Combining retinal and choroidal microvascular metrics improves discriminative power for diabetic retinopathy

Bingyao Tan, Nicole-Ann Lim, Rose Tan, Alfred Tau Liang Gan, Jacqueline Chua, Simon Nusinovici, Chui Ming Gemmy Cheung, Usha Chakravarthy, Tien Yin Wong, Leopold Schmetterer, Gavin Tan*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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Abstract

Purpose: To use optical coherence tomography angiography (OCTA) parameters from both the retinal and choroidal microvasculature to detect the presence and severity of diabetic retinopathy (DR).
Method: This is a cross-sectional case–control study. OCTA parameters from retinal vasculature, fovea avascular zone (FAZ) and choriocapillaris were evaluated from 3×3 mm2 fovea-centred scans. Areas under the receiver operating characteristic (ROC) curve were used to compare the discriminative power on the presence of diabetes mellitus (DM), the presence of DR and need for referral: group 1 (no DM vs DM no DR), group 2 (no DR vs any DR) and group 3 (non-proliferative DR (NPDR) vs proliferative DR (PDR)).

Results: 35 eyes from 27 participants with no DM and 132 eyes from 75 with DM were included. DR severity was classified into three groups: no DR group (62 eyes), NPDR (51 eyes), PDR (19 eyes). All retinal vascular parameters, FAZ parameters and choriocapillaris parameters were strongly altered with DR stages (p<0.01), except for the deep plexus FAZ area (p=0.619). Choriocapillaris parameters allowed to better discriminate between no DM versus DM no DR group compared with retinal parameters (areas under the ROC curve=0.954 vs 0.821, p=0.006). A classification model including retinal and choroidal microvasculature significantly improved the discrimination between DR and no DR compared with each parameter separately (p=0.029).

Conclusions: Evaluating OCTA parameters from both the retinal and choroidal microvasculature in 3×3 mm scans improves the discrimination of DM and early DR.
Original languageEnglish
JournalBritish Journal of Ophthalmology
Early online date09 Feb 2022
DOIs
Publication statusEarly online date - 09 Feb 2022

Keywords

  • Clinical science
  • 1506
  • imaging
  • retina
  • choroid

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