scholarly journals Role of Optical Coherence Tomography Angiography to differentiate Intraretinal microvascular abnormalities and retinal neovascularization in Diabetic Retinopathy

2021 ◽  
Vol 38 (1) ◽  
Author(s):  
Abdul Sami Memon ◽  
Nasir Ahmed Memon ◽  
Pir Salim Mahar
Keyword(s):  
Optical Coherence Tomography ◽  
Diabetic Retinopathy ◽  
Clinical Diagnosis ◽  
Proliferative Diabetic Retinopathy ◽  
Optical Coherence Tomography Angiography ◽  
Retinal Neovascularization ◽  
Wide Field ◽  
Optical Coherence ◽  
Fundus Fluorescein Angiography

Objective: To assess proliferative diabetic retinopathy (PDR) and to describe the difference in angiographic representation of new vessels (NVs) and Intra retinal microvascular abnormalities (IRMA) on optical coherence tomography angiography (OCTA). Methods: A cross-sectional observational study was performed at ISRA Postgraduate Institute of Ophthalmology, Karachi, from March 2018 to September 2018. Forty-two eyes of 21 patients with history of diabetes mellitus (DM) were examined. Twenty-eight eyes with a clinical diagnosis of severe non proliferative diabetic retinopathy (NPDR) or proliferative diabetic retinopathy (PDR) according to early treatment diabetic retinopathy study (ETDRS) were included and evaluated using Swept source optical coherence tomography angiography (SS-OCTA). Then face wide field SS-OCTA images and co registered structural optical coherence tomography (OCT) with flow overlay were used to distinguish the features of IRMA and retinal NVs. Results: Forty-two eyes (21 patients) were examined clinically. Fourteen eyes had moderate NPDR, 15 had severe NPDR and 13 eyes had changes consistent with PDR. After clinical diagnosis, we included 28 eyes in our study based on inclusion criteria. These 28 eyes went through SS-OCTA evaluation and we observed 15 cases with PDR and 13 with severe NPDR changes. The OCTA and clinical diagnosis were similar except in 2 eyes, which is critical but not statically significant showing the importance of this noninvasive technology. Conclusions: Widefield OCTA can work as an alternative to fundus fluorescein angiography (FFA) in the diagnosis of diabetic retinopathy (DR). As it is a non-invasive and depth encoded technique so can be used frequently to monitor the retinal changes and their progression. doi: https://doi.org/10.12669/pjms.38.1.3891 How to cite this:Memon AS, Memon NA, Mahar PS. Role of Optical Coherence Tomography Angiography to differentiate Intraretinal microvascular abnormalities and retinal neovascularization in Diabetic Retinopathy. Pak J Med Sci. 2022;38(1):---------.  doi: https://doi.org/10.12669/pjms.38.1.3891 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Observation of Retinal Neovascularization using Optical Coherence Tomography Angiography after Panretinal Photocoagulation for Proliferative Diabetic Retinopathy

2021 ◽  
Author(s):  
Feng He ◽  
Fangtian Dong ◽  
Weihong Yu
Keyword(s):  
Optical Coherence Tomography ◽  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Optical Coherence Tomography Angiography ◽  
Quantitative Information ◽  
Retinal Neovascularization ◽  
Prospective Clinical Study ◽  
Panretinal Photocoagulation ◽  
Optical Coherence ◽  
Fundus Fluorescein Angiography

Abstract Background: To describe the longitudinal changes of retinal neovascularization elsewhere (NVE) on optical coherence tomography angiography (OCTA) in proliferative diabetic retinopathy (PDR) treated by panretinal photocoagulation (PRP). Methods: Each patient included in this prospective clinical study was newly diagnosed PDR and NVE on both fundus fluorescein angiography (FFA) and OCTA. They received PRP of 4 sessions using multi-wavelength laser. Best-corrected visual acuity (BCVA) and OCTA images encompassing NVE were obtained before each PRP session and at 1 month, 3 months, and 6 months. Paired sample t-test was used to investigate differences between BCVA and NVE area before and after PRP. Results: Thirty-two eyes of 32 patients with a mean age of 50.56 ± 7.05 years were included. We found statistically significant reduction in the NVE size at all timepoints compared with the baseline except at 6 months (all P < 0.05). Further analysis demonstrated no statistically significant change of NVE size between two adjacent timepoints except from baseline to post-1st PRP and from 3 months to 6 months (both P < 0.05). BCVA at 3 months showed a statistically significant improvement compared with baseline (P < 0.05), but no significant changes of BCVA were observed during other visits.Conclusions: Using OCTA we found an overall regression in the NVE size following PRP starting as early as 1 week after 1st session and lasting until 3 months. OCTA provides quantitative information of vascular changes and could be a practical method for the longitudinal evaluation of neovascularization.

scholarly journals Observation of retinal neovascularization using optical coherence tomography angiography after panretinal photocoagulation for proliferative diabetic retinopathy

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
H. E. Feng ◽  
Y. U. Weihong ◽  
Fangtian Dong
Keyword(s):  
Optical Coherence Tomography ◽  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Optical Coherence Tomography Angiography ◽  
Quantitative Information ◽  
Retinal Neovascularization ◽  
Prospective Clinical Study ◽  
Panretinal Photocoagulation ◽  
Optical Coherence ◽  
Fundus Fluorescein Angiography

Abstract Background To describe the longitudinal changes in retinal neovascularization elsewhere (NVE) as observed on optical coherence tomography angiography (OCTA) in proliferative diabetic retinopathy (PDR) treated by panretinal photocoagulation (PRP). Methods Each patient included in this prospective clinical study was newly diagnosed with PDR and NVE confirmed by both fundus fluorescein angiography (FFA) and OCTA. They received four sessions of PRP using a multiwavelength laser. Best-corrected visual acuity (BCVA) and OCTA images of the NVE were obtained before each PRP session and at 1 month, 3 months, and 6 months after the PRP treatment. Generalized estimating equations (GEE) was used to investigate the differences between the BCVA and NVE areas before and after PRP. Results Thirty-two eyes of 32 patients with a mean age of 50.56 ± 7.05 years were included. We found a statistically significant reduction in the NVE area at all time points compared with the baseline except at 6 months (all P < 0.05). Further analysis demonstrated no statistically significant change in the NVE area between two adjacent timepoints except from baseline to post-1st PRP (P < 0.05). BCVA at 3 months showed a statistically significant improvement compared with baseline (P < 0.05), but no significant changes in BCVA were observed during the other visits. Conclusions We found an overall regression in the NVE area following PRP starting as early as 1 week after the 1st session and lasting up to 3 months. OCTA provides quantitative information on vascular changes and could be a practical method for the longitudinal evaluation of neovascularization.

scholarly journals Optical coherence tomography angiography measured area of retinal neovascularization is predictive of treatment response and progression of disease in patients with proliferative diabetic retinopathy

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Anna Stage Vergmann ◽  
Kristian Tølbøl Sørensen ◽  
Thomas Lee Torp ◽  
Ryo Kawasaki ◽  
Tien Wong ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Diabetic Retinopathy ◽  
Treatment Response ◽  
Proliferative Diabetic Retinopathy ◽  
Optical Coherence Tomography Angiography ◽  
Retinal Neovascularization ◽  
Panretinal Photocoagulation ◽  
Optical Coherence ◽  
Progression Of Disease ◽  
Treatment Naïve

Abstract Background The purpose of this study was to evaluate the area of retinal neovascularization in patients with treatment-naïve proliferative diabetic retinopathy (PDR) as measured by optical coherence tomography angiography (OCT-A) as a marker of subsequent treatment response after panretinal photocoagulation (PRP), and to examine if this area correlated with area of retinal neovascularization as measured by fluorescein angiography (FA). Methods En face OCT-A scans (4.5 × 4.5 mm) of neovascularizations were obtained at baseline (BL) before PRP and at month (M) 3 and M6 after treatment. Progression of PDR were defined as lesion growth (assessed by ophthalmoscopy and wide-field fundus photo) or increasing leakage by Optos ultra-widefield FA, and patients were divided into two groups; progression or non-progression. Mann–Whitney U test and Wilcoxon signed-rank test were used to analyse differences between groups and between time points. Areas of retinal neovascularizations (OCT-A and FA) were calculated by algorithms developed in Python (version 3.6.8, The Python Software Foundation, USA). Results Of 21 eyes included, 14 had progression of disease. Median OCT-A area did not differ between the two groups (progression vs. non-progression) at BL (76.40 ± 162.03 vs. 72.62 ± 94.15, p = 0.43) but were statistically significantly larger in the progression group at M6 (276.69 ± 168.78 vs. 61.30 ± 70.90, p = 0.025). Median FA area did not differ in the progression vs. the non-progression group at BL (111.42 ± 143.08 vs. 60.80 ± 54.83, p = 0.05) or at M6 (200.12 ± 91.81 vs. 123.86 ± 162.16, p = 0.62). Intraclass correlation between area by OCT-A and FA was −5.99 (95% CI: −35.28–0.993), p = 0.71. Conclusions In this study of patients with treatment-naïve PDR, we showed that increasing area of retinal neovascularizations measured by OCT-A at M6 indicated progression of disease after PRP treatment. Our results suggest that area by OCT-A reflects disease activity and that it can be used as an indicator to monitor the progression of PDR over time, and to evaluate treatment response six months after PRP. Trial registrationhttps://clinicaltrials.gov (identifier: NCT03113006). Registered April 13, 2017.

scholarly journals Longitudinal neovascular changes on optical coherence tomography angiography in proliferative diabetic retinopathy treated with panretinal photocoagulation alone versus with intravitreal conbercept plus panretinal photocoagulation: a pilot study

Eye ◽  
2019 ◽  
Vol 34 (8) ◽  
pp. 1413-1418 ◽  
Author(s):  
Feng He ◽  
Weihong Yu
Keyword(s):  
Optical Coherence Tomography ◽  
Diabetic Retinopathy ◽  
Pilot Study ◽  
Proliferative Diabetic Retinopathy ◽  
Optical Coherence Tomography Angiography ◽  
Combination Group ◽  
Panretinal Photocoagulation ◽  
Optical Coherence ◽  
Fundus Fluorescein Angiography ◽  
Significant Difference

Abstract Purpose To investigate the longitudinal changes in neovascularization of the retinal elsewhere (NVE) size on optical coherence tomography angiography (OCTA) in proliferative diabetic retinopathy (PDR) treated by panretinal photocoagulation (PRP) alone or by single intravitreal conbercept injection plus PRP. Methods A prospective pilot study. Forty-four PDR eyes with NVE confirmed by fundus fluorescein angiography (FFA) and OCTA were included. They were assigned to receive PRP alone (PRP group) or intravitreal conbercept injection plus PRP (combination group). Ophthalmic examinations, including BCVA and OCTA to measure the NVE size, were performed at baseline before each PRP session, and at 1, 3, and 6 months. Results Twenty-nine eyes were included in the PRP group, and 15 eyes were included in the combination group. There was no significant difference between the two groups with respect to age, BCVA, and NVE area at baseline. In both groups, there was a significant (P < 0.05) NVE size reduction during the majority of study visits, with the reduction observed in the combination group significantly larger than that in the PRP group. No significant BCVA changes were observed in either groups, except that in the PRP group, the BCVA at 3 months was significantly improved (P < 0.05). No deaths or unexpected adverse events (AEs) were reported. Conclusions Intravitreal conbercept plus PRP was more effective than PRP monotherapy in NVE regression. Precise quantification of the NVE area by OCTA makes it a useful tool for monitoring the response of retinal neovascular lesions to the therapy.

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