Morphological and topographical appearance of microaneurysms on optical coherence tomography angiography

2018 ◽  
Vol 103 (5) ◽  
pp. 630-635 ◽  
Author(s):  
Vivian Schreur ◽  
Artin Domanian ◽  
Bart Liefers ◽  
Freerk G Venhuizen ◽  
B Jeroen Klevering ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Macular Oedema ◽  
Optical Coherence Tomography Angiography ◽  
Diabetic Macular Oedema ◽  
Optical Coherence ◽  
Retinal Area ◽  
Fundus Fluorescein Angiography ◽  
Morphological Appearance ◽  
Capillary Plexus ◽  
Retinal Microaneurysms

AimsTo investigate retinal microaneurysms in patients with diabetic macular oedema (DME) by optical coherence tomography angiography (OCTA) according to their location and morphology in relationship to their clinical properties, leakage on fundus fluorescein angiography (FFA) and retinal thickening on structural OCT.MethodsOCTA and FFA images of 31 eyes of 24 subjects were graded for the presence of microaneurysms. The topographical and morphological appearance of microaneurysms on OCTA was evaluated and classified. For each microaneurysm, the presence of focal leakage on FFA and associated retinal thickening on OCT was determined.ResultsOf all microaneurysms flagged on FFA, 295 out of 513 (58%) were also visible on OCTA. Microaneurysms with focal leakage and located in a thickened retinal area were more likely to be detected on OCTA than not leaking microaneurysms in non-thickened retinal areas (p=0.001). Most microaneurysms on OCTA were seen in the intermediate (23%) and deep capillary plexus (22%). Of all microaneurysms visualised on OCTA, saccular microaneurysms were detected most often (31%), as opposed to pedunculated microaneurysms (9%). Irregular, fusiform and mixed fusiform/saccular-shaped microaneurysms had the highest likeliness to leak and to be located in thickened retinal areas (p<0.001, p<0.001 and p=0.001).ConclusionsRetinal microaneurysms in DME could be classified topographically and morphologically by OCTA. OCTA detected less microaneurysms than FFA, and this appeared to be dependent on leakage activity and retinal thickening. Morphological appearance of microaneurysms (irregular, fusiform and mixed saccular/fusiform) was associated with increased leakage activity and retinal thickening.

Optical coherence tomography angiography in pseudophakic cystoid macular oedema compared to diabetic macular oedema: qualitative and quantitative evaluation of retinal vasculature

2018 ◽  
Vol 102 (12) ◽  
pp. 1684-1690 ◽  
Author(s):  
Riccardo Sacconi ◽  
Eleonora Corbelli ◽  
Adriano Carnevali ◽  
Stefano Mercuri ◽  
Alessandro Rabiolo ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Macular Oedema ◽  
Optical Coherence Tomography Angiography ◽  
Diabetic Macular Oedema ◽  
Foveal Avascular Zone ◽  
Cystoid Macular Oedema ◽  
Control Group ◽  
Retinal Vasculature ◽  
Ophthalmological Examination ◽  
Optical Coherence

AimsTo describe optical coherence tomography angiography (OCT-A) abnormalities of patients with pseudophakic cystoid macular oedema (PCMO) before and after pharmacological resolution, compared with diabetic macular oedema (DMO) and normal eyes.MethodsIn this retrospective, observational study, 44 eyes (30 patients) were included: 15 eyes (15 patients) affected by PCMO; 14 healthy fellow eyes used as negative control group; 15 eyes (15 age-matched and sex-matched patients) with DMO used as positive control group. All patients underwent a complete ophthalmological examination at baseline, including OCT-A scans of the macula through AngioPlex CIRRUS-5000 (Carl Zeiss Meditec, Dublin, USA). Patients with PCMO and DMO were re-evaluated after the pharmacological resolution of cystoid macular oedema (CMO).ResultsDisruption of parafoveal capillary arcade and cystoid spaces in deep capillary plexus (DCP) were frequent in patients with PCMO and DMO (73% and 100%, 87% and 100%). Capillary abnormalities and non-perfusion greyish areas in DCP were more frequent in DMO (P<0.001 and P=0.014). Patients with PCMO showed a larger foveal avascular zone area in DCP at baseline (P<0.001), which significantly reduced after treatment (P=0.001). Vessel density of full-thickness retina and DCP was reduced in patients with PCMO (P=0.022 and P=0.001), and no changes were observed after treatment. Interestingly, DCP appeared less represented in patients with DMO than PCMO subjects (P=0.001).ConclusionsPatients with PCMO have an impairment of mainly DCP, partially reversible after treatment. Furthermore, we disclosed that different alterations of the retinal vasculature characterise CMO derived from two different diseases, namely PCMO and DMO, and this could be due to their distinct pathophysiology.

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

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.

scholarly journals Optical Coherence Tomography Angiography in Diabetic Patients: A Systematic Review

Biomedicines ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 88
Author(s):  
Ana Boned-Murillo ◽  
Henar Albertos-Arranz ◽  
María Dolores Diaz-Barreda ◽  
Elvira Orduna-Hospital ◽  
Ana Sánchez-Cano ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Optical Coherence Tomography ◽  
Diabetic Retinopathy ◽  
Macular Oedema ◽  
Literature Search ◽  
Optical Coherence Tomography Angiography ◽  
Diabetic Macular Oedema ◽  
Oct Angiography ◽  
Diabetic Patients ◽  
Optical Coherence

Background: Diabetic retinopathy (DR) is the leading cause of legal blindness in the working population in developed countries. Optical coherence tomography (OCT) angiography (OCTA) has risen as an essential tool in the diagnosis and control of diabetic patients, with and without DR, allowing visualisation of the retinal and choroidal microvasculature, their qualitative and quantitative changes, the progression of vascular disease, quantification of ischaemic areas, and the detection of preclinical changes. The aim of this article is to analyse the current applications of OCTA and provide an updated overview of them in the evaluation of DR. Methods: A systematic literature search was performed in PubMed and Embase, including the keywords “OCTA” OR “OCT angiography” OR “optical coherence tomography angiography” AND “diabetes” OR “diabetes mellitus” OR “diabetic retinopathy” OR “diabetic maculopathy” OR “diabetic macular oedema” OR “diabetic macular ischaemia”. Of the 1456 studies initially identified, 107 studies were screened after duplication, and those articles that did not meet the selection criteria were removed. Finally, after looking for missing data, we included 135 studies in this review. Results: We present the common and distinctive findings in the analysed papers after the literature search including the diagnostic use of OCTA in diabetes mellitus (DM) patients. We describe previous findings in retinal vascularization, including microaneurysms, foveal avascular zone (FAZ) changes in both size and morphology, changes in vascular perfusion, the appearance of retinal microvascular abnormalities or new vessels, and diabetic macular oedema (DME) and the use of deep learning technology applied to this disease. Conclusion: OCTA findings enable the diagnosis and follow-up of DM patients, including those with no detectable lesions with other devices. The evaluation of retinal and choroidal plexuses using OCTA is a fundamental tool for the diagnosis and prognosis of DR.

scholarly journals Microaneurysms visualisation using five different optical coherence tomography angiography devices compared to fluorescein angiography

2020 ◽  
pp. bjophthalmol-2020-316817 ◽  
Author(s):  
Salvatore Parrulli ◽  
Federico Corvi ◽  
Mariano Cozzi ◽  
Davide Monteduro ◽  
Federico Zicarelli ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Fluorescein Angiography ◽  
Optical Coherence Tomography Angiography ◽  
Imaging Modality ◽  
Optical Coherence ◽  
Capillary Plexus ◽  
Retinal Microaneurysms ◽  
Scan Pattern ◽  
Superficial Capillary Plexus ◽  
Higher Sensitivity

BackgroundTo compare fluorescein angiography (FA) and five different optical coherence tomography angiography (OCTA) devices and to test their reproducibility in the evaluation of retinal microaneurysms (MAs) secondary to diabetic retinopathy (DR).MethodsOn the same day, patients with DR were imaged with FA and five OCTA devices: prototype Spectralis OCTA, prototype PlexElite, RTVue XR Avanti, AngioPlex and DRI OCT Triton. For all OCTA devices, a 3×3 volume scan pattern was performed. MAs were evaluated for the superficial capillary plexus (SCP) and deep capillary plexus (DCP).ResultsTwenty eyes of 15 patients with DR were included. FA counted a significantly higher number of MAs compared to OCTA devices. Spectralis OCTA obtained a significantly higher number of MAs compared to PlexElite, RTVue XR Avanti, AngioPlex and DRI OCT Triton (p<0.0001). PlexElite and AngioPlex showed a greater number of MAs in the SCP, Spectralis OCTA, RTVue XR Avanti and DRI OCT Triton in the DCP. Higher sensitivity (43.3%) but lowest specificity (54.4%) was observed for Spectralis OCTA compared to other devices. The higher specificity (78.5%) and positive predictive value (83.3%) were observed for DRI OCT Triton.ConclusionsFA remains the best imaging modality to visualise retinal MAs. Spectralis OCTA was able to detect more MAs compared to other devices, likely due to the higher number of B-scans in the scanned area as well as due to the higher number of repeated B-scans. The high variability between OCTA devices should be taken into account for future clinical trials as in clinical practice.

Simulating vascular leakage on optical coherence tomography angiography using an overlay technique with corresponding thickness maps

2019 ◽  
Vol 104 (4) ◽  
pp. 514-517
Author(s):  
Talisa E de Carlo ◽  
Sarwar Zahid ◽  
Kelley J Bohm ◽  
R V Paul Chan ◽  
Jennifer I Lim ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Positive Predictive Value ◽  
Macular Oedema ◽  
Predictive Value ◽  
Optical Coherence Tomography Angiography ◽  
Diabetic Macular Oedema ◽  
Diabetic Patients ◽  
Optical Coherence ◽  
Retinal Pathology ◽  
Overlay Technique

BackgroundTo demonstrate a technique for using optical coherence tomography angiography (OCTA) to simulate leakage in eyes with diabetic macular oedema and determine the sensitivity and positive predictive value of detecting leaking microvasculature on OCTA using fluorescein angiography (FA) as the comparative norm.Methods6×6 mm OCT angiograms were overlaid with the corresponding OCT thickness maps. Microvascular abnormalities on the OCT angiogram underlying areas of thickening on the OCT thickness map were assumed to be leaking. Two independent readers blindly read the OCTA overlay images then the FA images cropped to the same approximate region to delineate areas of leaking microvasculature. The results were compared to determine the sensitivity and positive predictive value of OCTA for detection of leaking vessels.Results28 eyes of 19 diabetic patients were included. Each eye demonstrated an average of seven leaking microvascular abnormalities on the OCTA images and 22 leaking abnormalities on the FA images. Sensitivity of leaking microvasculature detection by OCTA was 26.1% and positive predictive value was 68.4%. The correlation coefficient of the two readers’ detection of leaking microvasculature was 0.605 for OCTA reads compared with 0.916 for FA.ConclusionOCTA as a whole can be used to simulate leakage, but currently, sensitivity of the technique is low. Further understanding of the OCTA technology may yield novel means of detecting retinal pathology.

Acute macular neuroretinopathy in a patient with acute coronary syndrome

2020 ◽  
Vol 13 (12) ◽  
pp. e238625
Author(s):  
Pulak Agarwal ◽  
Vinod Kumar ◽  
Pallavi Singh ◽  
Mousumi Banerjee
Keyword(s):  
Optical Coherence Tomography ◽  
Acute Coronary Syndrome ◽  
Optical Coherence Tomography Angiography ◽  
Outer Nuclear Layer ◽  
Optical Coherence ◽  
Fundus Fluorescein Angiography ◽  
Coronary Syndrome ◽  
Acute Macular Neuroretinopathy ◽  
Indocyanine Angiography ◽  
Capillary Plexus

A young man presented with bilateral diminution of vision after acute coronary syndrome. Fundus showed dark wedge-shaped perifoveal lesions in both eyes. Fundus fluorescein angiography and indocyanine angiography were normal. Optical coherence tomography showed characteristic findings of outer nuclear layer thinning and disruption of ellipsoid zone. Optical coherence tomography angiography showed flow voids in deep capillary plexus. A diagnosis of acute macular neuroretinopathy was made. The multimodal imaging findings and pathophysiology of such a scenario are presented.

scholarly journals To Study the correlation between fundus fluorescein angiography and optical coherence tomography patterns in clinically significant macular oedema

2017 ◽  
Vol 5 (5) ◽  
pp. 2187
Author(s):  
Neeti R. Sheth ◽  
Sushilkumar G. Chaudhari ◽  
Hiren D. Matai
Keyword(s):  
Optical Coherence Tomography ◽  
Fluorescein Angiography ◽  
Macular Oedema ◽  
Diabetic Macular Oedema ◽  
Optical Coherence ◽  
Fundus Fluorescein Angiography ◽  
Foveal Thickness ◽  
Number Of Patients ◽  
Clinically Significant ◽  
Macular Ischemia

Background: To Study the correlation between Fundus Fluorescein Angiography and Optical Coherence Tomography  patterns in Clinically Significant Macular Oedema.Methods: This is a retrospective study which compares patterns in FFA and OCT in patients with CSME.Results: A total of 54 eyes were examined. Participants included 64.81 % males and 34.85% females. On Fundus Fluorescein Angiography (FFA) 37.03% eyes showed diffuse leak, 27.77% eyes showed focal leak, 35.18 % eyes showed CME, 53.7% eyes showed macular ischemia. Maximum pattern is macular ischemia type in FFA. On OCT 42.6 % eyes showed spongy oedema, 68.51% eyes showed combined pattern, 48.15 % eyes showed ERM/Traction, 46.3 % eyes showed CME, 40.7 % eyes showed hard exudates 14.8 % eyes showed serous detachment.Conclusions: Both FFA and OCT are indispensable tools for diagnosis and management of Diabetic macular oedema. Measurement of central foveal thickness, tractional, ERM was possible with OCT but large number of patients showed macular ischemia on FFA which was not possible to diagnose with OCT. So, both FFA and OCT are necessary for management of Diabetic macular oedema.

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