title: CHARACTERIZATION OF THE MIDDLE CAPILLARY PLEXUS USING OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY IN HEALTHY AND DIABETIC EYES.
abstract: OBJECTIVE
  To assess the ability of optical coherence tomography angiography to image the retinal middle capillary plexus (MCP), and to characterize the MCP as a unique vascular network separate from the superficial and deep capillary plexus (DCP).
  
  
  METHODS
  Healthy and diabetic eyes were imaged using the Avanti XR optical coherence tomography angiography instrument (Optovue Inc, Fremont, CA). Using manual segmentation of the retinal layers, the authors generated en face angiograms to distinguish the three capillary plexuses (superficial capillary plexus, MCP, DCP).
  
  
  RESULTS
  In healthy eyes, arterioles gave rise to distinct branches in the MCP, and venules gave rise to prominent vortex like branches in the DCP. The foveal avascular zone was most well-defined at the level of the MCP, and had a larger area in the DCP. In diabetic eyes, the three capillary plexuses showed varying degrees of nonperfusion, including variable shapes and extent of the foveal avascular zone, with loss of border integrity at the MCP. Microaneurysms appeared in all the three capillary plexuses.
  
  
  CONCLUSIONS
  Using customized segmentation analysis in optical coherence tomography angiography, the authors demonstrate that the MCP is qualitatively and functionally distinct from the superficial capillary plexus and DCP, which may help clarify the pathogenesis of different middle retinal ischemic entities and provide new insights into retinal ischemia in diabetic retinopathy.
authors.affiliation: *Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; †Functional Optical Imaging Laboratory, Department of Biomedical Engineering, Northwestern University, Evanston, Illinois; and ‡Medical Scientist Training Program, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Justin J
authors.initials: JJ
authors.lastname: Park
authors.forename: Brian T
authors.initials: BT
authors.lastname: Soetikno
authors.forename: Amani A
authors.initials: AA
authors.lastname: Fawzi
mesh_terms: D000328:Adult; D000368:Aged; D002196:Capillaries; D003922:Diabetes Mellitus, Type 1 / Q000150:complications; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D003930:Diabetic Retinopathy / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D005451:Fluorescein Angiography; D064368:Healthy Volunteers; D006801:Humans; D017075:Laser Coagulation; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012161:Retinal Artery / Q000000981:diagnostic imaging*; D012169:Retinal Vein / Q000000981:diagnostic imaging*; D041623:Tomography, Optical Coherence; D014792:Visual Acuity; D055815:Young Adult