Faculty Collaboration Database

Foveal avascular zone morphology and parafoveal capillary perfusion in sickle cell retinopathy. Br J Ophthalmol 2020 Apr;104(4):473-479

Date

07/25/2019

Pubmed ID

31337609

Pubmed Central ID

PMC6980907

DOI

10.1136/bjophthalmol-2019-314567

Scopus ID

2-s2.0-85069941171 (requires institutional sign-in at Scopus site)   18 Citations

Abstract

BACKGROUND/AIMS: To assess foveal avascular zone (FAZ) morphology and parafoveal capillary perfusion in patients with various stages of sickle cell retinopathy (SCR) using optical coherence tomography angiography (OCT-A).

METHODS: This is a multi-institutional retrospective study of patients with various stages of SCR compared with healthy controls. Parafoveal OCT-A images obtained using a commercial spectral domain-OCT system were reviewed. Foveal-centred 3×3 mm full vascular slab OCT-As were used for image processing and data analysis. FAZ area, perimeter, and acircularity index were determined on the OCT-A image after manual delineation of the FAZ border. Quadrant-based parafoveal capillary density and per cent area deviating from normal distribution were also measured.

RESULTS: Fifty-two patients with SCR (33 non-proliferative and 19 proliferative) and 20 age and race-matched healthy controls were included. One randomly selected eye per study participant was analysed. FAZ perimeter and acircularity index were significantly greater in SCR eyes when compared with the controls. While parafoveal capillary density was significantly lower, per cent area deviated from normal distribution was significantly higher in SCR eyes than that of the control. However, no statistically significant difference between the two SCR stages was observed. In quadrant-based analysis, the temporal quadrant showed greater parafoveal capillary dropout due to SCR, with the most profound effect in patients with proliferative SCR.

CONCLUSIONS: Abnormal FAZ morphology and altered parafoveal capillary perfusion were found in patients with SCR. Our customised OCT-A image analysis method uniquely highlights significant quantitative alterations in perfusion density mapping in a qualitative display, with minimal obscuration of OCT-A image detail.

Author List

Lynch G, Scott AW, Linz MO, Han I, Andrade Romo JS, Linderman RE, Carroll J, Rosen RB, Chui TY

Author

Joseph J. Carroll PhD Director, Professor in the Ophthalmology and Visual Sciences department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Anemia, Sickle Cell
Capillaries
Female
Fluorescein Angiography
Fovea Centralis
Humans
Ischemia
Male
Middle Aged
Retinal Diseases
Retinal Vessels
Retrospective Studies
Tomography, Optical Coherence
Visual Acuity
Young Adult