Macular, Peripapillary, and Midperipheral Nonperfusion in Diabetic Subjects: A Wide-Field OCTA Quantification

Area of Science:

• Ophthalmology
• Medical Imaging
• Diabetic Retinopathy Research

Background:

• Diabetic retinopathy (DR) is a leading cause of vision loss, characterized by retinal vascular changes.
• Assessing peripheral retinal perfusion is crucial for comprehensive DR management.
• Optical coherence tomography angiography (OCTA) offers noninvasive visualization of retinal vasculature.

Purpose of the Study:

• To correlate geometric perfusion deficit (GPD) between macular, peripapillary, and midperipheral retinal regions in diabetic patients.
• To quantify the relationship between nonperfusion metrics in different retinal areas using widefield swept-source OCTA.
• To investigate GPD correlations in eyes with and without diabetic retinopathy.

Main Methods:

• Widefield swept-source OCTA imaging was performed on 197 diabetic eyes.
• Geometric perfusion deficit (GPD) was calculated for macular, peripapillary, and midperipheral regions.
• GPD was assessed in superficial (SCP) and deep (DCP) capillary plexuses, and radial peripapillary capillary plexus (RPCP).

Main Results:

• Moderate-to-strong positive correlations were found between macular and midperipheral GPD in both SCP and DCP.
• The RPCP showed moderate correlations with midperipheral SCP and DCP.
• Significant correlations between macular and midperipheral GPD persisted in subgroup analyses of DR and no-DR eyes.

Conclusions:

• Macular and peripapillary GPD are positively correlated with midperipheral perfusion deficits in diabetic patients.
• OCTA-based assessment of perfusion deficits can noninvasively monitor DR.
• This approach may facilitate early detection of peripheral vascular alterations in diabetic retinopathy.