Y. C.J.F. S.T.B. T.S.H.); Conceptualization (Q.S.Y. Y.J. T.S.H.); Methodology (Q.S.Y.); Writing – original draft (Q.S.Y.); Writing – reviewing and editing (T.S.H.); Formal analysis (J.W.); Software (J.W. Y.G. S.P.); Supervision (D.H. Y.J. T.S.H.); Funding Acquisition (Y.J. T.S.H.); Project administration (Y.J.). All authors attest that they meet the current ICMJE criteria for authorship.
Funding Information:
All authors have completed and submitted the ICMJE form for disclosure of potential conflicts of interest. Funding/Support: Supported by National Eye Institute grants R01 EY024544 , R01 EY027833 , and P30 EY010572 , an unrestricted departmental funding grant, and the William and Mary Greve Special Scholar Award from Research to Prevent Blindness, New York, New York, USA. Financial Disclosures: Drs Jia, Bailey, and Huang have a significant financial interest in Optovue Inc. The other authors have no financial conflict of interest. We thank Dongseok Choi from Oregon Health and Science University and the Portland State University School of Public Health for his help with logistic regression analysis. Investigation (Q.S.Y., C.J.F., S.T.B., T.S.H.); Conceptualization (Q.S.Y., Y.J., T.S.H.); Methodology (Q.S.Y.); Writing – original draft (Q.S.Y.); Writing – reviewing and editing (T.S.H.); Formal analysis (J.W.); Software (J.W., Y.G., S.P.); Supervision (D.H., Y.J., T.S.H.); Funding Acquisition (Y.J., T.S.H.); Project administration (Y.J.). All authors attest that they meet the current ICMJE criteria for authorship.
Publisher Copyright:
© 2020 Elsevier Inc.
PY - 2020/9
Y1 - 2020/9
N2 - Purpose: To assess the association between optical coherence tomography angiography (OCTA)–quantified avascular areas (AAs) and diabetic retinopathy (DR) severity, progression, and treatment requirement in the following year. Design: Prospective cohort study. Methods: We recruited patients with diabetes from a tertiary academic retina practice and obtained 3-mm × 3-mm macular OCTA scans with the AngioVue system and standard 7-field color photographs at baseline and at a 1-year follow-up visit. A masked grader determined the severity of DR from the color photographs using the Early Treatment of Diabetic Retinopathy scale. A custom algorithm detected extrafoveal AA (EAA) excluding the central 1-mm circle in projection-resolved superficial vascular complex (SVC), intermediate capillary plexus (ICP), and deep capillary plexus (DCP). Results: Of 138 patients, 92 (41 men, ranging in age from 26-84 years [mean 59.4 years]) completed 1 year of follow-up. At baseline, EAAs for SVC, ICP, and DCP were all significantly correlated with retinopathy severity (P < .0001). DCP EAA was significantly associated with worse visual acuity (r = −0.24, P = .02), but SVC and ICP EAA were not. At 1 year, 11 eyes progressed in severity by at least 1 step. Multivariate logistic regression analysis demonstrated the progression was significantly associated with baseline SVC EAA (odds ratio = 8.73, P = .04). During the follow-up period, 33 eyes underwent treatment. Multivariate analysis showed that treatment requirement was significantly associated with baseline DCP EAA (odds ratio = 3.39, P = .002). No baseline metric was associated with vision loss at 1 year. Conclusions: EAAs detected by OCTA in diabetic eyes are significantly associated with baseline DR severity, disease progression, and treatment requirement over 1 year.
AB - Purpose: To assess the association between optical coherence tomography angiography (OCTA)–quantified avascular areas (AAs) and diabetic retinopathy (DR) severity, progression, and treatment requirement in the following year. Design: Prospective cohort study. Methods: We recruited patients with diabetes from a tertiary academic retina practice and obtained 3-mm × 3-mm macular OCTA scans with the AngioVue system and standard 7-field color photographs at baseline and at a 1-year follow-up visit. A masked grader determined the severity of DR from the color photographs using the Early Treatment of Diabetic Retinopathy scale. A custom algorithm detected extrafoveal AA (EAA) excluding the central 1-mm circle in projection-resolved superficial vascular complex (SVC), intermediate capillary plexus (ICP), and deep capillary plexus (DCP). Results: Of 138 patients, 92 (41 men, ranging in age from 26-84 years [mean 59.4 years]) completed 1 year of follow-up. At baseline, EAAs for SVC, ICP, and DCP were all significantly correlated with retinopathy severity (P < .0001). DCP EAA was significantly associated with worse visual acuity (r = −0.24, P = .02), but SVC and ICP EAA were not. At 1 year, 11 eyes progressed in severity by at least 1 step. Multivariate logistic regression analysis demonstrated the progression was significantly associated with baseline SVC EAA (odds ratio = 8.73, P = .04). During the follow-up period, 33 eyes underwent treatment. Multivariate analysis showed that treatment requirement was significantly associated with baseline DCP EAA (odds ratio = 3.39, P = .002). No baseline metric was associated with vision loss at 1 year. Conclusions: EAAs detected by OCTA in diabetic eyes are significantly associated with baseline DR severity, disease progression, and treatment requirement over 1 year.
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U2 - 10.1016/j.ajo.2020.04.024
DO - 10.1016/j.ajo.2020.04.024
M3 - Article
C2 - 32360332
AN - SCOPUS:85087672263
SN - 0002-9394
VL - 217
SP - 268
EP - 277
JO - American Journal of Ophthalmology
JF - American Journal of Ophthalmology
ER -