Role of optical coherence tomography-angiography in diabetes mellitus: Utility in diabetic retinopathy and a comparison with fluorescein angiography in vision threatening diabetic retinopathy

Purpose: To assess the current role of fluorescein angiography after the introduction of optical coherence tomography angiography in real-life clinical practice. Methods: This was a multicentric retrospective observational study to evaluate the number of fluorescein angiography and optical coherence tomography angiography procedures performed by different devices from January 2013 to December 2018. The centers involved were Centro Italiano Macula (Rome), and ophthalmology departments of University “G. D’Annunzio” Chieti–Pescara (Chieti) and “Azienda Ospedaliero Universitaria Careggi” (Florence). Results: Out of 19,898 total fluorescein angiography procedures performed in the observation period, 3444 (17.3%) were in 2013, 3972 (19.9%) were in 2014, 3601 (18.1%) were in 2015, 3407 (17.2%) were in 2016, 3285 (16.5%) were in 2017, and 2189 (11%) were in 2018. Out of 7949 optical coherence tomography angiography procedures performed in the observation period, none were performed in 2013, 550 (6.9%) were in 2014, 908 (11.5%) were in 2015, 2098 (26.4%) were in 2016, 2090 (26.3%) were in 2017, and 2303 (28.9%) were in 2018. Conclusion: Fluorescein angiography procedures were performed less often after the introduction of optical coherence tomography angiography technology. The ease, speed, and safety of the optical coherence tomography angiography procedure in everyday clinical practice have facilitated more optical coherence tomography angiography application compared to fluorescein angiography in recent years. In the future, we will probably evaluate the different pathologies that still need an evaluation by fluorescein angiography.

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Optical Coherence Tomography Angiography in Diabetic Patients: A Systematic Review

Biomedicines ◽

10.3390/biomedicines10010088 ◽

2021 ◽

Vol 10 (1) ◽

pp. 88

Author(s):

Ana Boned-Murillo ◽

Henar Albertos-Arranz ◽

María Dolores Diaz-Barreda ◽

Elvira Orduna-Hospital ◽

Ana Sánchez-Cano ◽

...

Keyword(s):

Diabetes Mellitus ◽

Optical Coherence Tomography ◽

Diabetic Retinopathy ◽

Macular Oedema ◽

Literature Search ◽

Optical Coherence Tomography Angiography ◽

Diabetic Macular Oedema ◽

Oct Angiography ◽

Diabetic Patients ◽

Optical Coherence

Background: Diabetic retinopathy (DR) is the leading cause of legal blindness in the working population in developed countries. Optical coherence tomography (OCT) angiography (OCTA) has risen as an essential tool in the diagnosis and control of diabetic patients, with and without DR, allowing visualisation of the retinal and choroidal microvasculature, their qualitative and quantitative changes, the progression of vascular disease, quantification of ischaemic areas, and the detection of preclinical changes. The aim of this article is to analyse the current applications of OCTA and provide an updated overview of them in the evaluation of DR. Methods: A systematic literature search was performed in PubMed and Embase, including the keywords “OCTA” OR “OCT angiography” OR “optical coherence tomography angiography” AND “diabetes” OR “diabetes mellitus” OR “diabetic retinopathy” OR “diabetic maculopathy” OR “diabetic macular oedema” OR “diabetic macular ischaemia”. Of the 1456 studies initially identified, 107 studies were screened after duplication, and those articles that did not meet the selection criteria were removed. Finally, after looking for missing data, we included 135 studies in this review. Results: We present the common and distinctive findings in the analysed papers after the literature search including the diagnostic use of OCTA in diabetes mellitus (DM) patients. We describe previous findings in retinal vascularization, including microaneurysms, foveal avascular zone (FAZ) changes in both size and morphology, changes in vascular perfusion, the appearance of retinal microvascular abnormalities or new vessels, and diabetic macular oedema (DME) and the use of deep learning technology applied to this disease. Conclusion: OCTA findings enable the diagnosis and follow-up of DM patients, including those with no detectable lesions with other devices. The evaluation of retinal and choroidal plexuses using OCTA is a fundamental tool for the diagnosis and prognosis of DR.

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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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Optical coherence tomography angiography findings of neurovascular changes in type 2 diabetes mellitus patients without clinical diabetic retinopathy

Acta Diabetologica ◽

10.1007/s00592-018-1202-3 ◽

2018 ◽

Vol 55 (10) ◽

pp. 1075-1082 ◽

Cited By ~ 21

Author(s):

Zijing Li ◽

Mohammad Alzogool ◽

Jianhui Xiao ◽

Si Zhang ◽

Peng Zeng ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Optical Coherence Tomography ◽

Type 2 Diabetes Mellitus ◽

Diabetic Retinopathy ◽

Optical Coherence Tomography Angiography ◽

Optical Coherence

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

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.38.1.3891 ◽

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.

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

Journal of Diabetes Research ◽

10.1155/2022/7723706 ◽

2022 ◽

Vol 2022 ◽

pp. 1-9

Author(s):

Ruoyu Chen ◽

Anyi Liang ◽

Jie Yao ◽

Zicheng Wang ◽

Yesheng Chen ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Diabetic Retinopathy ◽

Fluorescein Angiography ◽

Detection Rate ◽

Optical Coherence Tomography Angiography ◽

Optical Coherence ◽

Face Images ◽

Potential Biomarker ◽

En Face Oct ◽

En Face

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.

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