Relationship Between Nonperfusion Area from Widefield Optical Coherence Tomography Angiography and Macular Vascular Parameters in Diabetic Retinopathy

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Abstract Purpose To evaluate the relationship between the nonperfusion area (NPA) from wide optical coherence tomography angiography (OCTA) and macular vascular parameters in diabetic retinopathy (DR). Methods In total, 51 eyes from 51 patients with proliferative DR (PDR) or moderate/severe non-PDR were included. Widefield OCTA using the Zeiss Plex Elite 9000 was performed. A semi-automatic algorithm calculated the percentages of the NPA within the total image. Macular OCTA (3 × 3 mm and 6 × 6 mm area) was scanned using the RTVue-XR avanti. Vessel density (VD) was automatically separated into the superficial (SCP) and deep capillary plexus (DCP), and foveal avascular zone (FAZ) measurements were computed according to the parafoveal (1–3 mm) and perifoveal (3–6 mm) regions. Results A negative correlation was found between the average VD of the SCP and DCP obtained 3 × 3 mm and 6 × 6 mm area and the NPA. Multiple regression analysis revealed that the temporal–perifoveal region most negatively correlated with the NPA (r = − 0.55, p < 0.0001). No correlation was found between FAZ measurements and DR severity (area, p = 0.07; perimeter, p = 0.13). Conclusion Diabetic macular nonperfusion was significantly associated with the NPA from widefield OCTA. In particular, the temporal–perifoveal DCP disorder may be a sensitive indicator of wide NPA.

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