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Noh, Ryu, and Sagong: Analysis of Foveal Microvascular Structures Using Optical Coherence Tomography Angiography in Age-stratified Healthy Koreans
Original Article

Journal of the Korean Ophthalmological Society 2017; 58(9): 1058-1065.

Published online: 18 September 2017

DOI: https://doi.org/10.3341/jkos.2017.58.9.1058

Analysis of Foveal Microvascular Structures Using Optical Coherence Tomography Angiography in Age-stratified Healthy Koreans

Donghyoun Noh, MD, Gahyung Ryu, MD, Min Sagong, MD, PhD

Department of Ophthalmology, Yeungnam University College of Medicine, Daegu, Korea.

Address reprint requests to: Min Sagong, MD, PhD. Department of Ophthalmology, Yeungnam University Hospital, #170 Hyeonchung-ro, Nam-gu, Daegu 42415, Korea. Tel: 82-53-620-3443, Fax: 82-53-626-5936, msagong@ynu.ac.kr

Received 26 July 2017       Revised 16 August 2017       Accepted 5 September 2017

©2017 The Korean Ophthalmological Society

The Korean Ophthalmological Society

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate foveal avascular zone (FAZ) microvascular structural changes in healthy Korean subjects stratified by age using optical coherence tomography angiography (OCTA).

Methods

Eighty eyes of 43 healthy volunteer subjects who had 20/20 or better best corrected visual acuity without other ocular or systemic disease except vitreous floaters and dry eye syndrome were enrolled and stratified by age group. To measure FAZ size and vascular density (VD) of the superficial capillary plexus (SCP) and deep capillary plexus (DCP), OCTA (DRI OCT Triton, Swept Source OCT, Topcon, Tokyo, Japan) scans were performed over fovea-centered 3 × 3 mm2 regions, and then compared with central macular thickness (CMT) and subfoveal choroidal thickness.

Results

Mean age of the participants was 46.4 ± 16.1 (20–78). The SCP and DCP FAZ sizes were 0.32 ± 0.11 mm2 and 0.41 ± 0.14 mm2, respectively. There was a significant difference by age group (p < 0.001, p < 0.001), respectively. The FAZ VD for SCP and DCP was 28.96 ± 3.05% and 33.15 ± 3.64%, respectively. There was no difference between age groups (p = 0.118, p = 0.637). Univariate and multiple linear regression analysis showed that the FAZ size of SCP and DCP was significantly correlated with age (p = 0.039, p = 0.002) and CMT (p = 0.007, p = 0.013), respectively. The SCP and DCP FAZ size were positively correlated with age (R2 = 0.279, p < 0.001, R2 = 0.344, p < 0.001), and negatively correlated with CMT (R2 = 0.354, p < 0.001, R2 = 0.285, p < 0.001), respectively.

Conclusions

The FAZ size of SCP and DCP increased with age and were negatively correlated with CMT. These results suggest that consideration of age and CMT is important when performing the clinical evaluation of FAZ size in healthy subjects.

Keywords: Age, Foveal avascular zone, Healthy subjects, Optical coherence tomography angiography, Vascular density

Figures and Tables

Figure 1

Manual outlining (green) of the border of foveal avascular zone. Optical coherence tomography angiography 3 × 3 mm scans segmented at the superficial capillary plexus (A) and the deep capillary plexus (B).

jkos-58-1058-g001
Figure 2

Variation of foveal avascular zone (FAZ) area with age and central macular thickness (CMT). Area of superficial capillary plexus (SCP) FAZ (A) showed significant positive correlation with age, while CMT (B) was negatively correlated (R2 = 0.279, p < 0.001, R2 = 0.354, p < 0.001). Also, the area of deep capillary plexus (DCP) FAZ (C) showed positive correlation with age, while CMT (D) was negatively correlated (R2 = 0.344, p < 0.001, R2 = 0.285, p < 0.001).

jkos-58-1058-g002
Table 1

Baseline characteristics and microvascular structures using optical coherence tomography angiogaphy in age-stratified healthy subjects

jkos-58-1058-i001

Values are presented as mean ± SD unless otherwise indicated. Post hoc analysis by Mann-whitney U-test. SCP FAZ: 20-29 vs. 50-59 = 0.001, 20-29 vs. Over 60 < 0.001, 30-39 vs. 50-59 = 0.004, 30-39 vs. Over 60 < 0.001, 40-49 vs. Over 60 = 0.001. DCP FAZ: 20-29 vs. 50-59 < 0.001, 20-29 vs. Over 60 < 0.001, 30-39 vs. 50-59 < 0.001, 30-39 vs. Over 60 < 0.001. CMT: 20-29 vs. 50-59 = 0.001.

pts = patients; M = male; F = female; SE = spherical equivalent; SCP = superficial capillary plexus; FAZ = foveal avascular zone; DCP = deep capillary plexus; CMT = central macular thickness; SubChT = subfoveal choroidal thickness.

*Fisher-exact test; †Kruskal Wallis test.

Table 2

Linear regression analysis of factors affecting the foveal avascular zone size

jkos-58-1058-i002

FAZ = foveal avascular zone; M = male; F = female; SE = spherical equivalent; CMT = central macular thickness; SubChT = subfoveal choroidal thickness.

Notes

This study was presented as a narration at the 116th Annual Meeting of the Korean Ophthalmological Society 2016.

Conflicts of Interest The authors have no conflicts to disclose.

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