scholarly journals Diabetic Macular Ischemia Diagnosis: Comparison between Optical Coherence Tomography Angiography and Fluorescein Angiography

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Jose Mauricio Botto de Barros Garcia ◽  
Talita Toledo Lima ◽  
Ricardo Noguera Louzada ◽  
Alessandra Thome Rassi ◽  
David Leonardo Cruvinel Isaac ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Fluorescein Angiography ◽  
Optical Coherence Tomography Angiography ◽  
Foveal Avascular Zone ◽  
Rank Test ◽  
Diabetic Patients ◽  
Optical Coherence ◽  
Signed Rank ◽  
Signed Rank Test ◽  
Macular Ischemia

Purpose. To compare fluorescein angiography (FA) and optical coherence tomography angiography (OCTA) images of foveal avascular zone (FAZ) in patients with diabetic retinopathy (DR) with and without diabetic macular ischemia (DMI).Methods. The Wilcoxon signed-rank test was used to compare area measurements andpvalues of <0.05 were considered statistically significant. FA and OCTA images were independently graded by 2 observers that reached agreement regarding quantitative DMI according established protocols. The ischemic area was divided into “large” macular ischemia (superior to 0.32 mm2) and “small” (inferior to 0.32 mm2) groups. Quantitative analyses of the FAZ were performed using custom software.Results. Thirty-four eyes from 34 diabetic patients were enrolled. Subjects with DMI presented a mean area on FA and OCTA of 0.68 ± 0.53 mm2and 0.58 ± 0.35 mm2, respectively (p=0.1374). Patients without DMI presented a mean area on FA and OCTA of 0.19 ± 0.67 mm2and 0.20 ± 0.79 mm2, respectively (p=0.9594). The ICC for the FAZ measurements between the 2 observers on FA and OCTA was 0.96 and 0.92, respectively.Conclusion. OCTA represents a novel technique for the diagnosis of DMI and it may become an alternative to FA for this purpose.

Optical coherence tomography angiography in diabetic patients without diabetic retinopathy

2019 ◽  
Vol 30 (6) ◽  
pp. 1418-1423 ◽  
Author(s):  
Claudio Furino ◽  
Grazia Montrone ◽  
Maria Vittoria Cicinelli ◽  
Stefania Balestra ◽  
Maria Oliva Grassi ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Diabetic Retinopathy ◽  
Optical Coherence Tomography Angiography ◽  
Vessel Density ◽  
Foveal Avascular Zone ◽  
Diabetic Patients ◽  
Optical Coherence ◽  
Avascular Zone ◽  
Capillary Plexus ◽  
Superficial Capillary Plexus

Purpose: To investigate a subset of diabetic patients without diabetic retinopathy with optical coherence tomography angiography, assessing the differences in macular perfusion between diseased eyes and healthy controls. Methods: Monocentric cross-sectional study, including 86 eyes from 43 diabetic patients with no clinical signs of diabetic retinopathy and 78 eyes from 39 controls. Patients underwent 3.0 × 3.0 mm and 4.5 × 4.5 mm swept-source optical coherence tomography angiography. Vessel density (%), foveal avascular zone area (mm2), and avascular density (%) were provided for the superficial capillary plexus and the deep capillary plexus. Results: The foveal avascular zone area at the superficial capillary plexus was larger in the study group compared to controls, irrespective of the area of the slab considered. A meaningful difference was found in the vessel density at the deep capillary plexus of the 3.0 × 3.0 mm slab (p = 0.03). Almost all the variables considered in the study showed a significant within-subject effect. Age significantly correlated with vessel density of superficial capillary plexus on 4.5 × 4.5 mm in both control and diabetic eyes. Conclusion: Diabetic patients with subclinical diabetic retinopathy feature a larger foveal avascular zone at the superficial capillary plexus compared with controls, as well as relative reduction of the vessel density at the deep capillary plexus. These findings might serve as the basis for screening between normal and diabetic subjects.

scholarly journals Fundus Fluorescein Angiography and Optical Coherence Tomography Angiography Findings in Diabetic Retinopathy and Diabetic Macular Edema

2018 ◽  
pp. 130-137
Keyword(s):  
Optical Coherence Tomography ◽  
Diabetic Retinopathy ◽  
Fluorescein Angiography ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Optical Coherence Tomography Angiography ◽  
Imaging Technique ◽  
Diabetic Patients ◽  
Type I ◽  
Optical Coherence

Diabetic retinopathy is an important public health issue as its prevalence has been increasing every year. It is one of the major causes of visual loss which can be preventable with early diagnosis and appropriate treatment. The fundus examination must be done in detail using mydriatics, and digital images must be recorded in all diabetic patients with special emphasis on the disease type (type I and type II), duration, and prognosis. Fluorescein angiography (FA) is a gold standard invasive retinal imaging technique for the diagnosis, monitoring, and evaluating the response of the treatment in diabetic patients, but FA has limitations due to possible side effects. Optical coherence tomography angiography (OCTA) is a recent, non-invasive, dye-free imaging technique that can be used in every visit. It has the capability to image all retinal and choroidal vascular layers (segmentation) and quantify macular ischemia in a short period of time which is beneficial for the patient, and the ophthalmologist. The aim of this review is to address the findings, advantages, and disadvantages of FA and OCTA in patients with diabetic retinopathy and diabetic macular edema.

scholarly journals Retinal Sensitivity Loss Correlates with Deep Capillary Plexus Impairment in Diabetic Macular Ischemia

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Fabio Scarinci ◽  
Monica Varano ◽  
Mariacristina Parravano
Keyword(s):  
Optical Coherence Tomography ◽  
Optical Coherence Tomography Angiography ◽  
Diabetic Patients ◽  
Retinal Sensitivity ◽  
Optical Coherence ◽  
Type 2 Diabetic Patients ◽  
Sensitivity Loss ◽  
Capillary Plexus ◽  
Macular Ischemia ◽  
Sd Oct

Purpose. To assess retinal sensitivity and retinal morphologic changes of capillary nonperfused areas in diabetic macular ischemia. Methods. Observational cross-sectional study. Patients were examined at IRCCS—Bietti Foundation, Rome, Italy. Fourteen consecutive diabetic eyes showing outer retinal changes on spectral domain optical coherence tomography B-scan were included. Ten eyes of ten diabetic patients with normal outer retinal structure on SD-OCT were included as controls. All eyes underwent optical coherence tomography angiography (OCTA) and MP1 microperimetry. To explore the outer retina findings and localized areas of capillary nonperfusion at the superficial and deep capillary plexus, we used the Spectralis HRA + OCTA (Heidelberg Engineering, Heidelberg, Germany). The B-scans as either normal or having outer retinal disruption and the enface images at the level of the superficial and/or deep capillary plexus were evaluated to identify areas of capillary nonperfusion. Results. Fourteen eyes of 12 consecutive type 2 diabetic patients with outer retinal disruption on SD-OCT showed that areas of capillary nonperfusion of the deep capillary plexus were colocalized to areas of reduced retinal sensitivity. Conclusions. On optical coherence tomography angiography, areas of capillary nonperfusion of deep capillary plexus due to macular ischemia are associated with photoreceptor structural abnormalities and retinal sensitivity loss on microperimetry. This highlights that the health status of deep capillary plexus and not only the choroid is important to the oxygen requirements of the photoreceptors in patients with diabetic macular ischemia. Also, the anatomical and functional consequences of these findings might help to explore the efficacy of new therapy into the macular area in clinical practice.

scholarly journals Quantification of diabetic macular ischemia: Assessing agreement and reproducibility between Optical coherence tomography angiography and Fluorescein angiography

2020 ◽  
Vol 3 (1) ◽  
Author(s):  
Jeniffer Trenado ◽  
Sergio Rojas juárez
Keyword(s):  
Optical Coherence Tomography ◽  
Diabetic Retinopathy ◽  
Fluorescein Angiography ◽  
Choroidal Thickness ◽  
Optical Coherence Tomography Angiography ◽  
Intraclass Correlation ◽  
Optical Coherence ◽  
Study Protocols ◽  
Level Of Agreement ◽  
Macular Ischemia

Introduction: The purpose was to assess the level of agreement and reproducibility between fluorescein angiography (FA) and optical coherence tomography angiography (OCTA), throughout the evaluation of the foveal avascular zone (FAZ) to diagnose diabetic macular ischemia (DMI). Methods: In this ambispective, observational, cross-sectional research, 41 patients underwent traditional FA and OCTA to obtain the level of agreement and reproducibility between them, using an intraclass correlation coefficient (ICC) in mixed models. Two raters independently graded the area of the FAZ using the ImageJ software and the Early Treatment Diabetic Retinopathy Study protocols. Spearman and rank-biserial correlational analysis were used to calculate the strength of linear relationship between the area of the retinal vessels, the thickness of subfoveal retinal and choroid layers, the presence of neovascularization, and the visual acuity. A classification, based on the radius of the FAZ, was proposed and used to categorize the severity of DMI into five different grades. Result: From 52 evaluated eyes, the level of agreement between the OCTA and FA among the raters had an ICC of 0.99 and 0.907 (p<.001), respectively. Furthermore, the reproducibility analysis had an ICC of 0.85 (p<.001). In the correlation analysis, the enlargement of the FAZ was associated with a decrease in the outer retinal layers (r=-0.458, p<0.001), the photoreceptor layer (r=-0.32, p=0.021), their outer segments (r=-0.32, p=0.021) and the subfoveal choroidal thickness (r=-0.483, p<0.001). A reduction of the vascular area was observed in higher grades of diabetic retinopathy (r= -0.395, p=0.38). Additionally, meager choroidal thickness was found in grater grades of DMI (r=-0.461, p=0.014). Conclusion: Compelling evidence of a high level of agreement and reproducibility between OCTA and FA was obtained to diagnose diabetic macular ischemia. Moreover, it is suggested that the increase in macular ischemia leads to the thinning of the photoreceptor, outer retinal and choroid layers.

Optical coherence tomography angiography findings of diabetic patients with and without retinopathy

2021 ◽  
pp. 112067212199056
Author(s):  
Emine Temel ◽  
Figen Batıoğlu
Keyword(s):  
Optical Coherence Tomography ◽  
Optical Coherence Tomography Angiography ◽  
Foveal Avascular Zone ◽  
Diabetic Patients ◽  
Optical Coherence ◽  
Significant Difference ◽  
Capillary Plexus ◽  
The Difference ◽  
Healthy Persons ◽  
Group 1

Purpose: To emphasize the importance of optical coherence tomography angiography (OCTA) in the diagnosis and follow-up of diabetic individuals with and without retinopathy. Methods: Retrospective, cross-sectional, observational study of healthy persons and diabetic individuals with and without retinopathy. Area of the foveal avascular zone (FAZ) (mm²), non-perfused areas in the superficial capillary plexus (SCP), mean vessel density (VD) in the SCP, and deep capillary plexus (DCP) were calculated. In eyes with diabetic retinopathy (DR), measurements at baseline, 3rd, 6th, 9th, and 12th months were evaluated. Results: This study conducted on 39 eyes of 23 patients with DR (group 1), 59 eyes of 30 diabetic individuals without DR (group 2), and 51 eyes of 27 healthy persons (group 3). When the mean area of the FAZ at baseline was compared between groups, the difference among groups 1 and 3 ( p < 0.001) and the difference among groups 2 and 3 ( p = 0.001) were statistically significant. There was no significant difference among the measurements of mean area of the FAZ, mean non-perfused area in the SCP, mean VD in SCP, and DCP at baseline, 3rd, 6th, 9th, and 12th months in group 1. Conclusion: OCTA is a developing technology that can detect early microvascular changes in diabetic patients.

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.

Association of Foveal Avascular Zone Enlargement and Diabetic Retinopathy Progression Using Optical Coherence Tomography Angiography

2018 ◽  
Vol 2 (6) ◽  
pp. 343-350
Author(s):  
Katsuya Suzuki ◽  
Miho Nozaki ◽  
Noriaki Takase ◽  
Aki Kato ◽  
Hiroshi Morita ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Diabetic Retinopathy ◽  
Optical Coherence Tomography Angiography ◽  
Retrospective Chart Review ◽  
Foveal Avascular Zone ◽  
Diabetic Patients ◽  
Optical Coherence ◽  
Avascular Zone ◽  
Capillary Plexus

Purpose: The purpose of this article is to evaluate long-term change of the foveal avascular zone (FAZ) area in diabetic eyes using optical coherence tomography angiography (OCTA) (AngioVue, Avanti OCT, Optovue). Methods: A retrospective chart review was conducted of patients who had undergone OCTA fundus examinations with at least 12 months of follow-up. Eyes with previous laser photocoagulation and antivascular endothelial growth factor treatments were excluded. ImageJ software was used to evaluate the FAZ area in the superficial capillary plexus (SCP) and deep capillary plexus (DCP). Results: Forty eyes were analyzed in this study and divided into 3 groups: healthy controls (13 eyes), diabetic patients without diabetic retinopathy (DR) (14 eyes), and diabetic patients with DR (13 eyes). During the 22 months of follow-up, the FAZ area of eyes with DR in the DCP enlarged from 0.64 ± 0.20 mm2 to 0.70 ± 0.20 mm2 ( P = .021), which was a 10.1% increase from baseline (5.1% per year). No significant changes were observed during the study period for FAZ areas in the DCP of controls and diabetic patients without DR. Enlargement of FAZ in the DCP was significantly greater in eyes with DR progression vs those without progression (19.2% and 1.2%, respectively, P = .013). Conclusions: Our data suggest FAZ enlargement in the DCP is associated with DR progression. Assessment of the FAZ by OCTA might be useful for the evaluation of microcirculation abnormalities in DR and the onset of DR progression.

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