Fractal analysis of retinal vasculature in normal subjects on ultra-wide field fluorescein angiography

Int J Ophthalmol. 2020 Jul 18;13(7):1109-1114. doi: 10.18240/ijo.2020.07.15. eCollection 2020.

Abstract

Aim: To evaluate the fractal feature of the retinal vasculature of normal eyes on a stereographic projected and montaged ultra-wide field (UWF) fluorescein angiography (FA).

Methods: Prospective, observational, cross-sectional study. Totally 59 eyes of 31 normal subjects were imaged using the Optos 200Tx. Images obtained at different gaze angles stereographically projected and montaged. The early-phase UWF FA frames were processed to segment the retinal vasculature and the results were exported as binary masks. The fractal dimension (FD) was calculated using the box-counting method.

Results: The global FD for the entire retina was 1.6±0.04, with no difference between males and females (1.59±0.04 vs 1.61±0.04, P=0.084) or between right and left eyes (1.6±0.04 vs 1.6±0.05, P=0.61). FD was non-uniformly distributed among four quadrants (P<0.001) and decreased as the distance from the fovea increased (P<0.001). A negative association was observed between FD and age (R=-0.37, P=0.006), and this relationship was observed in the posterior and mid-peripheral retina (P<0.05) but absent in far-periphery (P>0.05).

Conclusion: Fractal geometry is non-uniformly distributed across the retina in normal eyes and decreases from the fovea to the far-periphery. Subjects with an older age tend to have a smaller FD, however, the FD in the far-periphery does not appear to be influenced by age.

Keywords: fluorescein angiography; fractal analysis; normal subject; retina; ultra-wide field.