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Article

Correlation of Optical Coherence Tomography Angiography Characteristics with Visual Function to Define Vision-Threatening Diabetic Macular Ischemia

by
Wei-Shan Tsai
1,2,
Sridevi Thottarath
1,
Sarega Gurudas
2,
Piyali Sen
2,
Elizabeth Pearce
3,
Andrea Giani
3,
Victor Chong
2,
Chui Ming Gemmy Cheung
4 and
Sobha Sivaprasad
1,2,*
1
NIHR Moorfields Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, 162 City Road, London EC1V 2PD, UK
2
Institute of Ophthalmology, University College London, 11-43 Bath Street, London EC1V 9EL, UK
3
Boehringer Ingelheim, Binger Street 173, 55218 Ingelheim am Rhein, Germany
4
Singapore National Eye Centre, 11 Third Hospital Avenue, Singapore 168751, Singapore
*
Author to whom correspondence should be addressed.
Diagnostics 2022, 12(5), 1050; https://doi.org/10.3390/diagnostics12051050
Submission received: 24 March 2022 / Revised: 15 April 2022 / Accepted: 20 April 2022 / Published: 22 April 2022
(This article belongs to the Special Issue Optical Coherence Tomography Angiography: Value for Retinal Diseases Diagnostics)
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Abstract

The thresholds of macular microvasculature parameters associated with mild visual impairment in diabetic macular ischemia (DMI) patients are unclear. Therefore, this prospective observational study is aimed at demonstrating the optical coherence tomography angiography parameters that best correlate with mild visual impairment (<70 Early Treatment Diabetic Retinopathy Study (ETDRS) letters, Snellen equivalent 20/40) in DMI. The study was completed at the Moorfields Eye Hospital from December 2019 to August 2021. A total of 123 eyes of 87 patients with stable-treated proliferative diabetic retinopathy following panretinal photocoagulation were recruited. DMI was defined as an irregular foveal avascular zone (FAZ) area ≥ 0.5 mm2 or a smaller FAZ area with parafoveal capillary dropout in at least one quadrant. The analysis showed that the whole image deep vascular complex vessel density (DVC VD) in the 3 × 3 mm area had the best discriminatory ability to identify participants with mild visual impairment at 41.9% (area under the curve = 0.77, sensitivity 94%, specificity 54%, likelihood ratio [LR] = 2.04), and the FAZ area had the greatest post-test LR = 4.21 at 0.64 mm2. The 3 × 3 mm whole image DVC VD and FAZ area cutoffs are useful for screening vision-threatening DMI, but DVC VD has low specificity.
Keywords: diabetic macular ischemia; optical coherence tomography angiography; visual acuity; low-luminance visual acuity; proliferative diabetic retinopathy; panretinal photocoagulation diabetic macular ischemia; optical coherence tomography angiography; visual acuity; low-luminance visual acuity; proliferative diabetic retinopathy; panretinal photocoagulation

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MDPI and ACS Style

Tsai, W.-S.; Thottarath, S.; Gurudas, S.; Sen, P.; Pearce, E.; Giani, A.; Chong, V.; Cheung, C.M.G.; Sivaprasad, S. Correlation of Optical Coherence Tomography Angiography Characteristics with Visual Function to Define Vision-Threatening Diabetic Macular Ischemia. Diagnostics 2022, 12, 1050. https://doi.org/10.3390/diagnostics12051050

AMA Style

Tsai W-S, Thottarath S, Gurudas S, Sen P, Pearce E, Giani A, Chong V, Cheung CMG, Sivaprasad S. Correlation of Optical Coherence Tomography Angiography Characteristics with Visual Function to Define Vision-Threatening Diabetic Macular Ischemia. Diagnostics. 2022; 12(5):1050. https://doi.org/10.3390/diagnostics12051050

Chicago/Turabian Style

Tsai, Wei-Shan, Sridevi Thottarath, Sarega Gurudas, Piyali Sen, Elizabeth Pearce, Andrea Giani, Victor Chong, Chui Ming Gemmy Cheung, and Sobha Sivaprasad. 2022. "Correlation of Optical Coherence Tomography Angiography Characteristics with Visual Function to Define Vision-Threatening Diabetic Macular Ischemia" Diagnostics 12, no. 5: 1050. https://doi.org/10.3390/diagnostics12051050

APA Style

Tsai, W.-S., Thottarath, S., Gurudas, S., Sen, P., Pearce, E., Giani, A., Chong, V., Cheung, C. M. G., & Sivaprasad, S. (2022). Correlation of Optical Coherence Tomography Angiography Characteristics with Visual Function to Define Vision-Threatening Diabetic Macular Ischemia. Diagnostics, 12(5), 1050. https://doi.org/10.3390/diagnostics12051050

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