In Vivo Assessment of Macular Vascular Density in Healthy Human Eyes Using Optical Coherence Tomography Angiography

Abstract Purpose To quantify density of macular vascular networks over regions of interest in healthy subjects using optical coherence tomography angiography (OCTA). Design Prospective cross-sectional study. Methods Settings: Retina and Oncology Services of Wills Eye Hospital. Subjects with no known...

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Bibliographic Details
Published in:American journal of ophthalmology 2016-05, Vol.165, p.39-46
Main Authors: Shahlaee, Abtin, MD, Samara, Wasim A., MD, Hsu, Jason, MD, Say, Emil Anthony T., MD, Khan, M. Ali, MD, Sridhar, Jayanth, MD, Hong, Bryan K., MD, Shields, Carol L., MD, Ho, Allen C., MD
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Algorithms
Automation
Capillaries - anatomy & histology
Capillaries - diagnostic imaging
Child
Confidence intervals
Cross-Sectional Studies
Disease
Female
Fluorescein Angiography
Funding
Healthy Volunteers
Humans
Male
Medical imaging
Middle Aged
Ophthalmology
Prospective Studies
Regional Blood Flow - physiology
Reproducibility of Results
Retinal Vessels - anatomy & histology
Retinal Vessels - diagnostic imaging
Studies
Tomography, Optical Coherence
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Summary:Abstract Purpose To quantify density of macular vascular networks over regions of interest in healthy subjects using optical coherence tomography angiography (OCTA). Design Prospective cross-sectional study. Methods Settings: Retina and Oncology Services of Wills Eye Hospital. Subjects with no known systemic disease and without retinal pathology were included. OCTA was performed on a 3×3-mm region centered on the macula (RTVue-XR Avanti, Optovue) and en face angiograms of the superficial and deep vascular networks were acquired. Vascular density was calculated using an automated image thresholding method (ImageJ, National Institutes of Health) over regions of interest. Foveal and parafoveal vascular density were calculated. The differences between vascular networks, genders, fellow eyes and correlation between vascular density, signal strength, and age as well as reproducibility of measurements were evaluated. Results A total of 198 healthy eyes were imaged from which 163 eyes of 122 subjects were included based on image quality criteria. In the parafoveal region, deep vascular density was significantly higher than the superficial (52±2.4% vs. 46±2.2%; P< 0.001) whereas the opposite was found in the foveal region (27±5.2% vs. 32±3.2%; P< 0.001). All vascular density measurements were statistically similar in fellow eyes and there was no gender difference ( P >0.05). There was a negative correlation between vascular density and age that persisted upon adjusting for signal strength. Vascular density measurements were highly correlated between separate imaging sessions with intraclass correlation coefficients of over 0.85 for all assessments. Conclusions Calculation of vascular density using OCTA is a reproducible and non-invasive method to quantitate individual networks within the macula. Understanding normal values and their correlations could affect clinical evaluation of the macula in healthy patients and disease states.
ISSN:0002-9394
1879-1891
DOI:10.1016/j.ajo.2016.02.018