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      Macular vascular density at the superficial capillary plexus using the optical coherence tomography angiography

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          Abstract

          Purpose

          The aim of this study was to assess the effects of age, gender, axial length and retinal thickness on the vascular density in a normal population using the Optovue optical coherence tomography angiography (OCT-A).

          Methods

          A total of 209 eyes of 209 healthy subjects were scanned using the OCT-A on an outpatient basis. Patients were 20–75 years of age. The built-in software covered a 3×3 mm circle centered at the macula. The circle was divided into five sectors: a 1 mm central foveal circle and an upper, lower, nasal and temporal sector each spanning 1–3 mm away from the central circle. The vascular density (VD) at the superficial capillary plexus was measured, which spanned from the inner limiting membrane to the inner plexiform layer.

          Results

          The fovea was the least dense area (32.5%±5.9%), and the temporal area was the densest (52.4%± 4.4%). Similarly, the fovea was the thinnest part of the retina (237.8±20.7 µm); however, the nasal sector was the thickest (308.5±15.1 µm). We found a correlation of the retinal thickness ( r=0.541, P<0.001) with VD only at the fovea. Similarly, males had a greater density at the fovea ( P=0.002). All regions significantly and negatively correlated with age even after adjusting for axial length. The age sees a decline in the density after the fifth decade where the variability also seems to increase.

          Conclusion

          This study provides normative data for the Pakistani population. Additionally, it demonstrates that VD is affected by the retinal thickness at the fovea and the density begins to decline after the fifth decade.

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          Most cited references21

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          A review of optical coherence tomography angiography (OCTA)

          Optical coherence tomography angiography (OCTA) is a new, non-invasive imaging technique that generates volumetric angiography images in a matter of seconds. This is a nascent technology with a potential wide applicability for retinal vascular disease. At present, level 1 evidence of the technology’s clinical applications doesn’t exist. In this paper, we introduce the technology, review the available English language publications regarding OCTA, and compare it with the current angiographic gold standards, fluorescein angiography (FA) and indocyanine green angiography (ICGA). Finally we summarize its potential application to retinal vascular diseases. OCTA is quick and non-invasive, and provides volumetric data with the clinical capability of specifically localizing and delineating pathology along with the ability to show both structural and blood flow information in tandem. Its current limitations include a relatively small field of view, inability to show leakage, and proclivity for image artifact due to patient movement/blinking. Published studies hint at OCTA’s potential efficacy in the evaluation of common ophthalmologic diseases such age related macular degeneration (AMD), diabetic retinopathy, artery and vein occlusions, and glaucoma. OCTA can detect changes in choroidal blood vessel flow and can elucidate the presence of choroidal neovascularization (CNV) in a variety of conditions but especially in AMD. It provides a highly detailed view of the retinal vasculature, which allows for accurate delineation of the foveal avascular zone (FAZ) in diabetic eyes and detection of subtle microvascular abnormalities in diabetic and vascular occlusive eyes. Optic disc perfusion in glaucomatous eyes is notable as well on OCTA. Further studies are needed to more definitively determine OCTA’s utility in the clinical setting and to establish if this technology may offer a non-invasive option of visualizing the retinal vasculature in detail.
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            Retinal Capillary Density and Foveal Avascular Zone Area Are Age-Dependent: Quantitative Analysis Using Optical Coherence Tomography Angiography.

            The purpose of this study was to quantify retinal capillary density and the foveal avascular zone (FAZ) area in normal subjects according to age, using optical coherence tomography angiography (OCTA).
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              Macular perfusion in healthy Chinese: an optical coherence tomography angiogram study.

              To investigate macular perfusion in healthy Chinese individuals and examine its dependence on age and sex.
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                Author and article information

                Journal
                Clin Ophthalmol
                Clin Ophthalmol
                Clinical Ophthalmology
                Clinical Ophthalmology (Auckland, N.Z.)
                Dove Medical Press
                1177-5467
                1177-5483
                2019
                08 February 2019
                : 13
                : 295-302
                Affiliations
                Department of Ophthalmology and Visual Sciences, Hashmanis Hospital, Karachi, Pakistan, naumanhashmani@ 123456hashmanis.edu.pk
                Author notes
                Correspondence: Nauman Hashmani, Department of Ophthalmology and Visual Sciences, Hashmanis Hospital, 68/B Khayaban-e-Shahbaz, DHA Phase 7, Karachi, Pakistan, Tel +92 321 282 8062, Email naumanhashmani@ 123456hashmanis.edu.pk
                Article
                opth-13-295
                10.2147/OPTH.S189515
                6371924
                30799915
                72cbd8f2-afca-4c97-b482-ef397b46a2be
                © 2019 Hashmani et al. This work is published and licensed by Dove Medical Press Limited

                The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

                History
                Categories
                Original Research

                Ophthalmology & Optometry
                retina,vasculature,normative,pakistan,spectral domain,vessel density,vascular
                Ophthalmology & Optometry
                retina, vasculature, normative, pakistan, spectral domain, vessel density, vascular

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