Assessing total retinal blood flow in diabetic retinopathy using multiplane en face Doppler optical coherence tomography.

Aim: To assess total retinal blood flow (TRBF) in diabetic retinopathy (DR) using multiplane en face Doppler optical coherence tomography (OCT).
Methods: A 70 kHz spectral-domain OCT system scanned a 2×2 mm area centred at the optic disc of the eyes with DR and healthy participants. The multiplane en face Doppler OCT algorithm generated a three-dimensional volumetric data set consisting of 195 en face planes. The TRBF was calculated from the maximum flow values of each branching retinal vein at an optimised en face plane. DR severity was graded according to the international clinical classification system. The generalised linear model method was used to compare flow values between DR groups and the control group.
Results: A total of 71 eyes from 71 participants were included. Ten eyes were excluded due to poor image quality. The within-visit repeatability of scans was 4.1% (coefficient of variation). There was no significant difference in the TRBF between the healthy (46.7±10.2 µL/min) and mild/moderate non-proliferative DR (44.9±12.6 µL/min) groups. The TRBF in severe non-proliferative DR (39.1±12.6 µL/min) and proliferative DR (28.9±8.85 µL/min) groups were significantly lower ( p =0.04 and p <0.0001, respectively) than that of the healthy group. TRBF was correlated with DR disease severity ( p <0.0001, linear trend test).
Conclusion: The novel multiplane en face Doppler OCT method provided reliable measurements of TRBF in DR eyes. This may be a useful tool in understanding the pathophysiology of DR.
Competing Interests: Competing interests: Oregon Health & Science University (OHSU), OT, DH and YJ have a significant financial interest in Optovue, a company that may have a commercial interest in the results of this research and technology. OT and DH have a significant financial interest in Carl Zeiss Meditec. These potential conflicts of interest have been reviewed and managed by OHSU.
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