Quantification of Diabetic Macular Ischemia Using Optical Coherence Tomography Angiography and Its Relationship with Visual Acuity

Purpose To quantify foveal avascular zone (FAZ) area and macular vascular density objectively using optical coherence tomography angiography (OCTA) and to examine correlations with visual acuity in eyes with diabetic retinopathy (DR) in the absence of diabetic macular edema. Design Retrospective observational case series. Participants Eighty-four eyes from 55 patients with DR and 34 control eyes from 27 age-matched healthy participants. Methods All eyes underwent OCTA (RTVue-XR Avanti; Optovue, Inc, Fremont, CA). Integrated automated algorithms were used to quantify FAZ area and macular vascular density. Main Outcome Measures FAZ area, vessel area density (VAD), vessel length density (VLD), and visual acuity. Results In each study eye, DR was classified as mild nonproliferative DR (NPDR; n = 32 [38%]), moderate-to-severe NPDR (n = 31 [37%]), or proliferative DR (n = 21 [25%]). Mean FAZ area was greater in diabetic eyes compared with control eyes both in the superficial (0.427 mm 2 vs. 0.275 mm 2 ; P 2 vs. 0.372 mm 2 ; P P P −1 vs. 21.55 mm −1 ; P −1 vs. 24.38 mm −1 ; P P P P P Conclusions Automated quantitative algorithms allow for objective assessment of retinal vascular changes in eyes with DR that are correlated to visual acuity. These methods may prove useful in monitoring disease progression and identifying parameters that affect visual function.