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      Evaluation of macular and peri-papillary blood vessel density following uncomplicated phacoemulsification in diabetics using optical coherence tomography angiography

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          Abstract

          Purpose:

          The aim of this study was to evaluate the macular and peri-papillary blood vessel density following uncomplicated phacoemulsification in diabetics using optical coherence tomography angiography (OCT-A).

          Methods:

          An observational case-control study was conducted on 60 patients eligible for phacoemulsification, divided equally into diabetic and control groups. Both study groups were matching in sex, age, and axial length. We excluded diabetic patients of any form of macular edema or treatment history for macular edema. All study participants were subjected to preoperative OCT and OCT-A, which was repeated for all study population 1 month postoperatively.

          Results:

          We had a mean age of 54.5 ± 6.34 years in the non-diabetic group and 57.2 ± 4.09 years in the diabetic group ( P = 0.06). There was a significant increase in the mean value of the macular blood vessels density in the nasal area in both study groups ( P = 0.047 in non-diabetic group, P = 0.002 in the diabetic group). The percentage of the radial peripapillary capillary plexus vessel density (RPCP VD) change was non-significant on comparing the results for the diabetic group (mean preoperative value = 52.8 ± 4.47, postoperative = 52.0 ± 4.59, P = 0.204, D is the preoperative-postoperative value = 0.8), and also was non-significant for the non-diabetic group (mean preoperative value = 50.9 ± 4.89, postoperative = 52.1 ± 4.89, P = 0. 0.090, D = -1.3). On comparing the results of the diabetic and nondiabetic groups, the RPCP VD D was significantly different ( P = 0.034).

          Conclusion:

          Uncomplicated phacoemulsification results in increase of the nasal macular blood vessel density in the normal population and in diabetic patients without retinopathy.

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          Most cited references15

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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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            Early retinal neurovascular impairment in patients with diabetes without clinically detectable retinopathy.

            To investigate the function and the corresponding neurovascular structures in patients with diabetes without clinically detectable retinopathy. METHODS : Sixty-six patients with type 2 diabetes without retinopathy (NDR) and 62 healthy controls were recruited. The 16 and 32 Tds flicker electroretinography (ERG) was performed using a mydriasis-free, full-field flicker ERG recording device (RETeval). The vessel density (VD) of superficial capillary plexus (SCP) and deep capillary plexus (DCP), FD300 and ganglion cell complex (GCC) thickness in the macula were quantified using optical coherence tomography angiography (OCTA). The retinal nerve fibre layer (RNFL) thickness and the radial peripapillary capillary (RPC) density in the peripapillary area were also measured with OCTA.
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              Spectral transmission of the human crystalline lens in adult and elderly persons: color and total transmission of visible light.

              To experimentally measure the spectral transmission of human crystalline lenses belonging to adult and elderly persons, and to determine the color and total transmission of visible light of such crystalline lenses.
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                Author and article information

                Journal
                Indian J Ophthalmol
                Indian J Ophthalmol
                IJO
                Indian Journal of Ophthalmology
                Wolters Kluwer - Medknow (India )
                0301-4738
                1998-3689
                May 2021
                30 April 2021
                : 69
                : 5
                : 1173-1177
                Affiliations
                [1]Faculty of Medicine, Cairo University, Cairo, Egypt
                Author notes
                Correspondence to: Dr. Shireen M Shousha, 60 Sudan Street, ElDokki, Giza, Egypt. E-mail: Shireen.Shousha@ 123456kasralainy.edu.eg
                Article
                IJO-69-1173
                10.4103/ijo.IJO_2187_20
                8186633
                33913854
                72cbe63f-0e16-479f-97ce-86fdea4e1bf7
                Copyright: © 2021 Indian Journal of Ophthalmology

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                : 04 July 2020
                : 23 September 2020
                : 10 December 2020
                Categories
                Special Focus on Uvea and Retina, Original Article

                Ophthalmology & Optometry
                diabetes,macular vessel density,optical coherence tomography- angiography,phacoemulsification,radial peripapillary capillary plexus

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