LUCAS RAMOS DE PRETTO

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search.filters.applied.f.ispartof: Investigative Ophthalmology & Visual Science × Agência de fomento: Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) ×

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    Artigo IPEN-doc 26682
    Retinal nonperfusion relationship to arteries or veins observed on widefield optical coherence tomography angiography in diabetic retinopathy
    2019 - ISHIBAZAWA, AKIHIRO; PRETTO, LUCAS R. de; ALIBHAI, A. YASIN; MOULT, ERIC M.; ARYA, MALVIKA; SOROUR, OSAMA; MEHTA, NIHAAL; BAUMAL, CAROLINE R.; WITKIN, ANDRE J.; YOSHIDA, AKITOSHI; DUKER, JAY S.; FUJIMOTO, JAMES G.; WAHEED, NADIA K.
    PURPOSE. To evaluate whether retinal capillary nonperfusion is found predominantly adjacent to arteries or veins in eyes with diabetic retinopathy (DR). METHODS. Sixty-three eyes from 44 patients with proliferative DR (PDR) or non-PDR (NPDR) were included. Images (12 3 12-mm) foveal-centered optical coherence tomography (OCT) angiography (OCTA) images were taken using the Zeiss Plex Elite 9000. In 37 eyes, widefield montages with five fixation points were also obtained. A semiautomatic algorithm that detects nonperfusion in full-retina OCT slabs was developed, and the percentages of capillary nonperfusion within the total image area were calculated. Retinal arteries and veins were manually traced. Based on the shortest distance, nonperfusion pixels were labeled as either arterial-side or venous-side. Arterial-adjacent and venous-adjacent nonperfusion and the A/V ratio (arterial-adjacent nonperfusion divided by venous-adjacent nonperfusion) were quantified. RESULTS. Twenty-two eyes with moderate NPDR, 16 eyes with severe NPDR, and 25 eyes with PDR were scanned. Total nonperfusion area in PDR (median: 8.93%) was greater than in moderate NPDR (3.49%, P < 0.01). Arterial-adjacent nonperfusion was greater than venousadjacent nonperfusion for all stages of DR (P < 0.001). The median A/V ratios were 1.93 in moderate NPDR, 1.84 in severe NPDR, and 1.78 in PDR. The A/V ratio was negatively correlated with the total nonperfusion area (r ¼ 0.600, P < 0.0001). The results from the widefield montages showed similar patterns. CONCLUSIONS. OCTA images with arteries and veins traced allowed us to estimate the nonperfusion distribution. In DR, smaller nonperfusion tends to be arterial-adjacent, while larger nonperfusion tends toward veins.
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    Resumo IPEN-doc 25645
    Quantitative analysis of capillary non-perfusion in diabetic retinopathy using widefield OCT-angiography
    2018 - ALIBHAI, A.Y.; PRETTO, LUCAS R. de; MOULT, ERIC; SCHOTTENHAMML, JULIA; OR, CHRIS; ARYA, MALVIKA; MCGOWAN, MITCHELL; BAUMAL, CAROLINE; WITKIN, ANDRE J.; DUKER, JAY S.; FUJIMOTO, JAMES G.; WAHEED, NADIA K.
    Purpose : Several OCT angiography (OCTA) studies suggest an association between capillary non-perfusion, a surrogate for retinal ischemia, and diabetic retinopathy (DR) severity. However, due to technical limitations, these studies focused on either 3x3mm or 6x6mm fields of view centered on the macula. In contrast, widefield fluorescein angiography (FA) studies suggest that the majority of capillary non-perfusion in early DR occurs outside of the macular region. The recent development of high-speed, widefield OCTA systems, has for the first time allowed non-invasive visualization of retinal vasculature over wider fields of view—a functionality that, in light of previous widefield FA studies, may be promising for early detection and monitoring of DR. This study aims to couple the recent technological advances in high-speed, widefield OCTA with image processing methods to allow for semi-automatic quantitative analysis of capillary non-perfusion of widefield OCTA images of diabetic eyes. Methods : A semi-automatic, texture-based algorithm that detects areas of non-perfusion on 12x12mm SS-OCTA images from the Zeiss PlexElite™ system was developed. We tested the algorithm on a series of patients with diabetes without DR (28 eyes, 21 subjects; 54.8 ± 10.9 y/o), eyes with non-proliferative DR (NPDR) (24 eyes, 16 subjects; 62.1 ± 13.2 y/o) and eyes with proliferative DR (PDR) (21 eyes, 14 subjects; 52.2 ± 12.7 y/o). Results : There was a general trend of increasing capillary non-perfusion with increasing DR severity; however, there was significant overlap between patients having different DR severities (Fig. 1). Conclusions : Quantitative analysis of widefield OCTA images may be useful for early detection and monitoring for diabetic retinopathy progression in diabetics. Additional work is needed to determine the added value of widefield OCTA.