scholarly journals Fluorescein Leakage and Optical Coherence Tomography Angiography Features of Microaneurysms in Diabetic Retinopathy

2022 ◽  
Vol 2022 ◽  
pp. 1-9
Author(s):  
Ruoyu Chen ◽  
Anyi Liang ◽  
Jie Yao ◽  
Zicheng Wang ◽  
Yesheng Chen ◽  
...  

Background and Objective. To correlate optical coherence tomography angiography (OCTA) characteristics of diabetic microaneurysms (MAs) with leakage status on fluorescein angiography (FA). Patients and Methods. 167 MAs from 39 diabetic eyes were analyzed using OCTA and FA simultaneously. The characteristics of MAs on OCTA en face, OCT en face, and OCT B-scan with flow overlay were evaluated and correlated with fluorescein leakage status. Results. Thirty-six, fifty-two, and seventy-nine MAs showed no, mild, and severe leakage on FA, respectively. Most MAs (61.7%) were centered in the inner nuclear layer. Cystoid spaces were observed adjacent to 60 (35.9%) MAs. MAs with severe leakage had a statistically higher flow proportion compared to MAs with no or mild leakage (both P < 0.001 ). Only 112 MAs (67.1%) were visualized in the OCTA en face images, while 165 MAs (98.8%) could be visualized in the OCT en face images. The location of MAs did not associate significantly with FA leakage status. The presence of nearby cystoid spaces and higher flow proportion by OCT B-scan with flow overlay correlated significantly with FA leakage status. Conclusion. The flow proportion of MAs observed on OCT B-scans with flow overlay might be a potential biomarker to identify leaking MAs. A combination of OCT B-scan, OCT en face, and OCTA en face images increased the detection rate of diabetic MAs in a noninvasive way.

2017 ◽  
Vol 1 (6) ◽  
pp. 424-427 ◽  
Author(s):  
Douglas S. M. Iaboni ◽  
Mark E. Seamone ◽  
Netan Choudhry ◽  
R. Rishi Gupta

Purpose: To report a case of torpedo maculopathy presenting with fovea plana in a 21-year-old female patient. Methods: Multimodal imaging including fluorescein angiography, fundus autofluorescence, and spectral domain optical coherence tomography (OCT) was used to characterize pathology. Results: A well-circumscribed ellipsoidal hypopigmented lesion was observed inferotemporal to the fovea OS. Fluorescein angiography and fundus autofluorescence revealed hyperfluorescence and focal hypoautofluorescence, respectively, corresponding to the hypopigmented lesion. Spectral domain optical coherence tomography imaging of the lesion revealed attenuation of the ellipsoid zone and retinal pigment epithelium with a hyporeflective subretinal cleft. En face OCT imaging demonstrated an area of subretinal hyporeflectivity at the subretinal cleft. Spectral domain optical coherence tomography revealed the absence of a foveal pit. Conclusion: We have described a novel case presentation of fovea plana alongside torpedo maculopathy. The significance of this association remains unclear. Further study into these conditions is necessary to help better determine factors responsible for visual symptoms or lack thereof and circumstances that promote their development.


2016 ◽  
Vol 27 (1) ◽  
pp. 9-12 ◽  
Author(s):  
Maria Vittoria Cicinelli ◽  
Lorenzo Iuliano ◽  
Alessandro Rabiolo ◽  
Alessandro Marchese ◽  
Giuseppe Querques ◽  
...  

Purpose To report a case of juxtapapillary polypoidal choroidal neovascularization (PCNV) associated with choroidal nevus investigated by means of optical coherence tomography angiography (OCT-A). Methods Case report. Results A 72-year-old woman presented with visual loss and metamorphopsia in her left eye for 5 days secondary to PCNV that developed on the border of a juxtapapillary choroidal nevus. Fluorescein angiography, indocyanine green angiography, and spectral-domain OCT confirmed the diagnosis. En face OCT-A disclosed a large tangled hyperreflective PCNV spreading from the optic disc at different levels of the choriocapillaris; the polyp lumina appeared hyporeflective. The patient was treated with 3 intravitreal injections of anti-vascular endothelial growth factor with partial functional recovery. Conclusions Our case showed the application of OCT-A in the diagnosis of a case of active PCNV complicating a benign intraocular tumor.


2020 ◽  
Author(s):  
Fariba Ghassemi ◽  
Kaveh Fadakar ◽  
Sahar Berijani ◽  
Ameneh Babeli ◽  
Alireza Gholizadeh ◽  
...  

Abstract Background: To determine the discrepancy between quantitative measurement of retinal and choriocapillaris (CC) vascular density (VD) in diabetic retinopathy (DR) stages using spectral domain optical coherence tomography angiography (SD OCTA) and compare it with normal subjects.Methods: 188 eyes of 97 participants were recruited in this cross-sectional study. Macular OCTA (3x3mm) scan was performed and VD at the level of superficial capillary plexus (SCP), deep capillary plexus (DCP) and CC were measured with the device software.Results: In normal subjects, VD in SCP, DCP, and CC were higher in all subsegments. In retinal VD, all calculated parameters were reduced in the more extreme stages of DR, except for foveal VD of SCP. There was a constant pattern of decrease in VD of CC from normal cases to cases of NDR and NPDR and then a slight increase happened in the PDR stage but never touching the normal quantities. Age, fasting blood sugar, and years of diabetes mellitus were correlated with reduced VD in different segments. Multivariate linear regression analysis showed that best-corrected visual acuity (BCVA) was positively correlated with parafoveal VD at SCP and VD of foveal area at CC. VD of all subfields of macular area except foveal DCP VD showed reduced levels in diabetic macular edema (DME) patients compared to those without DME.Conclusions: The findings of the study endorse retina VD changes as a potential biomarker for DR development before retinopathy becomes clinically evident. It seems that parafoveal VD of SCP and foveal VD of CC are good biomarkers to predict VA in the diabetic patients.


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.


PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243830
Author(s):  
Yining Dai ◽  
Hao Zhou ◽  
Qinqin Zhang ◽  
Zhongdi Chu ◽  
Lisa C. Olmos de Koo ◽  
...  

Purpose To quantitatively assess choriocapillaris (CC) flow deficits in eyes with diabetic retinopathy (DR) using swept-source optical coherence tomography angiography (SS-OCTA). Methods Diabetic subjects with different stages of DR and age-matched healthy subjects were recruited and imaged with SS-OCTA. The en face CC blood flow images were generated using previously published and validated algorithms. The percentage of CC flow deficits (FD%) and the mean CC flow deficit size were calculated in a 5-mm-diameter circle centered on the fovea from the 6×6-mm scans. Results Forty-five diabetic subjects and 27 control subjects were included in the study. The CC FD% in diabetic eyes was on average 1.4-fold greater than in control eyes (12.34±4.14% vs 8.82±2.61%, P < 0.001). The mean CC FD size in diabetic eyes was on average 1.4-fold larger than in control eyes (2151.3± 650.8μm2 vs 1574.4±255.0 μm2, P < 0.001). No significant difference in CC FD% or mean CC FD size was observed between eyes with nonproliferative DR and eyes with proliferative DR (P = 1.000 and P = 1.000, respectively). Conclusions CC perfusion in DR can be objectively and quantitatively assessed with FD% and FD size. In the macular region, both CC FD% and CC FD size are increased in eyes with DR. SS-OCTA provides new insights for the investigations of CC perfusion status in diabetes in vivo.


2019 ◽  
Vol 3 (5) ◽  
pp. 289-296
Author(s):  
Verena R. Juncal ◽  
Armin Abadeh ◽  
Keyvan Koushan ◽  
Alan R. Berger ◽  
David R. Chow

Purpose: This study assesses the frequency of projection artifacts in optical coherence tomography angiography (OCTA) en face images and compares images before and after applying a 3-dimensional projection artifact removal (3D-PAR) algorithm. Methods: This is a single-center, retrospective study that included consecutive patients with any underlying diagnosis who had OCTA obtained from January to March 2017. Patients with various retinal diseases and also healthy eyes were included. All participants underwent imaging with a scan area of 3 mm × 3 mm. The 4 default en face slabs were analyzed: superficial capillary plexus (SCP), deep capillary plexus (DCP), outer retina (OR), and choriocapillaris (CC). Images were qualitatively analyzed before and after 3D-PAR by 2 independent graders. Results: None of the SCP images had projection artifact before or after 3D-PAR. Scans of the DCP presented projection artifact in 96.5% of the cases. After 3D-PAR, 14.7% had a complete improvement of projection artifact, 56.5% had a partial improvement, 14.1% were worse, and 14.7% presented no change. In the OR, 2.9% had projection artifact, with a complete improvement after 3D-PAR in 40%, partial improvement in 20%, and no change in 40%. Projection artifact was initially present in 97.6% of the images in the CC. After 3D-PAR, there was a complete improvement in 72.9%, partial improvement in 26.5%, and no change in 0.6%. Choroidal neovascularization (CNV) was detected in 29 eyes (17.1%), and 3D-PAR improved detection of CNV in 12 cases (41.4%). Conclusions: OCTA with 3D-PAR technology minimizes the appearance of projection artifacts in the DCP and CC slabs.


Author(s):  
Jeniffer Trenado ◽  
Sergio Rojas juárez

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.


2019 ◽  
Vol 243 (1) ◽  
pp. 21-26 ◽  
Author(s):  
Christian Enders ◽  
Franziska Baeuerle ◽  
Gabriele E. Lang ◽  
Jens Dreyhaupt ◽  
Gerhard K. Lang ◽  
...  

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