Comparison Between Graders in Detection of Diabetic Neovascularization With Swept Source Optical Coherence Tomography Angiography and Fluorescein Angiography

Al-Khersan, Hasenin; Russell, Jonathan F.; Lazzarini, Thomas A.; Scott, Nathan L.; Hinkle, John W.; Patel, Nimesh A.; Yannuzzi, Nicolas A.; Fowler, Benjamin J.; Hussain, Rehan M.; Barikian, Anita; Sridhar, Jayanth; Russell, Stephen R.; Haddock, Luis J.; Smiddy, William E.; Shi, Yingying; Wang, Liang; Feuer, William J.; Gregori, Giovanni; Rosenfeld, Philip J.

doi:10.1016/j.ajo.2020.11.020

Cited by 11 publications

(16 citation statements)

References 17 publications

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“…WF-OCTA also has the added advantage of using the vitreoretinal interface (VRI) angio slab to improve detection rates of neovascularization [ 62 ]. Similar rates of NV detection were reported using WF-OCTA and UWF-FA, regardless of the level of training for the grader (resident, retina fellow or attending) [ 63 ].…”

Section: Wide Field Optical Coherence Tomography Angiography (Wf-octa) Quantitative Metricssupporting

confidence: 58%

Ultrawide Field Imaging in Diabetic Retinopathy: Exploring the Role of Quantitative Metrics

Ashraf

Cavallerano

Sun

et al. 2021

JCM

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Ultrawide field imaging (UWF) has allowed the visualization of a significantly greater area of the retina than previous standard approaches. In diabetic retinopathy (DR), significantly more lesions are seen on UWF imaging compared to the seven-standard ETDRS fields. In addition, some eyes have lesions that are located predominantly in the peripheral retina that are associated with an increased risk of DR progression. The current DR severity scales are still largely based on clinically visible retinal microvascular lesions and do not incorporate retinal periphery, neuroretinal, or pathophysiologic changes. Thus, current scales are not well suited for documenting progression or regression in eyes with very early or advanced DR, nor in the setting of vascular endothelial growth factor inhibitors (antiVEGF). In addition, the categorical system is highly subjective, and grading is variable between different graders based on experience level and training background. Recently, there have been efforts to quantify DR lesions on UWF imaging in an attempt to generate objective metrics for classification, disease prognostication and prediction of treatment response. The purpose of this review is to examine current quantitative metrics derived from UWF fluorescein angiograms and UWF color imaging to determine their feasibility in any potential future DR classification.

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Section: Wide Field Optical Coherence Tomography Angiography (Wf-octa) Quantitative Metricssupporting

confidence: 58%

Ultrawide Field Imaging in Diabetic Retinopathy: Exploring the Role of Quantitative Metrics

Ashraf

Cavallerano

Sun

et al. 2021

JCM

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“…The agreement between graders was almost identical in the FA and WF-OCTA en face analysis, proving that ophthalmologists of all levels were able to identify NVCs in WF-OCTA [82]. However, despite the good results in NVCs with WF-OCTA, IRMAs remain a source of false positives and NVD was missed more frequently than NVE (Figure 4) [82]. Subtle smaller fronds of NVE, requiring more careful examination, were also missed more often (Figure 4) [82].…”

Section: Additional Observationsmentioning

confidence: 68%

“…Al-Khersan et al [82], in 2020, looked into the challenge of any ophthalmologist identifying NVCs in WF-OCTA by comparing the performance of non-expert ophthalmologists with several training levels using WF-OCTA and FA. The agreement between graders was almost identical in the FA and WF-OCTA en face analysis, proving that ophthalmologists of all levels were able to identify NVCs in WF-OCTA [82]. However, despite the good results in NVCs with WF-OCTA, IRMAs remain a source of false positives and NVD was missed more frequently than NVE (Figure 4) [82].…”

Section: Additional Observationsmentioning

confidence: 99%

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Update on Optical Coherence Tomography and Optical Coherence Tomography Angiography Imaging in Proliferative Diabetic Retinopathy

2021

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Proliferative diabetic retinopathy (PDR) is a major cause of blindness in diabetic individuals. Optical coherence tomography (OCT) and OCT-angiography (OCTA) are noninvasive imaging techniques useful for the diagnosis and assessment of PDR. We aim to review several recent developments using OCT and discuss their present and potential future applications in the clinical setting. An electronic database search was performed so as to include all studies assessing OCT and/or OCTA findings in PDR patients published from 1 January 2020 to 31 May 2021. Thirty studies were included, and the most recently published data essentially focused on the higher detection rate of neovascularization obtained with widefield-OCT and/or OCTA (WF-OCT/OCTA) and on the increasing quality of retinal imaging with quality levels non-inferior to widefield-fluorescein angiography (WF-FA). There were also significant developments in the study of retinal nonperfusion areas (NPAs) using these techniques and research on the impact of PDR treatment on NPAs and on vascular density. It is becoming increasingly clear that it is critical to use adequate imaging protocols focused on optimized segmentation and maximized imaged retinal area, with ongoing technological development through artificial intelligence and deep learning. These latest findings emphasize the growing applicability and role of noninvasive imaging in managing PDR with the added benefit of avoiding the repetition of invasive conventional FA.

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“…Previous studies [ 3 ] have reported that diabetic retinas are mainly accompanied by microaneurysms, punctate hemorrhage, cotton-floss plaques and retinal microvascular abnormalities under continuous hyperglycemia stimulation. The pathological manifestation of diabetic retinopathy is that the patient's continuous hyperglycemia environment leads to the apoptosis of retinal peripheral vascular cells, promotes the abnormal proliferation of retinal vascular endothelial cells, and seriously affects the function of retinal blood vessels [ 4 – 6 ]. At present, the primary treatment strategy [ 7 ] is still to control the body’s blood glucose concentration and alleviate the sustained damage caused by hyperglycemia stimulation, but the mechanism of diabetic retinopathy targeting vascular endothelial function is still unclear.…”

Section: Introductionmentioning

confidence: 99%

Circ_001209 aggravates diabetic retinal vascular dysfunction through regulating miR-15b-5p/COL12A1

Wang

Zhang

2021

J Transl Med

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Objective Diabetic retinopathy, a common complication of diabetes mellitus and a major cause of blindness. circRNAs spongs target miRNA and thus influencing mRNA expression in DR. We investigated the mechanism of circ_001209 in regulating diabetic retinal vascular dysfunction. Methods QRT-PCR analysis was performed to detect the expression of miR-15b-5p, COL12A1 and circ_001209 in human retinal vascular endothelial cells (HRVECs) under high glucose conditions. Western blot assay, wound healing assay, transwell assay and tube formation were used to explore the roles of circ_001209/miR-15b-5p/COL12A1 in retinal vascular dysfunction. Bioinformatics analysis and luciferase reporter, RNA-FISH, and overexpression assays were performed to reveal the mechanisms of the circ_001209/miR-15b-5p/COL12A1 interaction. TUNEL staining and H&E staining were used to evaluate the pathological changes in streptozotocin (STZ)-induced DR in rats. Results Downregulation of miR-15b-5p under HG conditions promoted proliferation, migration, and tube formation of HRVECs. QRT-PCR and western blot results revealed that miR-15b-5p affected the HRVECs function through targeting COL12A1. Under HG conditions, circ_001209, which acts as a sponge of miR-15b-5p, is upregulated. Besides, overexpression of circ_001209 can affect HRVEC function and aggravate retinal injury in diabetic rats. Conclusion Upregulation of circ_001209 contributes to vascular dysfunction in diabetic retinas through regulating miR-15b-5p and COL12A1, providing a potential treatment strategy for diabetic retinopathy.

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Comparison Between Graders in Detection of Diabetic Neovascularization With Swept Source Optical Coherence Tomography Angiography and Fluorescein Angiography

Cited by 11 publications

References 17 publications

Ultrawide Field Imaging in Diabetic Retinopathy: Exploring the Role of Quantitative Metrics

Ultrawide Field Imaging in Diabetic Retinopathy: Exploring the Role of Quantitative Metrics

Update on Optical Coherence Tomography and Optical Coherence Tomography Angiography Imaging in Proliferative Diabetic Retinopathy

Circ_001209 aggravates diabetic retinal vascular dysfunction through regulating miR-15b-5p/COL12A1

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