Fractal Dimension Analysis of OCTA Images of Diabetic Retinopathy Using Circular Mass-Radius Method
Abstract
BACKGROUND AND OBJECTIVE:
To quantify fractal dimension (FD) by mass-radius method in optical coherence tomography angiography (OCTA) images and characterize microvascular differences in eyes with and without diabetic retinopathy (DR).
PATIENTS AND METHODS:
A retrospective study was conducted using OCTA images of 3 mm × 3 mm and 6 mm × 6 mm scans for superficial and deep capillary plexuses from 49 control eyes and 58 eyes with DR.
RESULTS:
Analysis of variance showed a significant difference between the FD of control and diabetic eyes in deep plexus scans, and the 3 mm × 3 mm superficial plexus scan (P < .05). In the 3 mm × 3 mm superficial plexus, the FD of severe nonproliferative DR (NPDR) and proliferative DR (PDR) were significantly lower compared to control. The scans of the deep plexus showed only severe NPDR was significantly reduced in the 6 mm × 6 mm scan, whereas moderate NPDR, severe NPDR, and PDR were significantly lower in the 3 mm × 3 mm scan.
CONCLUSION:
The study suggests the use of FD as a measure of microvascular dropout in DR.
[Ophthalmic Surg Lasers Imaging Retina. 2021;52:116–122.]
- 1.. Diabetic retinopathy. Lancet. 2010; 376(9735):124–136.
10.1016/S0140-6736(09)62124-3 PMID:20580421 Crossref Medline, Google Scholar - 2.. IDF Diabetes Atlas: global estimates of diabetes prevalence for 2017 and projections for 2045. Diabetes Res Clin Pract. 2018; 138:271–281.
10.1016/j.diabres.2018.02.023 PMID:29496507 Crossref Medline, Google Scholar - 3.. Diabetic retinopathy. Nat Rev Dis Primers. 2016; 2(1):16012.
10.1038/nrdp.2016.12 PMID:27159554 Crossref Medline, Google Scholar - 4.. Guidelines on Diabetic Eye Care: The International Council of Ophthalmology Recommendations for Screening, Follow-up, Referral, and Treatment Based on Resource Settings. Ophthalmology. 2018; 125(10):1608–1622.
10.1016/j.ophtha.2018.04.007 PMID:29776671 Crossref Medline, Google Scholar - 5.. Diabetic retinopathy, an overview. Vision Res. 2017; 139:1–6.
10.1016/j.visres.2017.07.006 PMID:28757399 Crossref Medline, Google Scholar - 6.. Early detection of diabetic retinopathy. Surv Ophthalmol. 2018; 63(5):601–608.
10.1016/j.survophthal.2018.04.003 PMID:29679616 Crossref Medline, Google Scholar - 7.. Diabetic retinopathy. N Engl J Med. 2004; 350(1):48–58.
10.1056/NEJMra021678 PMID:14702427 Crossref Medline, Google Scholar - 8.. Retinal thickness in diabetic retinopathy: comparison of optical coherence tomography, the retinal thickness analyzer, and fundus photography. Retina. 2006; 26(1):49–57.
10.1097/00006982-200601000-00009 PMID:16395139 Crossref Medline, Google Scholar - 9.. Optical coherence tomography (OCT) for detection of macular oedema in patients with diabetic retinopathy. Cochrane Database Syst Rev. 2015; 1:CD008081.
10.1002/14651858.CD008081.pub3 PMID:25564068 Crossref Medline, Google Scholar - 10.. The diagnostic value of optical coherence tomography angiography in diabetic retinopathy: a systematic review. Int Ophthalmol. 2019; 39(10):2413–2433.
10.1007/s10792-018-1034-8 PMID:30382465 Crossref Medline, Google Scholar - 11.. An Update on Optical Coherence Tomography Angiography in Diabetic Retinopathy. J Ophthalmic Vis Res. 2018; 13(4):487–497.
10.4103/jovr.jovr_57_18 PMID:30479720 Crossref Medline, Google Scholar - 12.. Optical Coherence Tomography Angiography Features of Diabetic Retinopathy. Retina. 2015; 35(11):2371–2376.
10.1097/IAE.0000000000000716 PMID:26308529 Crossref Medline, Google Scholar - 13.. Statistical Model of Optical Coherence Tomography Angiography Parameters That Correlate With Severity of Diabetic Retinopathy. Invest Ophthalmol Vis Sci. 2018; 59(10):4292–4298.
10.1167/iovs.18-24142 PMID:30167660 Crossref Medline, Google Scholar - 14.. Characterisation of human nonproliferative diabetic retinopathy using the fractal analysis. Int J Ophthalmol. 2015; 8(4):770–776. PMID:
26309878 Medline, Google Scholar - 15.. Value of Fractal Analysis of Optical Coherence Tomography Angiography in Various Stages of Diabetic Retinopathy. Retina. 2018; 38(9):1816–1823.
10.1097/IAE.0000000000001774 PMID:28723846 Crossref Medline, Google Scholar - 16.. Fractal Dimensional Analysis of Optical Coherence Tomography Angiography in Eyes With Diabetic Retinopathy. Invest Ophthalmol Vis Sci. 2016; 57(11):4940–4947.
10.1167/iovs.16-19656 PMID:27654421 Crossref Medline, Google Scholar - 17.. Notes on the implementation of the mass-radius method of fractal dimension estimation. Comput Appl Biosci. 1993; 9(5):547–550.
10.1093/bioinformatics/9.5.547 PMID:8293328 Crossref Medline, Google Scholar - 18.. Fractal analysis of region-based vascular change in the normal and non-proliferative diabetic retina. Curr Eye Res. 2002; 24(4):274–280.
10.1076/ceyr.24.4.274.8411 PMID:12324866 Crossref Medline, Google Scholar - 19.. Detection of neovascularization based on fractal and texture analysis with interaction effects in diabetic retinopathy. PLoS One. 2013; 8(12):e75699.
10.1371/journal.pone.0075699 PMID:24358105 Crossref Medline, Google Scholar - 20.. Characterisation of the neovascularisation process in diabetic retinopathy by means of fractal geometry: diagnostic implications. Graefes Arch Clin Exp Ophthalmol. 1993; 231(12):681–686.
10.1007/BF00919281 PMID:8299974 Crossref Medline, Google Scholar - 21.. The fractal geometry of proliferative diabetic retinopathy: implications for the diagnosis and the process of retinal vasculogenesis. Curr Eye Res. 1993; 12(12):1103–1109.
10.3109/02713689309033508 PMID:8137633 Crossref Medline, Google Scholar - 22.. Retinal vascular layers imaged by fluorescein angiography and optical coherence tomography angiography. JAMA Ophthalmol. 2015; 133(1):45–50.
10.1001/jamaophthalmol.2014.3616 PMID:25317632 Crossref Medline, Google Scholar - 23.. Retinal Vascular Perfusion Density Mapping Using Optical Coherence Tomography Angiography in Normals and Diabetic Retinopathy Patients. Retina. 2015; 35(11):2353–2363.
10.1097/IAE.0000000000000862 PMID:26465617 Crossref Medline, Google Scholar - 24.. Association Between Vessel Density and Visual Acuity in Patients With Diabetic Retinopathy and Poorly Controlled Type 1 Diabetes. JAMA Ophthalmol. 2018; 136(7):721–728.
10.1001/jamaophthalmol.2018.1319 PMID:29800967 Crossref Medline, Google Scholar - 25.. Transretinal histopathological changes in capillary-free areas of diabetic retinopathy. Acta Ophthalmol (Copenh). 1994; 72(4):409–415.
10.1111/j.1755-3768.1994.tb02787.x PMID:7825403 Crossref Medline, Google Scholar

