TY - JOUR
T1 - Capillary density and caliber as assessed by optical coherence tomography angiography may be significant predictors of diabetic retinopathy severity
AU - Kushner-Lenhoff, Sam
AU - Kogachi, Kaitlin
AU - Mert, Melissa
AU - Chu, Zhongdi
AU - Shahidzadeh, Anoush
AU - Palejwala, Neal V.
AU - Wolfe, Jeremy
AU - Itty, Sujit
AU - Drenser, Kimberly A.
AU - Capone, Antonio
AU - Dugel, Pravin U.
AU - Moshfeghi, Andrew A.
AU - Ameri, Hossein
AU - Daskivich, Lauren P.
AU - Wang, Ruikang K.
AU - Kashani, Amir H.
N1 - Publisher Copyright:
© 2022 Kushner-Lenhoff et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2022/1
Y1 - 2022/1
N2 - Purpose To validate retinal capillary density and caliber associations with diabetic retinopathy (DR) severity in different clinical settings. Methods This cross-sectional study assessed retinal capillary density and caliber in the superficial retinal layer of 3-mm OCTA scans centered on the fovea. Images were collected from non-diabetic controls and subjects with mild or referable DR (defined DR worse than mild DR) between February 2016 and December 2019 at secondary and tertiary eye care centers. Vessel Skeleton Density (VSD), a measure of capillary density, and Vessel Diameter Index (VDI), a measure of vascular caliber, were calculated from these images. Discriminatory performance of VSD and VDI was evaluated using multivariable logistic regression models predicting DR severity with adjustments for sex, hypertension, and hyperlipidemia. Area under the curve (AUC) was estimated. Model performance was evaluated in two different cohorts. Results This study included 594 eyes from 385 subjects. Cohort 1 was a training cohort of 509 eyes including 159 control, 155 mild non-proliferative DR (NPDR) and 195 referable DR eyes. Cohort 2 was a validation cohort consisting of 85 eyes including 16 mild NPDR and 69 referable DR eyes. In Cohort 1, addition of VSD and VDI to a model using only demographic data significantly improved the model's AUC for discrimination of eyes with any DR severity from controls (0.91 [95% CI, 0.88-0.93] versus 0.80 [95% CI, 0.76-0.83], p < 0.001) and eyes with referable DR from mild NPDR (0.90 [95% CI, 0.86-0.93] versus 0.69 [95% CI, 0.64- 0.75], p < 0.001). The transportability of this regression model was excellent when implemented in Cohort 2 for the referable DR versus mild NPDR comparison. The odds ratio of having any DR compared to control subjects, and referable DR compared to mild DR decreased by 15% (95% CI: 12-18%), and 13% (95% CI: 10-15%), respectively, for every 0.001 unit increase in VSD after adjusting for comorbidities. Conclusion OCTA-derived capillary density has real world clinical value for rapidly assessing DR severity.
AB - Purpose To validate retinal capillary density and caliber associations with diabetic retinopathy (DR) severity in different clinical settings. Methods This cross-sectional study assessed retinal capillary density and caliber in the superficial retinal layer of 3-mm OCTA scans centered on the fovea. Images were collected from non-diabetic controls and subjects with mild or referable DR (defined DR worse than mild DR) between February 2016 and December 2019 at secondary and tertiary eye care centers. Vessel Skeleton Density (VSD), a measure of capillary density, and Vessel Diameter Index (VDI), a measure of vascular caliber, were calculated from these images. Discriminatory performance of VSD and VDI was evaluated using multivariable logistic regression models predicting DR severity with adjustments for sex, hypertension, and hyperlipidemia. Area under the curve (AUC) was estimated. Model performance was evaluated in two different cohorts. Results This study included 594 eyes from 385 subjects. Cohort 1 was a training cohort of 509 eyes including 159 control, 155 mild non-proliferative DR (NPDR) and 195 referable DR eyes. Cohort 2 was a validation cohort consisting of 85 eyes including 16 mild NPDR and 69 referable DR eyes. In Cohort 1, addition of VSD and VDI to a model using only demographic data significantly improved the model's AUC for discrimination of eyes with any DR severity from controls (0.91 [95% CI, 0.88-0.93] versus 0.80 [95% CI, 0.76-0.83], p < 0.001) and eyes with referable DR from mild NPDR (0.90 [95% CI, 0.86-0.93] versus 0.69 [95% CI, 0.64- 0.75], p < 0.001). The transportability of this regression model was excellent when implemented in Cohort 2 for the referable DR versus mild NPDR comparison. The odds ratio of having any DR compared to control subjects, and referable DR compared to mild DR decreased by 15% (95% CI: 12-18%), and 13% (95% CI: 10-15%), respectively, for every 0.001 unit increase in VSD after adjusting for comorbidities. Conclusion OCTA-derived capillary density has real world clinical value for rapidly assessing DR severity.
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U2 - 10.1371/journal.pone.0262996
DO - 10.1371/journal.pone.0262996
M3 - Article
C2 - 35081154
AN - SCOPUS:85123524312
SN - 1932-6203
VL - 17
JO - PloS one
JF - PloS one
IS - 1 January
M1 - e0262996
ER -