Bimodal imaging of proliferative diabetic retinopathy vascular features using swept source optical coherence tomography angiography

Elbendary, Amal M.; Abouelkheir, Hossam Youssef

doi:10.18240/ijo.2018.09.16

Cited by 10 publications

(8 citation statements)

References 24 publications

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“…We found a high frequency (87%) of NPAs adjacent to NVEs. Similar results were also encountered by de Carlo et al 30 and Elbendary et al 35 These results corroborate the idea of an association with ischemia and consequent VEGF release that stimulates the pathologic angiogenesis. 30 Although we have not aimed to specifically evaluate IRMAs, we found them adjacent to 70% of NVEs.…”

Section: Discussionsupporting

confidence: 90%

“…We 16 have previously tried to identify markers of neovascular activity using structural OCT alone before the advent of OCTA, but now OCTA renders the evaluation considerably simpler and the case presentations demonstrate its usefulness after treatment. 18 , 35 , 36 In the cases of NVCs without flow signal, all of which were NVDs, all had posterior shadowing. We hypothesize that this shadowing is related with loss of transmission from the fibrotic tissue proliferating associated with the NVD.…”

Section: Discussionmentioning

confidence: 99%

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<p>Optical Coherence Tomography Angiography Features of Neovascularization in Proliferative Diabetic Retinopathy</p>

Vaz-Pereira¹,

Silva²,

Freund³

et al. 2020

OPTH

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To describe features of neovascularization in proliferative diabetic retinopathy (PDR) using optical coherence tomography angiography (OCTA). Methods: A retrospective case series was performed in 23 eyes from 21 patients who underwent OCTA of neovascular complexes (NVCs) due to PDR. Eyes were imaged with the DRI Triton swept-source OCTA, Avanti RTVue XR or Cirrus HD-OCT 5000 as part of routine clinical examination. Segmentation was adjusted to include vasculature between the vitreous cavity and the internal limiting membrane (ILM). The presence of NVCs was confirmed by clinical examination and multimodal imaging such as color or red-free fundus photography, fluorescein angiography, multicolor imaging or near-infrared reflectance. Results: Thirty-five NVCs were imaged, of which, 34% were neovascularization of the disc (NVD) and 66% were neovascularization elsewhere (NVE). On structural OCT B-scans, NVE appeared as medium to highly reflective tissue that breached the ILM, while NVD showed highly reflective tissue protruding from the disc in a sea fan configuration. Flow signal was seen on OCTA in all cases of NVE and in 67% of NVD lesions. Areas with minimal or absent retinal flow signal identified retinal nonperfusion areas and were found adjacent to 87% of NVE. Intraretinal microvascular abnormalities (IRMAs) were noted next to 70% of NVE. Absent flow signal was seen in 4 NVD cases showing posterior shadowing and were considered inactive. Conclusion: OCTA appears useful for imaging NVCs, IRMAs, and retinal nonperfusion areas in eyes with diabetic retinopathy. This imaging modality enables noninvasive screening and monitoring of PDR and can obviate the need for additional testing in certain clinical settings.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

<p>Optical Coherence Tomography Angiography Features of Neovascularization in Proliferative Diabetic Retinopathy</p>

Vaz-Pereira¹,

Silva²,

Freund³

et al. 2020

OPTH

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“… 82 Different morphological patterns of neovascularization at disc (NVD) have been described on OCTA which can help us to detect the response to treatment. 88 Figure 4 shows NVD and NVE detected on OCTA.…”

Section: Octamentioning

confidence: 99%

Novel imaging biomarkers in diabetic retinopathy and diabetic macular edema

et al. 2020

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Diabetic retinopathy is one of the major microvascular complications of diabetes mellitus. The most common causes of vision loss in diabetic retinopathy are diabetic macular edema and proliferative diabetic retinopathy. Recent developments in ocular imaging have played a significant role in early diagnosis and management of these complications. Color fundus photography is an imaging modality, which is helpful for screening patients with diabetic eye disease and monitoring its progression as well as response to treatment. Fundus fluorescein angiography (FFA) is a dye-based invasive test to detect subtle neovascularization, look for areas of capillary non-perfusion, diagnose macular ischemia, and differentiate between focal and diffuse capillary bed leak in cases of macular edema. Recent advances in retinal imaging like the introduction of spectral-domain and swept source-based optical coherence tomography (OCT), fundus autofluorescence (FAF), OCT angiography, and ultrawide field imaging and FFA have helped clinicians in the detection of certain biomarkers that can identify disease at an early stage and predict response to treatment in diabetic macular edema. This article will summarize the role of different imaging biomarkers in characterizing diabetic retinopathy and their potential contribution in its management.

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“…Different authors have classified active NV by evaluating either the morphology of the NV and its origin [ 121 , 125 ] or blood flow and density maps [ 126 ]. One of the first descriptions of NV was given by Ishibazawa et al, characterising two different patterns both at the optic nerve and in other retinal places: one included exuberant vascular proliferation with small and irregular new vessels, and the other was described as pruned NVs that did not show leakage at the FA [ 125 ].…”

Section: Resultsmentioning

confidence: 99%

Optical Coherence Tomography Angiography in Diabetic Patients: A Systematic Review

et al. 2021

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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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Bimodal imaging of proliferative diabetic retinopathy vascular features using swept source optical coherence tomography angiography

Cited by 10 publications

References 24 publications

<p>Optical Coherence Tomography Angiography Features of Neovascularization in Proliferative Diabetic Retinopathy</p>

<p>Optical Coherence Tomography Angiography Features of Neovascularization in Proliferative Diabetic Retinopathy</p>

Novel imaging biomarkers in diabetic retinopathy and diabetic macular edema

Optical Coherence Tomography Angiography in Diabetic Patients: A Systematic Review

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