Assessing OCTA changes in morphology and structure of retinal microvascular bed in patients with exudative AMD
DOI:
https://doi.org/10.31288/oftalmolzh20192713Keywords:
optical coherence tomography angiography, age-related macular degeneration, foveal avascular zone, vessel densityAbstract
Background: Optical coherence tomography angiography (OCTA) enables measuring characteristics of the retinal microvascular bed such as vascular plexus density and foveal avascular zone (FAZ) area.
Purpose: To assess the OCTA changes in morphology and structural characteristics of the retinal microvascular bed in patients with exudative age-related macular degeneration (AMD).
Materials and Methods: Forty seven patients with exudative AMD (51 eyes) and 13 healthy controls (22 eyes) were included in the study. OCTA was used to measure superficial plexus FAZ area (SPFA), deep plexus FAZ area (DPFA), vessel density and retinal thickness. Patients were divided into three groups based on the ratio of SPFA to DPFA: Group 1 (SPFA/DPFA < 0.6; 15 eyes), Group 2 (0.6 ≤ SPFA/DPFA < 0.8; 17 eyes), and Group 3 (SPFA/DPFA ≥ 0.8; 19 eyes).
Results: Deep plexus FAZ area in all groups of patients was increased and superficial plexus FAZ area in Group 3 was significantly increased compared to controls. Patients in Group 1 exhibited mostly apparent signs of retinal edema and minimal alterations in the retinal microvascular bed. Patients in Group 2 had greater retinal thickness, but moderately lower plexus vessel density compared to controls. Patients in Group 3 had substantially lower superficial plexus vessel density and insubstantially altered retinal thickness compared to controls.
Conclusion: OCTA enables assessing the changes in morphology and structure of the retinal microvascular bed, measuring FAZ area and vessel density in patients with exudative AMD.
References
1.Wong WL, Su X, Li X, Cheung CM, Klein R, Cheng CY, Wong TY. Global prevalence of age-related macular degeneration and disease burden projection for 2020 and 2040: a systematic review and meta-analysis. Lancet Global Health. 2014 Feb;2(2):e106-16. https://doi.org/10.1016/S2214-109X(13)70145-1
2.Sulzbacher F, Kiss C, Munk M, Deak G, Sacu S, Schmidt-Erfurth U. Diagnostic evaluation of type 2 (classic) choroidal neovascularization: optical coherence tomography, indocyanine green angiography, an fluorescein angiography. Am J Ophthalmol. 2011 Nov;152(5):799-806.e1.https://doi.org/10.1016/j.ajo.2011.04.011
3.Lumbroso B, Huang D, Jia Y, Fujimoto JG, Rispoli M. Clinical guide to Angio-OCT: non invasive, dyeless OCT angiography. 1st ed. New Delhi: Jaypee Brothers Medical Publisher (P) Ltd; 2015.https://doi.org/10.5005/jp/books/12389_1
4.Jia Y, Tan O, Tokayer J, Potsaid B, Wang Y, Liu JJ, Kraus MF, Subhash H, Fujimoto JG, Hornegger J, Huang D. Split-spectrum amplitude-decorrelation angiography with optical coherence tomography. Opt Express. 2012 Feb 13;20(4):4710-25.https://doi.org/10.1364/OE.20.004710
5.Jia Y, Bailey ST, Wilson DJ, Tan O, Klein ML, Flaxel CJ, Potsaid B, Liu JJ, Lu CD, Kraus MF, Fujimoto JG, Huang D. Quantitative optical coherenсе tomography angiography of choroidal neovascularization in age-related macular degeneration. Ophthalmology. 2014 Jul;121(7):1435-44.https://doi.org/10.1016/j.ophtha.2014.01.034
6.Jia Y, Bailey ST, Hwang TS, McClintic SM, Gao SS, Pennesi ME, Flaxel CJ, Lauer AK, Wilson DJ, Hornegger J, Fujimoto JG, Huang D. Quantitative optical coherence tomography angiography of vascular abnormalities in the living human eye. Proc Natl Acad Sci USA. 2015 May 5;112(18):E2395-402.https://doi.org/10.1073/pnas.1500185112
7.Savastano MC, Lumbroso B, Rispoli M. In vivo characterization of retinal vascularization morphology using optical coherence tomography angiography. Retina. 2015 Nov;35(11):2196-203.https://doi.org/10.1097/IAE.0000000000000635
8.Tultseva SN, Astakhov YS, Rukhovets AG, Titarenko AI. [Informative value of OCT-angiography in combination with regional hemodynamic studies in retinal vein occlusion]. Oftalmologicheskie Vedomosti. 2017;10(2):40-48. Russian.https://doi.org/10.17816/OV10240-48
9.Nesper PL, Roberts PK, Onishi AC, Chai H, Liu L, Jampol LM, Fawzi AA. Quantifying microvascular abnormalities with increasing severity of diabetic retinopathy using optical coherence tomography angiography. Invest Ophthalmol Vis Sci. 2017 May 1;58(6):BIO307-BIO315.https://doi.org/10.1167/iovs.17-21787
10.Samara WA, Say EAT, Khoo CTL, Higgins TP, Magrath G, Ferenczy S, Shields CL. Correlation of foveal avascular zone size with foveal morphology in normal eyes using optical coherence tomography angiography. Retina. 2015 Nov;35(11):2188-95.https://doi.org/10.1097/IAE.0000000000000847
11.Carpineto P, Mastropasqua R, Marchini G, Toto L, Di Nicola M, Di Antonio L. Reproducibility and repeatability of foveal avascular zone measurements in healthy subjects by optical coherence tomography angiography. Br J Ophthalmol. 016 May;100(5):671-6.https://doi.org/10.1136/bjophthalmol-2015-307330
12.Balaratnasingam C, Inoue M, Ahn S, McCann J, Dhrami-Gavazi E, Yannuzzi LA, Freund KB. Visual acuity is correlated with the area of the foveal avascular zone in diabetic retinopathy and retinal vein occlusion. Ophthalmology. 2016 Nov;123(11):2352-2367.https://doi.org/10.1016/j.ophtha.2016.07.008
13.Al-Sheikh M, Akil H, Pfau M, Sadda SR. Swept-source OCT angiography imaging of the foveal avascular zone and macular capillary network density in diabetic retinopathy. Invest Ophthalmol Vis Sci. 2016 Jul 1;57(8):3907-13.https://doi.org/10.1167/iovs.16-19570
14.Takase N, Nozaki M, Kato A, Ozeki H, Yoshida M, Ogura Y. Enlargement of foveal avascular zone in diabetic eyes evaluated by en face optical coherence tomography angiography. Retina. 2015 Nov;35(11):2377-83.https://doi.org/10.1097/IAE.0000000000000849
15.Freiberg FJ, Pfau M, Wons J, Wirth MA, Becker MD, Michels S. Optical coherence tomography angiography of the foveal avascular zone in diabetic retinopathy. Graefes Arch Clin Exp Ophthalmol. 2016 Jun;254(6):1051-8.https://doi.org/10.1007/s00417-015-3148-2
16.Krawitz BD, Mo S, Geyman LS, Agemy SA, Scripsema NK, Garcia PM, Chui TYP, Rosen RB. Acircularity index and axis ratio of the foveal avascular zone in diabetic eyes and healthy-controls measured by optical coherence tomography angiography. Vision Res. 2017 Oct;139:177-186.https://doi.org/10.1016/j.visres.2016.09.019
17.Miotto S, Zemella N, Gusson E, Panozzo G, Saviano S, Scarpa G, Boschi G, Piermarocchi S. Morphologic criteria of lesion activity in neovascular age-related macular degeneration: a consensus article. J Ocul Pharmacol Ther. 2018 Apr;34(3):298-308.https://doi.org/10.1089/jop.2017.0022
18.Matsunaga D, Puliafito CA, Kashani AH. OCT angiography in healthy human subjects. Ophthalmic Surg Lasers Imaging Retina. 2014 Nov-Dec;45(6):510-5.https://doi.org/10.3928/23258160-20141118-04
19.Lumbroso B, Huang D, Chen CJ, Jia Y, Rispoli M, Romano A, Waheed NK. Clinical OCT angiography atlas. 1st ed. New Delhi: Jaypee Brothers Medical Publisher (P) Ltd; 2015.
20.Al-Sheikh M, Tepelus TC, Nazikyan T, Sadda SVR. Repeatability of automated vessel density measurements using optical coherence tomography angiography. Br J Ophthalmol. 2017 Apr;101(4):449-452.https://doi.org/10.1136/bjophthalmol-2016-308764
21.Tan CS, Lim LW, Chow VS, Chay IW, Tan S, Cheong KX, Tan GT, Sadda SR. Optical coherence tomography angiography evaluation of the parafoveal vasculature and its relationship with ocular factors. Invest Ophthalmol Vis Sci. 2016 Jul 1;57(9):OCT224-34.https://doi.org/10.1167/iovs.15-18869
22.Adhi M, Filho MA, Louzada RN, Kuehlewein L, de Carlo TE, Baumal CR, Witkin AJ, Sadda SR, Sarraf D, Reichel E, Duker JS, Waheed NK. Retinal Capillary Network and Foveal Avascular Zone in Eyes with Vein Occlusion and Fellow Eyes Analyzed With Optical Coherence Tomography Angiography. Invest Ophthalmol Vis Sci. 2016 Jul 1;57(9):OCT486-94.https://doi.org/10.1167/iovs.15-18907
23.Kashani AH, Lee SY, Moshfeghi A, Durbin MK, Puliafito CA. Optical coherence tomography angiography of retinal venous occlusion. Retina. 2015 Nov;35(11):2323-31.https://doi.org/10.1097/IAE.0000000000000811
24.Stavrev V, Sivkova N, Koleva-Georgieva D. Quantitative assessment of foveal avascular zone in patients with early and intermediate nonexudative age-related macular degeneration using optical coherence tomography-angiography. Open Journal of Ophthalmology. 2018;8(3):133-9.https://doi.org/10.4236/ojoph.2018.83017
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Н. С. Луценко, О. А. Рудичева, О. А. Ісакова, Т. С. Кирилова

This work is licensed under a Creative Commons Attribution 4.0 International License.
This work is licensed under a Creative Commons Attribution 4.0 International (CC BY 4.0) that allows users to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author as long as they cite the source.
COPYRIGHT NOTICE
Authors who publish in this journal agree to the following terms:
- Authors hold copyright immediately after publication of their works and retain publishing rights without any restrictions.
- The copyright commencement date complies the publication date of the issue, where the article is included in.
DEPOSIT POLICY
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) during the editorial process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work with an acknowledgement of its initial publication in this journal.
- Post-print (post-refereeing manuscript version) and publisher's PDF-version self-archiving is allowed.
- Archiving the pre-print (pre-refereeing manuscript version) not allowed.








