Monitoring proliferative diabetic retinopathy with optical coherence tomography angiography

A 52-year-old man, a known case of type 2 diabetes mellitus and hypertension, who presented to us with bilateral diminution of vision since 1 year. He was diagnosed as a case of bilateral proliferative diabetic retinopathy and hypertensive retinopathy. A non-invasive imaging modality, optical coherence tomography angiography (OCTA), detected foveal neovascularisation in a background of diffuse diabetic macular oedema which would have been obscured by other investigations like fluorescein angiography.

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Macrophage-Like Cell Density Is Increased in Proliferative Diabetic Retinopathy Characterized by Optical Coherence Tomography Angiography

Investigative Opthalmology & Visual Science ◽

10.1167/iovs.62.10.2 ◽

2021 ◽

Vol 62 (10) ◽

pp. 2

Author(s):

Janice X. Ong ◽

Peter L. Nesper ◽

Amani A. Fawzi ◽

Jacob M. Wang ◽

Jeremy A. Lavine

Keyword(s):

Optical Coherence Tomography ◽

Diabetic Retinopathy ◽

Cell Density ◽

Proliferative Diabetic Retinopathy ◽

Optical Coherence Tomography Angiography ◽

Optical Coherence

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Role of Optical Coherence Tomography Angiography to differentiate Intraretinal microvascular abnormalities and retinal neovascularization in Diabetic Retinopathy

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.38.1.3891 ◽

2021 ◽

Vol 38 (1) ◽

Author(s):

Abdul Sami Memon ◽

Nasir Ahmed Memon ◽

Pir Salim Mahar

Keyword(s):

Optical Coherence Tomography ◽

Diabetic Retinopathy ◽

Clinical Diagnosis ◽

Proliferative Diabetic Retinopathy ◽

Optical Coherence Tomography Angiography ◽

Retinal Neovascularization ◽

Wide Field ◽

Optical Coherence ◽

Fundus Fluorescein Angiography

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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Observation of Retinal Neovascularization using Optical Coherence Tomography Angiography after Panretinal Photocoagulation for Proliferative Diabetic Retinopathy

10.21203/rs.3.rs-147250/v1 ◽

2021 ◽

Author(s):

Feng He ◽

Fangtian Dong ◽

Weihong Yu

Keyword(s):

Optical Coherence Tomography ◽

Diabetic Retinopathy ◽

Proliferative Diabetic Retinopathy ◽

Optical Coherence Tomography Angiography ◽

Quantitative Information ◽

Retinal Neovascularization ◽

Prospective Clinical Study ◽

Panretinal Photocoagulation ◽

Optical Coherence ◽

Fundus Fluorescein Angiography

Abstract Background: To describe the longitudinal changes of retinal neovascularization elsewhere (NVE) on optical coherence tomography angiography (OCTA) in proliferative diabetic retinopathy (PDR) treated by panretinal photocoagulation (PRP). Methods: Each patient included in this prospective clinical study was newly diagnosed PDR and NVE on both fundus fluorescein angiography (FFA) and OCTA. They received PRP of 4 sessions using multi-wavelength laser. Best-corrected visual acuity (BCVA) and OCTA images encompassing NVE were obtained before each PRP session and at 1 month, 3 months, and 6 months. Paired sample t-test was used to investigate differences between BCVA and NVE area before and after PRP. Results: Thirty-two eyes of 32 patients with a mean age of 50.56 ± 7.05 years were included. We found statistically significant reduction in the NVE size at all timepoints compared with the baseline except at 6 months (all P < 0.05). Further analysis demonstrated no statistically significant change of NVE size between two adjacent timepoints except from baseline to post-1st PRP and from 3 months to 6 months (both P < 0.05). BCVA at 3 months showed a statistically significant improvement compared with baseline (P < 0.05), but no significant changes of BCVA were observed during other visits.Conclusions: Using OCTA we found an overall regression in the NVE size following PRP starting as early as 1 week after 1st session and lasting until 3 months. OCTA provides quantitative information of vascular changes and could be a practical method for the longitudinal evaluation of neovascularization.

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Optical Coherence Tomography Angiography of Foveal Neovascularization in Diabetic Retinopathy

Case Reports in Ophthalmology ◽

10.1159/000485831 ◽

2018 ◽

Vol 9 (1) ◽

pp. 93-97 ◽

Cited By ~ 3

Author(s):

Konstantinos Andreanos ◽

Tryfon Rotsos ◽

George Kymionis ◽

Chryssanthi Koutsandrea ◽

Athanasios Kotsolis ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Diabetic Retinopathy ◽

Proliferative Diabetic Retinopathy ◽

Multimodal Imaging ◽

Optical Coherence Tomography Angiography ◽

Insulin Dependent Diabetes Mellitus ◽

Dependent Diabetes Mellitus ◽

Optical Coherence ◽

Diagnostic Investigation ◽

Insulin Dependent

Purpose: To report a case of foveal neovascularization in a patient with proliferative diabetic retinopathy as seen on optical coherence tomography angiography (OCT-A). Methods: Multimodal imaging was used for diagnostic investigation. Patient: A 61-year-old male with a 16-year history of insulin-dependent diabetes mellitus was referred to our medical retina department for examination and management. Meticulous fundus examination and multimodal imaging revealed proliferative diabetic retinopathy lesions, including neovascularization located in the foveal area. Results: OCT-A allowed us to detect the neovascular lesion, confirm that it originated from perifoveal capillaries, estimate its retinal depth, and evaluate the vessel blood flow in multiple layers. Conclusion: To the best of our knowledge this is the first report of OCT-A imaging of foveal neovascularization in diabetic retinopathy. OCT-A is a very useful examination for the diagnostic investigation of patients with diabetic retinopathy.

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Detection of neovascularisation in the vitreoretinal interface slab using widefield swept-source optical coherence tomography angiography in diabetic retinopathy

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2020-317983 ◽

2020 ◽

pp. bjophthalmol-2020-317983

Author(s):

Edward S Lu ◽

Ying Cui ◽

Rongrong Le ◽

Ying Zhu ◽

Jay C Wang ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Diabetic Retinopathy ◽

Optic Disc ◽

Proliferative Diabetic Retinopathy ◽

Optical Coherence Tomography Angiography ◽

Optical Coherence ◽

Vitreoretinal Interface ◽

Cross Sectional ◽

Swept Source ◽

Detection Rates

AimsTo compare the efficacy of diabetic retinal neovascularisation (NV) detection using the widefield swept-source optical coherence tomography angiography (WF SS-OCTA) vitreoretinal interface (VRI) Angio slab and SS-OCT VRI Structure slab.MethodsA prospective, observational study was performed at Massachusetts Eye and Ear from January 2019 to June 2020. Patients with proliferative diabetic retinopathy (PDR), patients with non-proliferative diabetic retinopathy and patients with diabetes but without diabetic retinopathy were included. All patients were imaged with WF SS-OCTA using the 12×12 mm Angio scan protocol centred on the fovea and optic disc. The en-face SS-OCTA VRI Angio slab and SS-OCT VRI Structure slab were evaluated for the presence or absence of NV. SS-OCTA B-scan was used to classify NV according to cross-sectional morphology (forward, tabletop or flat). All statistical analyses were performed using SPSS V.26.0.ResultsOne hundred and forty-two eyes of 89 participants were included in the study. VRI Angio detected NV at higher rates compared with VRI Structure (p<0.05). Combining VRI Angio and Structure improved detection rates compared with VRI Angio alone (p<0.05). Due to segmentation errors of the internal limiting membrane, NV with flat morphological classification had lower rates of detection on VRI Angio compared with NV with forward and tabletop morphology (p<0.05).ConclusionsWF SS-OCTA 12×12 mm VRI Angio and SS-OCT VRI Structure imaging centred on the fovea and optic disc detected NV with high sensitivity and low false positives. The VRI slab may be useful to diagnose and monitor PDR in clinical practice.

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