JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE) ›› 2021, Vol. 41 ›› Issue (2): 166-172.doi: 10.3969/j.issn.1674-8115.2021.02.007

• Clinical research • Previous Articles     Next Articles

Detection of vessel density changes in eyes of patients with diabetic retinopathy and diabetic macular edema using optical coherence tomography angiography

Han-ying WANG(), Yan JIANG(), Ching-yi WANG, Xin SHI, Tian NIU, Xin-dan XING, Yin-chen SHEN, Chong CHEN, Kun LIU()   

  1. Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University; National Clinical Research Center for Eye Diseases; Shanghai Key Laboratory of Ocular Fundus Diseases; Shanghai Engineering Center for Visual Science and Photomedicine; Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai 200080, China
  • Received:2020-04-01 Online:2021-02-28 Published:2021-02-28
  • Contact: Kun LIU;;
  • Supported by:
    National Key Research and Development Program of China(2016YFC0904800);National Science and Technology Major Project of China(2017ZX09304010);National Natural Science Foundation of China(81870667);Shanghai Municipal Education Commission—Gaofeng Clinical Medicine Grant Support(20161426)

Abstract: Objective

·To observe the features of diabetic retinopathy (DR) at different stages, which is accompanied/not accompanied by diabetic macular edema (DME), using optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA), and to determine related risk factors and potential OCTA imaging biomarkers of DR progression.


·Ninety DR patients from Shanghai General Hospital, Shanghai Jiao Tong University were divided into four groups according to early treatment of diabetic retinopathy study (ETDRS) grading standard (mild, moderate, severe non-proliferative diabetic retinopathy and proliferative diabetic retinopathy groups), or two groups according to the presence of DME or not. OCTA metrics, including superficial vessel density, deep vessel density and foveal avascular zone area were compared. Logistic regression was used to exclude confounding factors. Imaging changes related to DR severity and DME occurrence, as well as other factors including gender, age, history of underlying diseases, use of antihypertensive drugs and blood indicators were searched.


·Lower age of the onset of diabetes (P=0.042, 95%CI -0.057--0.001) and lower deep vessel density (P=0.040, 95%CI -0.066--0.002) were significantly associated with DR progression. The absence of hyperlipidemia was a protective factor for the progression of DR disease (P=0.027, 95%CI -3.001--0.176). The incidence of DME increased with the severity of DR (P=0.004), and the occurrence of disorganization of retinal inner layers was significantly related to DME (P=0.000). No alteration in vessel density was observed between patients with DME and those without DME.


·The progression of DR may be closely related to the vessel density of deep retinal vessels, which may become an imaging biomarker to predict the development of DR.

Key words: diabetic retinopathy (DR), optical coherence tomography angiography (OCTA), vascular density, diabetic macular edema (DME)

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