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

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.

scholarly journals Comparison of two different optical coherence tomography angiography devices in detecting healthy versus glaucomatous eyes – an observational cross-sectional study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
A. R. Kee ◽  
V. C. H. Yip ◽  
E. L. T. Tay ◽  
C. W. Lim ◽  
J. Cheng ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Diagnostic Accuracy ◽  
Optic Disc ◽  
Optical Coherence Tomography Angiography ◽  
Optical Coherence ◽  
Cross Sectional ◽  
Swept Source ◽  
Retest Reliability ◽  
Significant Difference ◽  
Test Retest Reliability

Abstract Background To understand the differences between two different optical coherence tomography angiography (OCTA) devices in detecting glaucomatous from healthy eyes by comparing their vascular parameters, diagnostic accuracy and test-retest reliability. Methods A cross-sectional observational study was performed on healthy and glaucoma subjects, on whom two sets of OCTA images of optic disc and macula were acquired using both AngioVue (Optovue, USA) and Swept Source (Topcon, Japan) OCTA devices during one visit. A novel in-house software was used to calculate the vessel densities. Diagnostic accuracy of the machines in differentiating healthy versus glaucomatous eyes was determined using area under the receiver operating characteristic curve (AUROC) and test-retest repeatability of the machines was also evaluated. Results A total of 80 healthy and 38 glaucomatous eyes were evaluated. Glaucomatous eyes had reduced mean vessel density compared to healthy controls in all segmented layers of the optic disc and macula using AngioVue (p ≤ 0.001). However, glaucomatous eyes had higher mean vessel density on optic disc scans using Swept Source, with lack of statistically significant difference between healthy and glaucomatous eyes. The AUROC showed better diagnostic accuracy of AngioVue (0.761–1.000) compared to Swept Source (0.113–0.644). The test-retest reliability indices were generally better using AngioVue than Swept Source. Conclusions AngioVue showed better diagnostic capability and test-retest reliability compared to Swept Source. Further studies need to be undertaken to evaluate if there is any significant difference between the various machines in diagnosing and monitoring glaucoma.

scholarly journals Evaluation of Intravital Ranibizumab on Proliferative Diabetic Retinopathy with Macular Edema by Optical Coherence Tomography Angiography

2020 ◽  
pp. 14-25
Author(s):  
Mona Abdelkader ◽  
Hamza Abdelhamed ◽  
Ebtihal Abdelaziz ◽  
Amr Abdelkader
Keyword(s):  
Optical Coherence Tomography ◽  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Proliferative Diabetic Retinopathy ◽  
Optical Coherence Tomography Angiography ◽  
Macular Thickness ◽  
Central Macular Thickness ◽  
Optical Coherence ◽  
Swept Source ◽  
Treatment Regimens

Purpose: To evaluate the effect of ranibizumab by Optical Coherence Tomography Angiography (OCTA)in proliferative diabetic retinopathy (PDR) with macular edema and to evaluate the role of Swept Source Optical Coherence Tomography Angiography in detection and characterization of new vessels at the disc (NVD) and new vessels elsewhere (NVE). Subjects and Method: The study included patients with proliferative diabetic retinopathy (PDR) and clinically significant diabetic macular edema. Patients with central macular thickness (CMT) above 300 μm underwent intravitreal injection of 0.5 mg Ranibizumab& those having CMT below 300μm had laser treatment. Results: The study was conducted on 50 cases with proliferative diabetic retinopathy with macular edema There was significant increase in best corrected visual acuity (BCVA) across time of treatment. Mean (±SD) BCVA at diagnosis, at 1monthat 3 month were 9.1±0.1, 0.8±0.1, 0.7±0.2. respectively (p<0.001) Central macular thickness (CMT); Area of neovascularization (ArNV); Exuberant Vascular Proliferation (EVP)showed significant decrease across time of treatment, Conclusion: ranibizumab injections are a safe and effective alternative to Pan retinal photocoagulation for the management of PDR. OCTA is useful to monitor different NVD subtypes, their development, and the efficacy of treatment regimens as well as to define new vessel morphological details. Small scan size delineates minute morphology of NVD and misses extension of lesions beyond disc margin, while larger scan size masks fine details.

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

2020 ◽  
pp. bjophthalmol-2020-316245 ◽  
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.

Swept-source optical coherence tomography angiography vitreo-retinal segmentation in proliferative diabetic retinopathy

2020 ◽  
pp. 112067212094402
Author(s):  
Alessandro Papayannis ◽  
Emmanouil Tsamis ◽  
Francesco Stringa ◽  
Pierluigi Iacono ◽  
Maurizio Battaglia Parodi ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Optical Coherence Tomography Angiography ◽  
Response To Therapy ◽  
Secondary Outcome ◽  
Peripheral Retina ◽  
Diabetic Patients ◽  
Optical Coherence ◽  
Swept Source

Purpose: To identify a new cortical vitreous segmentation protocol for non invasive standardised investigation of Neovascularisation (NV) with detection of regression of NV activity in Proliferative Diabetic Retinopathy (PDR). Design: Retrospective study. Participants: One hundred and eighty-six eyes of 93 consecutive diabetic patients (mean age: 52.6 ± 11.0 years) imaged using Topcon Triton® Swept-Source Optical Coherence Tomography Angiography (SS-OCTA) from June 2015 to January 2017. Methods: Scans were performed through the macula, optic disc and areas of possible NV in mid-peripheral retina using 6 × 6 mm and/or 9 × 9 mm raster-patterns in three segmentation protocols: Vitreo-Retinal (VRS), Outer-Vitreous (OVS) and Core-Vitreous Segmentation (CVS). Any suspicion of PDR was confirmed in all patients by Heidelberg® Widefield-Fundus-Fluorescein-Angiography (WF-FFA) and/or Optos® Ultra-WF-FFA (UWF-FFA). Inter-observer reproducibility of NV diagnosis and agreement between SS-OCTA and UWF-FFA were assessed. Primary outcome was the identification of an effective and reproducible segmentation protocol. Secondary outcome was the identification of NV regression after treatment. Results: Sensitivity-specificity reached, respectively, the value of 100 to 100 in detecting NVD, and 96.6 to 100 in detecting NVE in compared areas. SS-OCTA was able to confirm absence of blood flow within the residual NV plexus when using VRS protocol in 30 eyes in which regression of NV with absence of leakage was documented on FFA. Conclusion: Three segmentation protocols (VRS, OVS and CVS) with different but complementary characteristics, allowed a reproducible and standardised investigation of NVD and NVE. The proposed new SS-OCTA cortical vitreous segmentation protocols may be of value when identifying and assessing NV-activity (VRS, OVS and CVS) or NV-regression (VRS) in PDR and therefore, response to therapy.

Sign in / Sign up

Export Citation Format

Share Document