The role of Optical Coherence Tomography Angiography to detect early microvascular changes in Diabetic Retinopathy: a systematic review

Objective: To assess proliferative diabetic retinopathy (PDR) and to describe the difference in angiographic representation of new vessels (NVs) and Intra retinal microvascular abnormalities (IRMA) on optical coherence tomography angiography (OCTA). Methods: A cross-sectional observational study was performed at ISRA Postgraduate Institute of Ophthalmology, Karachi, from March 2018 to September 2018. Forty-two eyes of 21 patients with history of diabetes mellitus (DM) were examined. Twenty-eight eyes with a clinical diagnosis of severe non proliferative diabetic retinopathy (NPDR) or proliferative diabetic retinopathy (PDR) according to early treatment diabetic retinopathy study (ETDRS) were included and evaluated using Swept source optical coherence tomography angiography (SS-OCTA). Then face wide ﬁeld SS-OCTA images and co registered structural optical coherence tomography (OCT) with ﬂow overlay were used to distinguish the features of IRMA and retinal NVs. Results: Forty-two eyes (21 patients) were examined clinically. Fourteen eyes had moderate NPDR, 15 had severe NPDR and 13 eyes had changes consistent with PDR. After clinical diagnosis, we included 28 eyes in our study based on inclusion criteria. These 28 eyes went through SS-OCTA evaluation and we observed 15 cases with PDR and 13 with severe NPDR changes. The OCTA and clinical diagnosis were similar except in 2 eyes, which is critical but not statically significant showing the importance of this noninvasive technology. Conclusions: Widefield OCTA can work as an alternative to fundus fluorescein angiography (FFA) in the diagnosis of diabetic retinopathy (DR). As it is a non-invasive and depth encoded technique so can be used frequently to monitor the retinal changes and their progression. doi: https://doi.org/10.12669/pjms.38.1.3891 How to cite this:Memon AS, Memon NA, Mahar PS. Role of Optical Coherence Tomography Angiography to differentiate Intraretinal microvascular abnormalities and retinal neovascularization in Diabetic Retinopathy. Pak J Med Sci. 2022;38(1):---------. doi: https://doi.org/10.12669/pjms.38.1.3891 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Role of optical coherence tomography-angiography in diabetes mellitus: Utility in diabetic retinopathy and a comparison with fluorescein angiography in vision threatening diabetic retinopathy

Indian Journal of Ophthalmology ◽

10.4103/ijo.ijo_1267_21 ◽

2021 ◽

Vol 69 (11) ◽

pp. 3218

Author(s):

ShoryaV Azad ◽

NawazishF Shaikh ◽

Rajpal Vohra ◽

Akshaya Balaji ◽

Rohan Chawla ◽

...

Keyword(s):

Diabetes Mellitus ◽

Optical Coherence Tomography ◽

Diabetic Retinopathy ◽

Fluorescein Angiography ◽

Optical Coherence Tomography Angiography ◽

Optical Coherence

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Quantitative Analysis of Retinal Microvascular Changes in Optical Coherence Tomography Angiography Of Diabetic Retinopathy

International Journal of Retina ◽

10.35479/ijretina.2018.vol001.iss001.43 ◽

2018 ◽

Vol 1 (1) ◽

pp. 1

Author(s):

Prettyla Yollamanda ◽

Arief Kartasasmita ◽

Iwan Sovani ◽

Erwin Iskandar ◽

Rova Virgana ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Diabetic Retinopathy ◽

Proliferative Diabetic Retinopathy ◽

Optical Coherence Tomography Angiography ◽

Imaging Modality ◽

Foveal Avascular Zone ◽

Control Group ◽

Optical Coherence ◽

Non Invasive ◽

Microvascular Changes

Introduction: Diabetic Retinopathy (DR) is a common microvascular complication in patients with Diabetes Mellitus (DM) that can cause visual impairment and blindness in adult populations. Retinal microvascular changes, reflecting capillary drop out, non perfusion, and retinal ischemia seen in patients with DM can be assessed not only qualitatively, but also quantitatively with the introduction of a new, non invasive imaging modality Optical Coherence Tomography Angiography (OCTA), avoiding potential advese risks that can occur with the use of dye-injection imaging technique. We quantified retinal microvascular changes in healthy control eyes and Diabetic Retinopathy using OCTA. Methods: A cross sectional study included 13 eyes of 9 patients with DR, consists of 11 eyes with Non Proliferative Diabetic Retinopathy (NPDR) and 2 eyes with Proliferative Diabetic Retinopathy (PDR) and 5 eyes of 5 age-matched controls. Participants were imaged with commercial OCTA device (CIRRUS HD-OCT 5000 Angioplex). We analyzed in the Superficial Capillary Plexus (SCP) the following OCTA parameters : Vessel Density (VD), Foveal Avascular Zone (FAZ) area, and FAZ circularity. Result: Normal eyes had a higher mean VD, FAZ circularity (p >0.05) and lower mean FAZ area ( p <0.05) in the SCP compared with the DR (NPDR + PDR) group. If we excluded the PDR eyes from the analytic data, mean VD and FAZ area were found to be lower in control group, and mean FAZ circularity was higher. However, no quantitative parameters were statistically significant between control group and NPDR group. Conclusion: Microvascular changes in DR can be assessed with the use of Optical Coherence Tomography Angioraphy, which is non invasive and provides high quality of images acquired from the chosen level of retina.

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Optical coherence tomography-angiography in diabetic retinopathy diagnosis and monitoring

Ophthalmology journal ◽

10.17816/ov52973 ◽

2021 ◽

Vol 14 (3) ◽

pp. 49-60

Author(s):

Natalia V. Pomytkina ◽

Evgenii L. Sorokin

Keyword(s):

Optical Coherence Tomography ◽

Diabetic Retinopathy ◽

3D Imaging ◽

Optical Coherence Tomography Angiography ◽

Optical Coherence ◽

Noninvasive Method ◽

Microvascular Changes ◽

Planning Treatment ◽

Vascular Plexuses ◽

Disease Stages

Optical coherence tomography-angiography is a modern noninvasive method of 3D imaging and quantitative analysis of the retinal and choroidal microvasculature. It allows detecting manifestation and progression of diabetic retinopathy, planning treatment and evaluating its results.Optical coherence tomography angiography expands our understanding of microvascular changes in retinal vascular plexuses at different disease stages and deepens the understanding of its pathogenesis.

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OCT-angiography detects longitudinal microvascular changes in glaucoma: a systematic review

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2020-318166 ◽

2021 ◽

pp. bjophthalmol-2020-318166

Author(s):

Ana Miguel ◽

André Silva ◽

Joao Barbosa-Breda ◽

Luis Azevedo ◽

Abdulkarim Abdulrahman ◽

...

Keyword(s):

Systematic Review ◽

Optical Coherence Tomography ◽

Optical Coherence Tomography Angiography ◽

Meta Analysis ◽

Glaucoma Surgery ◽

Oct Angiography ◽

Optical Coherence ◽

Longitudinal Changes ◽

Microvascular Changes ◽

Meta Analyses

Background/aimsOptical coherence tomography angiography (OCTA) allows the study of vessel density (VD). We intended to perform a systematic review of studies focusing on longitudinal changes in peripapillary and macular VD measurements in glaucoma.MethodsA search was performed across MEDLINE, Scopus, ISI Web of Science and Google Scholar, using the following query from inception until 20 September 2019: ((“optical coherence tomography angiography”[tiab]) OR (optical coherence tomography angiography[MeSH]) OR (“OCTA”[tiab]) OR (“OCT-A”[tiab]) OR (“angio-OCT”[tiab]) OR (“OCT- angiography”[tiab]) OR (“OCT-angio”[tiab]) OR (“OCT-angiographie”[tiab])) AND (glaucom*[tiab] OR glaucoma[MeSH]). Prospective studies that quantitatively assessed the longitudinal changes in VD in glaucoma with at least 3 months of follow-up were included.ResultsTen out of 4516 studies were included. The rate of VD change in glaucoma varied from 0.036/year to 1.08/year and 1.3% to 3.2% per year, with significantly different rates between glaucoma and healthy controls. Five studies assessed VD change after glaucoma surgery, obtaining variable results, ranging from a temporary VD decrease to increase after 3 months. Meta-analysis was not possible due to a wide variation in methods, measurements and region of VD.ConclusionOCTA is a non-invasive technology, which shows promise in glaucoma. Measures should be taken to increase the quality and standardise the methodology of VD measures in OCTA longitudinal studies, for future meta-analyses.

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