COMPARING FUNDUS FLUORESCEIN ANGIOGRAPHY AND SWEPT-SOURCE OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY IN THE EVALUATION OF DIABETIC MACULAR PERFUSION

Abstract Purpose To study the macular features in Eales disease patients observed with fundus fluorescein angiography (FA), optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA). Methods A cross-sectional study was done on treatment naïve 31 eyes (23 patients) with Eales disease. Baseline parameters such as Best-corrected visual acuity (BCVA), slit-lamp bio microscopy (SLB), indirect ophthalmoscopy, FA, spectral-domain OCT {quantitative (central macular thickness [CMT]) and qualitative analysis on SD-OCT} and OCTA were performed. Any media opacity precluding the above investigations was excluded. Results Macular findings comprised of- epiretinal membrane, macular exudation, full thickness macular hole, sub internal limiting membrane bleed, cystoid macular oedema, neurosensory detachment and retinal thickening. Sixteen (51.6%) of our patients had macular changes as seen on all modalities together. SLB and indirect ophthalmoscopy missed macular findings in 50% patients and FA in 18.8% patients. OCT and OCTA diagnosed all macular findings. On comparison of mean BCVA in patients with macular involvement on FA, OCT and OCTA, compared to those without macular involvement, patients with macular involvement had lower BCVA (p 0.000, 0.01 and 0.001 respectively). Thus, FA missed many patients who had significant macular involvement and hence less vision. Conclusion Eales disease though described in literature as classically being peripheral retina disease process, also has macular involvement. OCT and OCTA are useful guides to evaluation of macular involvement in these patients. The latter seems to be superior to FA in detecting macular abnormalities in this ailment. OCTA is non-invasive and shows deep capillary plexus changes which are not shown by any other modality.

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Fundus Fluorescein Angiography, Optical Coherence Tomography, and Optical Coherence Tomography Angiography Findings in Branch Retinal Vein Occlusion

Güncel Retina Dergisi (Current Retina Journal) ◽

10.37783/crj-0144 ◽

2019 ◽

pp. 83-87

Keyword(s):

Optical Coherence Tomography ◽

Fluorescein Angiography ◽

Retinal Vein Occlusion ◽

Branch Retinal Vein Occlusion ◽

Optical Coherence Tomography Angiography ◽

Serous Retinal Detachment ◽

Optical Coherence ◽

Fundus Fluorescein Angiography ◽

Vein Occlusion ◽

Capillary Plexus

Even though the diagnosis depends on clinical examination, in cases with branch retinal vein occlusion (BRVO), fundus fluorescein angiography (FFA), optical coherence tomography (OCT), and optical coherence tomography angiography (OCTA) provide unique data for follow-up, management and prognosis. In FFA, delay of laminar flow phase in the involved branch, hyperfluorescence due to leakage from the vessel wall in the late phases, hypofluorescence due to the blockage by hemorrhage, and soft exudates, and hyperfluorescence due to macular edema can be detected. In OCT, macular thickening, cystic spaces, serous retinal detachment, hyperreflective dots, disorganization of the outer retinal layers – particularly the photoreceptor inner and outer segments line and the external limiting membrane – can be seen. OCTA reveals non-perfusion, particularly in the deep capillary plexus.

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A Swept source optical coherence tomography angiography study: Imaging artifacts and comparison of non-perfusion areas with fluorescein angiography in diabetic macular edema

PLoS ONE ◽

10.1371/journal.pone.0249918 ◽

2021 ◽

Vol 16 (4) ◽

pp. e0249918

Author(s):

Dominika Podkowinski ◽

Sophie Beka ◽

Anna-Sophie Mursch-Edlmayr ◽

Rupert W. Strauss ◽

Lukas Fischer ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Fluorescein Angiography ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Optical Coherence Tomography Angiography ◽

Optical Coherence ◽

Swept Source ◽

Mean Size ◽

The Mean ◽

Imaging Artifacts

Purpose Swept Source Optical coherence tomography angiography (SS-OCTA) is a novel technique to visualize perfusion and vascular changes like ischemia in patients with diabetic retinopathy. The aim of this study was to compare non-perfusion areas on conventional fluorescein angiography (FA) with those on SS-OCTA using detailed manual annotation in patients with diabetic macular edema (DME) and to evaluate possible artifacts caused by DME on SS-OCTA. Methods 27 eyes of 21 patients with DME were analyzed in this prospective, cross-sectional study; on all, standard ophthalmological examination, SS-OCTA and FA imaging were performed. Early-phase FA and SS-OCTA images were analyzed for capillary dropout and foveal avascular zone (FAZ) was measured on both modalities. Artifacts in SS-OCTA imaging caused by DME were marked and analyzed. Results The mean age of the patients was 62.6 ± 11.5 years. On FA the mean size of the annotated non-perfusion areas was 0.14 ± 0.31 mm2 whereas the mean size in SS-OCTA was 0.04 ± 0.13 mm2; areas marked on FA were statistically significantly larger than on SS-OCTA (p<0.01). Mean size of FAZs was similar between FA and OCTA images. (p = 0.91). Seven eyes (25.9 percent) showed imaging artifacts due to DME in SS-OCTA. Conclusion SS-OCTA is a valid tool to analyze capillary perfusion status of patients with DME, although areas of non-perfusion were measured smaller than in conventional FA. More non-perfusion areas were found on SS-OCTA images. FAZ measurements were similar using the two modalities. However, SS-OCTA is prone to artifacts and therefore requires reviewing of imaging results: up to 25 percent of the analyzed eyes showed artifacts on OCTA, which occurred in the areas of diabetic macular edema and did not correspond to capillary drop out.

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Diabetic Macular Ischemia Diagnosis: Comparison between Optical Coherence Tomography Angiography & Fundus Fluorescein Angiography

Egyptian Journal of Medical Research ◽

10.21608/ejmr.2021.174980 ◽

2021 ◽

Vol 2 (2) ◽

pp. 156-169

Author(s):

Hossam El-din Mohamed Ahmed Khalil ◽

Mohamed Osman Abd-El Khalek ◽

Ahmed Abd Elsattar Elnoby

Keyword(s):

Optical Coherence Tomography ◽

Fluorescein Angiography ◽

Optical Coherence Tomography Angiography ◽

Optical Coherence ◽

Fundus Fluorescein Angiography ◽

Macular Ischemia

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Polypoidal Choroidal Vasculopathy Diagnosis and Neovascular Activity Evaluation Using Optical Coherence Tomography Angiography

BioMed Research International ◽

10.1155/2021/1637377 ◽

2021 ◽

Vol 2021 ◽

pp. 1-7

Author(s):

Georges Azar ◽

Vivien Vasseur ◽

Corinne Lahoud ◽

Catherine Favard ◽

Flore De Bats ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Polypoidal Choroidal Vasculopathy ◽

Optical Coherence Tomography Angiography ◽

Age Related Macular Degeneration ◽

Optical Coherence ◽

Fundus Fluorescein Angiography ◽

Swept Source ◽

Multicentric Study ◽

Age Related ◽

Choroidal Vasculopathy

Purpose. To examine choroidal neovascularization (CNV) characteristics in patients with exudative age-related macular degeneration (AMD) and polypoidal choroidal vasculopathy (PCV), using swept-source optical coherence tomography angiography (SS-OCTA), and investigate agreement with OCT B-scan, fundus fluorescein angiography (FFA), and indocyanine green angiography (ICGA) by two different examiners. Methods. This is a retrospective multicentric study that involved patients with a history of AMD and PCV. Examiner A, who had access to OCTA, B-scan OCT, FFA, and ICGA imaging, had to differentiate between AMD and PCV, study the activity of AMD using Coscas’ criteria (active vs. quiescent), and categorize PCV subtypes, while examiner B had only access to OCTA. Then, the diagnostic concordance was assessed between both examiners. Results. A total of 27 patients (11 females (40.7%) and 16 males (59.3%), P = 0.231 ) were included in the analysis. Among those, 13 patients presented with neovascular AMD and 14 patients with PCV. There were 92.3% of correct answers regarding appropriate diagnosis and lesion characterization among AMD patients, against 61.5% of correct answers among PCV patients. The overall interrater reliability agreement between examiners, using Cohen’s kappa coefficient ( κ ) was 0.70 (0.5082-0.8916). Disagreement was found with one active AMD misdiagnosed as inactive AMD, three inactive PCV misdiagnosed as inactive AMD, and one inactive PCV misdiagnosed as active AMD. Conclusion. SS-OCTA alone remains limited in some specific phenotypes of PCV, which suggests the ongoing role of B-scan OCT associated with FFA and ICGA in the diagnosis of these conditions.

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Comparison of optical coherence tomography angiography and fundus fluorescein angiography features of retinal capillary hemangioblastoma

Indian Journal of Ophthalmology ◽

10.4103/ijo.ijo_1199_17 ◽

2018 ◽

Vol 66 (6) ◽

pp. 872 ◽

Cited By ~ 10

Author(s):

Mahesh Shanmugam ◽

Pradeep Sagar ◽

R Rajesh ◽

VinayaKumar Konana ◽

Divyansh Mishra

Keyword(s):

Optical Coherence Tomography ◽

Fluorescein Angiography ◽

Optical Coherence Tomography Angiography ◽

Optical Coherence ◽

Fundus Fluorescein Angiography ◽

Retinal Capillary ◽

Retinal Capillary Hemangioblastoma

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Comparison of widefield swept-source optical coherence tomography angiography with ultra-widefield colour fundus photography and fluorescein angiography for detection of lesions in diabetic retinopathy

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2020-316245 ◽

2020 ◽

pp. bjophthalmol-2020-316245 ◽

Cited By ~ 2

Author(s):

Ying Cui ◽

Ying Zhu ◽

Jay C Wang ◽

Yifan Lu ◽

Rebecca Zeng ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Diabetic Retinopathy ◽

Fluorescein Angiography ◽

Optical Coherence Tomography Angiography ◽

Imaging System ◽

Fundus Photography ◽

Diabetic Patients ◽

Optical Coherence ◽

Swept Source ◽

Detection Rates

AimsTo compare widefield swept-source optical coherence tomography angiography (WF SS-OCTA) with ultra-widefield colour fundus photography (UWF CFP) and fluorescein angiography (UWF FA) for detecting diabetic retinopathy (DR) lesions.MethodsThis prospective, observational study was conducted at Massachusetts Eye and Ear from December 2018 to October 2019. Proliferative DR, non-proliferative DR and diabetic patients with no DR were included. All patients were imaged with a WF SS-OCTA using a Montage 15×15 mm scan. UWF CFP and UWF FA were taken by a 200°, single capture retinal imaging system. Images were independently evaluated for the presence or absence of DR lesions including microaneurysms (MAs), intraretinal microvascular abnormalities (IRMAs), neovascularisation elsewhere (NVE), neovascularisation of the optic disc (NVD) and non-perfusion areas (NPAs). All statistical analyses were performed using SPSS V.25.0.ResultsOne hundred and fifty-two eyes of 101 participants were included in the study. When compared with UWF CFP, WF SS-OCTA was found to be superior in detecting IRMAs (p<0.001) and NVE/NVD (p=0.007). The detection rates of MAs, IRMAs, NVE/NVD and NPAs in WF SS-OCTA were comparable with UWF FA images (p>0.05). Furthermore, when we compared WF SS-OCTA plus UWF CFP with UWF FA, the detection rates of MAs, IRMAs, NVE/NVD and NPAs were identical (p>0.005). Agreement (κ=0.916) between OCTA and FA in classifying DR was excellent.ConclusionWF SS-OCTA is useful for identification of DR lesions. WF SS-OCTA plus UWF CFP may offer a less invasive alternative to FA for DR diagnosis.

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