Optical coherence tomography angiography assessment of 577 nm laser effect on severe non-proliferative diabetic retinopathy with diabetic macular edema

Abstract Purpose:To evaluate dimensions of Foveal Avascular Zone (FAZ) at level of superficial and deep capillary plexuses (SCP/DCP), in patients with different grades of non proliferative diabetic retinopathy without Diabetic Macular Edema (DME) using Optical Coherence Tomography Angiography (OCTA).Patients and Methods: 80 type II diabetes mellitus patients and 20 healthy control subjects were included in this cross sectional study ,aged from 40-60 years with DM type 2 of more than five years ,ecxluding proliferative diabetic retinopathy and DME.Patients were subdivided into four groups according to ETDRS Classification (without retinopathy,mild ,moderate and sever retinopathy) .All subjects undewent: measurement of glycosylated hemoglobin level ,standard Structural Optical coherence tomography for the macula and optic nerve head with OCTA for evaluation of FAZ in both SCP and DCP networks of all eyes using (Heidelberg engineering, OCT spectralis, Germany) (SD-OCT). Results: Mean total macular thickness in control group (322.89 ± 16.31 μm) vs (316.57 ± 20.21 μm) in patients` group.Average RNFL thickness(158.61 ± 12.99 μm )in control group vs(156.07 ± 22.58) μm in patients` group.Mean FAZ in SCP in control group ( 0.32 ± 0.12) mm2 versus( 0.44 ± 0.17) mm2 in patients` group, while FAZ IN DCP (0.23) mm2 ± 0.12 in controls versus ( 0.34 ± 0.16) mm2 in patients.There was a statistically significant wider FAZ in DR patients (P-value 0.003).Conclusion: Enlargement of FAZ in SCP and DCP in patients with moderate to severe NPDR without DME was detected using OCTA, proceeded by neurodegenerative changes with reduction in thickness of ORL and GCC layer. This can be used to monitor the progression of the disease and to evaluate the response to treatment.

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

Güncel Retina Dergisi (Current Retina Journal) ◽

10.37783/crj-0081 ◽

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.

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

10.36811/irjo.2020.110006 ◽

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.

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Evaluation of morphological characteristics of diabetic macular edema in patients with non-proliferative versus proliferative diabetic retinopathy: a spectral-domain optical coherence tomography study

International Ophthalmology ◽

10.1007/s10792-021-01796-z ◽

2021 ◽

Author(s):

Irini Chatziralli ◽

George Theodossiadis ◽

Eleni Dimitriou ◽

Panagiotis Theodossiadis

Keyword(s):

Optical Coherence Tomography ◽

Diabetic Retinopathy ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Proliferative Diabetic Retinopathy ◽

Morphological Characteristics ◽

Spectral Domain ◽

Optical Coherence

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Aqueous angiopoietin-like levels correlate with optical coherence tomography angiography metrics in diabetic macular edema

International Journal of Ophthalmology ◽

10.18240/ijo.2021.12.12 ◽

2021 ◽

Vol 14 (12) ◽

pp. 1888-1894

Author(s):

Jie Yan ◽

◽

Ya-Zhou Qin ◽

Xuan-Yu Qiu ◽

Li Qin ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Diabetic Retinopathy ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Optical Coherence Tomography Angiography ◽

Fundus Photography ◽

Diabetic Patients ◽

Optical Coherence ◽

Suspension Array ◽

Circularity Index

AIM: To quantitatively detect aqueous levels of angiopoietin-like (ANGPTL)3, ANGPTL4, and ANGPTL6 and investigate their correlation with optical coherence tomography angiography (OCTA) findings in patients with diabetic macular edema (DME). METHODS: This cross-sectional study included 23 patients (27 eyes) with type 2 diabetes and 16 control subjects (20 eyes). All patients underwent OCTA imaging and ultra-wide field fundus photography. Diabetic patients were categorized into two groups according to the presence or absence of diabetic retinopathy (DME group, 14 patients, 16 eyes); and non-diabetic retinopathy (NDR) group, 9 patients, 11 eyes, respectively. Aqueous levels of ANGPTL3, ANGPTL4, and ANGPTL6 were assessed using suspension array technology, and foveal-centered 3×3 mm2 OCTA scans were automatically graded to determine the central, inner, and full vessel density (CVD, IVD, FVD); central, inner, and full perfusion density (CPD, IPD, FPD), foveal avascular zone (FAZ) area, FAZ perimeter, and FAZ circularity index (FAZ-CI) on superficial capillary plexuses. Additionally, central subfield thickness (CST), cube volume (CV), and cube average thickness (CAT) were measured in a model of macular cube 512×128. RESULTS: Aqueous ANGPTL3 levels were not significantly different among the three groups (P>0.05). ANGPTL4 levels were significantly higher in the DME group than the control and NDR groups (P<0.0001 and P<0.001), while ANGPTL6 levels were significantly higher in the DME group than the control group (P<0.05). In the whole cohort, the aqueous ANGPTL3 levels correlated negatively with the IVD, FVD, IPD, and FPD, and positively with the CV and CAT. The aqueous ANGPTL4 levels correlated negatively with the CVD, IVD, FVD, CPD, IPD, and FPD, and positively with the FAZ perimeter, CST, CV, and CAT. The aqueous ANGPTL6 levels correlated negatively with the IVD, FVD, IPD, FPD, FAZ-CI and positively with CST, CV, CAT. CONCLUSION: ANGPTL4 and ANGPTL6 may be associated with vascular leakage in DME and may represent good targets for DME therapy. In addition, OCTA metrics may be useful for evaluating macular ischemia in DME.

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