Comparison of multicolor scanning laser ophthalmoscopy and optical coherence tomography angiography for detection of microaneurysms in diabetic retinopathy

Abstract

This study aimed to evaluate the usefulness of multicolor (MC) scanning laser ophthalmoscopy (MC-SLO) in detecting microaneurysm (MA) in eyes with diabetic retinopathy (DR). This was a retrospective cross-sectional study. Eyes with DR underwent fluorescein angiography (FA), MC-SLO, optical coherence tomography angiography (OCTA), and color fundus photography (CFP) were analyzed. The foveal region was cut in an 6 × 6 mm image and the number of MA in each image was counted by retina specialists to determine the sensitivity and positive predictive value. FA results were used as the ground standard. MAs were classified as those with early, late, or no dye leakage based on FA images. Fifty-four eyes of 35 patients with an average age of 64.5 ± 1.24 years were included. The sensitivity of MA detection was 37.3%, 15.3%, and 4.12% in MC-SLO, OCTA, and CFP, respectively (P < 0.01 in each pair).The positive predictive value was 66.4%, 46.4%, and 27.6% in MC, OCTA, and CFP, respectively (P < 0.01 in each pair). Sensitivity for MAs with early leakage was 36.4% in MC-SLO, which was significantly higher than 4.02% in OCTA. MC-SLO was more useful in detecting MA in eyes with DR than OCTA.

Colour tone of retinal arterioles imaged with a colour scanning laser ophthalmoscope can be an indicator of systemic arterial stiffness

“…In the present study, cSLO showed a stronger green tint in the retinal arterioles of patients with higher CAVI. This is similar to the changes in retinal capillary aneurysms that we previously reported 26. In retinal capillary aneurysms, the centre of the lesion is the colour green, and the periphery is the colour red in cSLO.…”

“…We previously found that retinal capillary microaneurysms (MA) in diabetic retinopathy were more visible in a colour scanning laser ophthalmoscope (cSLO) than in CFPs 26. The colour tone of MA could be classified as retinal haemorrhage because alteration of the vessel wall in MA was observed in green at the centre and red at the periphery 26.…”

“…We previously found that retinal capillary microaneurysms (MA) in diabetic retinopathy were more visible in a colour scanning laser ophthalmoscope (cSLO) than in CFPs. 26 The colour tone of MA could be classified as retinal haemorrhage because alteration of the vessel wall in MA was observed in green at the centre and red at the periphery. 26 This result was obtained using three wavelengths of laser light in cSLO to evaluate the properties of the vessel wall, providing a more direct assessment of blood vessels than black box AI.…”

“… 26 The colour tone of MA could be classified as retinal haemorrhage because alteration of the vessel wall in MA was observed in green at the centre and red at the periphery. 26 This result was obtained using three wavelengths of laser light in cSLO to evaluate the properties of the vessel wall, providing a more direct assessment of blood vessels than black box AI. Since the histological findings between MA and retinal arterial sclerosis, such as hyaline substance deposition in the vessel wall and vascular smooth muscle cell damage, were similar, 1 2 27 we hypothesised cSLO could evaluate the arterial stiffness more accurately than the conventional CFP.…”

Reduced Size of Telangiectatic Capillaries After Intravitreal Injection of Anti-Vascular Endothelial Growth Factor Agents in Diabetic Macular Edema

“…Accordingly, Bourhis et al reported that structural OCT is highly sensitive for the detection of TelCaps and superior to IA because of the visualization of the TelCap wall. 15 Therefore, multimodal imaging approaches other than OCTA, such as structural OCT, 35 multicolor scanning laser ophthalmoscopy, 36 and infrared reflectance imaging, 20 may have a better therapeutic effect on DME in a less time- and labor-consuming manner.…”