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@#AIM:To investigate the effect of anti-VEGF combined with panretinal photocoagulation(PRP)in the treatment of severe non-proliferative diabetic retinopathy(sNPDR)with diabetic macular edema(DME)on the change of macular blood flow density.<p>METHODS: Data of 30 eyes in 30 patients at Guangxi Zhuang Autonomous Region People's Hospital from October 2018 to April 2019 were retrospectively reviewed, and they were randomly divided into group A and group B each with 15 cases. Group A was received PRP treatment after one initial intravitreal ranibizumab injection followed by pro re nata(PRN)at 7d, while group B was administered PRP alone. The blood flow density of superficial capillary plexus(SCP)and deep capillary plexus(DCP)in macular area(6mm×6mm), central macular thickness(CMT), and best corrected visual acuity \〖BCVA(LogMAR)\〗 were compared between the two groups before and after treatment. <p>RESULTS: Compared with before operation, the DCP blood flow density was significantly increased, CMT was obviously decreased, and BCVA was markedly improved in group A at 2wk and 1mo after surgery(all <i>P</i><0.05), while CMT was decreased and BCVA was improved in group B at 1mo after operation(all <i>P</i><0.05). Postoperative in group A at 2wk and 1mo, the DCP blood flow density was significantly higher than that in group B(43.37%±2.72% <i>vs</i> 41.03%±2.60%, 45.01%±2.28% <i>vs</i> 41.20%±2.43%, <i>P</i><0.05), CMT was obviously lower than group B(303.4±30.36μm <i>vs</i> 329.60±31.47μm, 268.67±30.27μm <i>vs</i> 319.40±28.63μm, all <i>P</i><0.05), and BCVA(LogMAR)was markedly improved compared with group B(0.28±0.11 <i>vs</i> 0.40±0.13, 0.23±0.14 <i>vs</i> 0.38±0.15, all <i>P</i><0.05).<p>CONCLUSION: Anti-VEGF combined with PRP can effectively increase DCP blood flow density, reduce macular edema and improve visual acuity in the short term in patients with sNPDR with DME.
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@#AIM: To investigate variations in macular blood flow density and morphological structural in early age-related macular degeneration(ARMD)by using optical coherence tomography angiography(OCTA).<p>METHODS: The retrospective review included 35 patients(35 eyes)which were first diagnosed with wet age-related macular degeneration(wARMD)in one eye and the fellow eye with early ARMD in our hospital at February 2018. A total of 35(35 subjects)healthy eyes with matched age were enrolled in the control group. All the patients with early ARMD eyes were imaged by OCTA at two points: baseline and 2y later. To obeserve the change of the range of 3mm×3mm macular blood flow density of superficial retinal layer, deep retinal layer and choroidal capillaries layer, foveal avascular zone area, perimeter and acircularity index, and the macular thickness of the full layer, inner layer, outer layer retina and ISOS-BRM.<p>RESULTS: The range of 3mm×3mm macular blood flow density of superficial retinal layer, deep retinal layer and choroidal capillaries layer in early ARMD patients were lower in early ARMD eyes than controls(<i>P</i><0.05), and the macular thickness of the full layer and inner layer were reduced(<i>P</i><0.05), while the thickness of ISOS-BRM increased(<i>P</i>=0.37). There was no significant change in the area of macular foveal, perimeter and acircularity index(<i>P></i>0.05). Two years after the initial diagnosis, the blood flow density of deep retinal layer and choroidal capillaries layer in early ARMD patients further increased than before(<i>P</i>=0.02), ISOS-BRM thickness increased further than before(<i>P</i>=0.18). There was no significant change in the area of macular foveal, perimeter and acircularity index(<i>P></i>0.05). In addition, the blood flow density of the choroidal capillary layer in early ARMD patients was positively correlated with the blood flow density in superficial retinal layer and deep retinal layer at baseline and two years after frist definite diagnosis.<p>CONCLUSION: Compared with the control group, the macular blood flow density of superficial retinal layer, deep retinal layer and choroidal capillary layer, and the thickness of inner layer retina in the patients with early ARMD decreased significantly, it is clinical reference significance for the early detection and intervention of ARMD.
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AIM: Using optical coherence tomography angiography (OCTA) to observe the changes and clinical significance of macular blood flow density in patients with diabetic retinopathy (DR).METHODS: Totally 47 eyes (28 patients) with diabetic retinopathy (DR) were enrolled in the DR group.According to the international clinical grading criteria of diabetic retinopathy, 30 eyes (19 patients) with non-proliferative diabetic retinopathy were classified as the NPDR group, and 17 eyes (11 patients) with proliferative diabetic retinopathy were classified as PDR group.A total of 46 (27 subjects) healthy eyes with matched age were enrolled in the control group.All the subjects underwent the 3mm×3mm scanning of macular retina by optical coherence tomography angiography (OCTA), obtaining 4 levels of macular blood flow density map.The macular blood flow density at 3 levels, including superficial retinal layer, deep retinal layer and choroidal capillaries layer, were measured.RESULTS: The macular blood flow density of superfical retinal layer, deep retinal layer and choroidal capillaries layer in DR group were 0.4963±0.0840, 0.4798±0.0801 and 0.5290±0.0528, respectively.Among them, the blood flow density of each layer were 0.5064±0.0843,0.4983±0.0766,0.5345±0.0529, respectively, for the NPDR group, and were 0.4786±0.0830, 0.4473±0.0778,0.5192±0.0526, respectively, for the PDR group.For the control group, the density of each layers were 0.5919±0.0704, 0.6301±0.0527, 0.5691±0.0169, respectively.The macular blood flow density was significantly different in the superficial retinal layer, deep retinal layer and choroidal capillary layer between the control group and the NPDR group, as well as the PDR group and the DR group (total P<0.001).Statistically significant difference was found between the NPDR group and the PDR group in the deep retina layer (P=0.029), but not in the superficial retina layer and choroid capillary layer (P=0.236, 0.268).CONCLUSION: Compared with the control group, the macular blood flow density of superficial retinal layer, deep retinal layer and choroidal capillary layer in the patients with diabetic retinopathy decreased significantly.It indicated that the macular ischemia existed in both retina and choroid.By quantitatively measurement of the macular blood flow, OCTA may be used for monitoring the progression of diabetes, and early detection of diabetic retinopathy.