Coscas Florence, Sellam Alexandre, Glacet-Bernard Agnès, Jung Camille, Goudot Mathilde, Miere Alexandra, Souied Eric H
Department of Ophtalmology Centre Hospitalier Intercommunal de Créteil, Créteil, France.
Centre de Recherche Clinique, Centre Hospitalier Intercommunal de Créteil, Université Paris Est, Créteil, France.
Invest Ophthalmol Vis Sci. 2016 Jul 1;57(9):OCT211-23. doi: 10.1167/iovs.15-18793.
To establish a normative database for vascular density (VD) and foveal avascular zone (FAZ) at the superficial (SCP) and deep capillary plexus (DCP) in healthy subjects with optical coherence tomography (OCT) angiography.
The study was a retrospective chart review of healthy patients who had undergone OCT angiography imaging. A 3- × 3-mm area, centered on the fovea, was scanned for all the study eyes. The automated segmentation allowed separate analysis of the SCP, the DCP, and a comprehensive C-scan including both vascular layers. On the obtained images, VD and FAZ measurements were computed. Interobserver reproducibility and intraobserver repeatability were also assessed.
A total of 135 eyes of 70 subjects (51% male) were analyzed. The mean age was 48.3 ± 17.5. We divided patients into group 1, from 20 to 39 years of age; group 2, from 40 to 59 years; and group 3, age 60 years or older. At the level of the SCP, mean VD and mean FAZ ± SD were, respectively, 52.58 ± 3.22% and 0.28 ± 0.1 mm2. At the level of the DCP, mean VD and mean FAZ were 57.87 ± 2.82% and 0.37 ± 0.12 mm2, respectively. The mean VD was significantly higher (P < 0.05) in DCP compared with SCP in all Early Treatment Diabetic Retinopathy Study (ETDRS) sectors and in all age groups. Vascular density was higher in women than in men after 60 years (P < 0.01). After adjustment on the signal strength index (SSI), the mean VD remained directly correlated with the age range and sex. The mean FAZ area was lower in group 3 (P < 0.05). Interobserver reproducibility was 0.78 to 0.99 in SCP and 0.67 to 0.92 in DCP, and intraobserver repeatability was 0.64 to 0.93 in SCP and 0.63 to 0.87 in DCP.
Our study has provided, for the first time, age-related VD mapping data using OCT angiography in healthy subjects. The prototype software used in this study may help to improve the concept of VD grading with high inter- and intraexaminer repeatability and interexaminer reproducibility.
利用光学相干断层扫描血管造影术(OCTA)建立健康受试者浅表毛细血管丛(SCP)和深部毛细血管丛(DCP)血管密度(VD)及黄斑无血管区(FAZ)的标准数据库。
本研究是对接受OCTA成像的健康患者进行的回顾性病历审查。对所有研究眼进行以黄斑为中心的3×3毫米区域扫描。自动分割可分别分析SCP、DCP以及包括两个血管层的综合C扫描。在获取的图像上计算VD和FAZ测量值。还评估了观察者间的可重复性和观察者内的重复性。
共分析了70名受试者的135只眼(男性占51%)。平均年龄为48.3±17.5岁。我们将患者分为1组(20至39岁)、2组(40至59岁)和3组(60岁及以上)。在SCP层面,平均VD和平均FAZ±标准差分别为52.58±3.22%和0.28±0.1平方毫米。在DCP层面,平均VD和平均FAZ分别为57.87±2.82%和0.37±0.12平方毫米。在所有糖尿病视网膜病变早期治疗研究(ETDRS)扇区和所有年龄组中,DCP的平均VD均显著高于SCP(P<0.05)。60岁以后女性的血管密度高于男性(P<0.01)。在调整信号强度指数(SSI)后,平均VD仍与年龄范围和性别直接相关。3组的平均FAZ面积较小(P<0.05)。SCP的观察者间可重复性为0.78至0.99,DCP为0.67至0.92;SCP的观察者内重复性为0.64至0.93,DCP为0.63至0.87。
我们的研究首次提供了健康受试者使用OCTA的年龄相关VD图谱数据。本研究中使用的原型软件可能有助于改进VD分级概念,具有较高的检查者间和检查者内重复性以及检查者间可重复性。