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.

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.

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.

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.

scholarly journals The predictive value of optical coherence tomography after grid laser photocoagulation for diffuse diabetic macular oedema

2007 ◽  
Vol 86 (3) ◽  
pp. 284-291 ◽  
Author(s):  
Wael Soliman ◽  
Birgit Sander ◽  
Kamell Abd El-Naser Soliman ◽  
Sameer Yehya ◽  
Mohamed Saad Abdel Rahamn ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Macular Oedema ◽  
Predictive Value ◽  
Laser Photocoagulation ◽  
Diabetic Macular Oedema ◽  
Optical Coherence

scholarly journals External validation of cut-off points for foveal thickness taking into account the intraretinal fluid using optical coherence tomography to diagnose diabetic macular oedema

PeerJ ◽  
2017 ◽  
Vol 5 ◽  
pp. e3922
Author(s):  
Carmen Hernández-Martínez ◽  
Antonio Palazón-Bru ◽  
Cesar Azrak ◽  
Aída Navarro-Navarro ◽  
Manuel Vicente Baeza-Díaz ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Likelihood Ratio ◽  
Macular Oedema ◽  
External Validation ◽  
Diabetic Macular Oedema ◽  
Diabetic Patients ◽  
Optical Coherence ◽  
Foveal Thickness ◽  
Intraretinal Fluid ◽  
Validation Parameters

Background In late 2015, cut-off points were published for foveal thickness to diagnose diabetic macular oedema taking into account the presence of intraretinal fluid using optical coherence tomography (OCT) in primary care patients (90 µm in the presence of intraretinal fluid and 310 µm otherwise). Methods This cross-sectional observational study was carried out on 134 eyes of diabetic patients treated in specialised ophthalmology services in a Spanish region in 2012–2013, to externally validate the aforementioned cut-off points. The main variable (Clinical Standard) was the diagnosis of macular oedema through indirect ophthalmoscopy and posterior segment slit-lamp biomicroscopy. As validation variables, both the foveal thickness and the presence of intraretinal fluid obtained by OCT were used. Validation was performed using bootstrapping by calculating the area under the ROC curve (AUC), sensitivity, specificity, positive likelihood ratio (PLR) and negative likelihood ratio (NLR). Results Forty-one eyes presented diabetic macular oedema (30.6%). The bootstrapping validation parameters were: AUC, 0.88; sensitivity, 0.75; specificity, 0.95; PLR, 14.31; NLR, 0.26. These values were very similar to those of the original publication. Conclusion We have externally validated in specialised care patients the cut-off points published for the diagnosis of diabetic macular oedema. We suggest that others carry out validation studies in their communities.

scholarly journals Comparison of multicolor scanning laser ophthalmoscopy and optical coherence tomography angiography for detection of microaneurysms in diabetic retinopathy

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Takato Sakono ◽  
Hiroto Terasaki ◽  
Shozo Sonoda ◽  
Ryoh Funatsu ◽  
Hideki Shiihara ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Diabetic Retinopathy ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Optical Coherence Tomography Angiography ◽  
Fundus Photography ◽  
Scanning Laser ◽  
Scanning Laser Ophthalmoscopy ◽  
Optical Coherence ◽  
Cross Sectional

AbstractThis study aimed to evaluate the usefulness of multicolor (MC) scanning laser ophthalmoscopy (MC-SLO) in detecting microaneurysm (MA) in eyes with diabetic retinopathy (DR). This was a retrospective cross-sectional study. Eyes with DR underwent fluorescein angiography (FA), MC-SLO, optical coherence tomography angiography (OCTA), and color fundus photography (CFP) were analyzed. The foveal region was cut in an 6 × 6 mm image and the number of MA in each image was counted by retina specialists to determine the sensitivity and positive predictive value. FA results were used as the ground standard. MAs were classified as those with early, late, or no dye leakage based on FA images. Fifty-four eyes of 35 patients with an average age of 64.5 ± 1.24 years were included. The sensitivity of MA detection was 37.3%, 15.3%, and 4.12% in MC-SLO, OCTA, and CFP, respectively (P < 0.01 in each pair).The positive predictive value was 66.4%, 46.4%, and 27.6% in MC, OCTA, and CFP, respectively (P < 0.01 in each pair). Sensitivity for MAs with early leakage was 36.4% in MC-SLO, which was significantly higher than 4.02% in OCTA. MC-SLO was more useful in detecting MA in eyes with DR than OCTA.

scholarly journals Foveal avascular zone segmentation in optical coherence tomography angiography images using a deep learning approach

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Reza Mirshahi ◽  
Pasha Anvari ◽  
Hamid Riazi-Esfahani ◽  
Mahsa Sardarinia ◽  
Masood Naseripour ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Diabetic Retinopathy ◽  
Deep Learning ◽  
Healthy Subjects ◽  
Optical Coherence Tomography Angiography ◽  
Validation Dataset ◽  
Diabetic Patients ◽  
Dice Similarity Coefficient ◽  
Optical Coherence ◽  
Avascular Zone

AbstractThe purpose of this study was to introduce a new deep learning (DL) model for segmentation of the fovea avascular zone (FAZ) in en face optical coherence tomography angiography (OCTA) and compare the results with those of the device’s built-in software and manual measurements in healthy subjects and diabetic patients. In this retrospective study, FAZ borders were delineated in the inner retinal slab of 3 × 3 enface OCTA images of 131 eyes of 88 diabetic patients and 32 eyes of 18 healthy subjects. To train a deep convolutional neural network (CNN) model, 126 enface OCTA images (104 eyes with diabetic retinopathy and 22 normal eyes) were used as training/validation dataset. Then, the accuracy of the model was evaluated using a dataset consisting of OCTA images of 10 normal eyes and 27 eyes with diabetic retinopathy. The CNN model was based on Detectron2, an open-source modular object detection library. In addition, automated FAZ measurements were conducted using the device’s built-in commercial software, and manual FAZ delineation was performed using ImageJ software. Bland–Altman analysis was used to show 95% limit of agreement (95% LoA) between different methods. The mean dice similarity coefficient of the DL model was 0.94 ± 0.04 in the testing dataset. There was excellent agreement between automated, DL model and manual measurements of FAZ in healthy subjects (95% LoA of − 0.005 to 0.026 mm2 between automated and manual measurement and 0.000 to 0.009 mm2 between DL and manual FAZ area). In diabetic eyes, the agreement between DL and manual measurements was excellent (95% LoA of − 0.063 to 0.095), however, there was a poor agreement between the automated and manual method (95% LoA of − 0.186 to 0.331). The presence of diabetic macular edema and intraretinal cysts at the fovea were associated with erroneous FAZ measurements by the device’s built-in software. In conclusion, the DL model showed an excellent accuracy in detection of FAZ border in enfaces OCTA images of both diabetic patients and healthy subjects. The DL and manual measurements outperformed the automated measurements of the built-in software.

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