Differentiating features of OCT angiography in diabetic macular edema

Mirshahi, Reza; Riazi-Esfahani, Hamid; Pour, Elias Khalili; Fadakar, Kaveh; Yarmohamadi, Parsa; Alemzadeh, Sayyed Amirpooya; Chaibakhsh, Samira; Falavarjani, Khalil Ghasemi

doi:10.1038/s41598-021-02859-y

Cited by 12 publications

(6 citation statements)

References 34 publications

(42 reference statements)

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“…1A,B). Manual segmentation error correction was also implemented for various retinal layers, as described elsewhere, 34 to enhance the accuracy of the measurements further. This advanced imaging approach allows for non‐invasive visualization and quantification of the retinal vasculature, enabling a comprehensive assessment of vascular characteristics and their variations across different retinal regions.…”

Section: Methodsmentioning

confidence: 99%

Neurodegeneration with Brain Iron Accumulation Disorders and Retinal Neurovascular Structure

Amini,

Rohani,

Fasano

et al. 2023

Movement Disorders

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BackgroundThe unique neurovascular structure of the retina has provided an opportunity to observe brain pathology in many neurological disorders. However, such studies on neurodegeneration with brain iron accumulation (NBIA) disorders are lacking.ObjectivesTo investigate NBIA's neurological and ophthalmological manifestations.MethodsThis cross‐sectional study was conducted on genetically confirmed NBIA patients and an age‐gender‐matched control group. The thickness of retinal layers, central choroidal thickness (CCT), and capillary plexus densities were measured by spectral domain‐optical coherence tomography (SD‐OCT) and OCT angiography, respectively. The patients also underwent funduscopy, electroretinography (ERG), visual evoked potential (VEP), and neurological examination (Pantothenate‐Kinase Associated Neurodegeneration‐Disease Rating Scale [PKAN‐DRS]). The generalized estimating equation model was used to consider inter‐eye correlations.ResultsSeventy‐four patients' and 80 controls' eyes were analyzed. Patients had significantly decreased visual acuity, reduced inner or outer sectors of almost all evaluated layers, increased CCT, and decreased vessel densities, with abnormal VEP and ERG in 32.4% and 45.9%, respectively. There were correlations between visual acuity and temporal peripapillary nerve fiber layer (positive) and between PKAN‐DRS score and disease duration (negative), and scotopic b‐wave amplitudes (positive). When considering only the PKAN eyes, ONL was among the significantly decreased retinal layers, with no differences in retinal vessel densities. Evidence of pachychoroid was only seen in patients with Kufor Rakeb syndrome.ConclusionObserving pathologic structural and functional neurovascular changes in NBIA patients may provide an opportunity to elucidate the underlying mechanisms and differential retinal biomarkers in NBIA subtypes in further investigations. © 2023 International Parkinson and Movement Disorder Society.

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Section: Methodsmentioning

confidence: 99%

Neurodegeneration with Brain Iron Accumulation Disorders and Retinal Neurovascular Structure

Amini,

Rohani,

Fasano

et al. 2023

Movement Disorders

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“…In fact, the perfusion state of macular vessels might not be changed. Mirshahi et al [19] found that macular edema was associated with more non-perfusion in OCTA compared to dry macula. Therefore, the inability of anti-VEGF treatments to improve capillary non-perfusion could be a reason for recurrent DME following intravitreal injection of aflibercept.…”

Section: Correlation Analysis Of Factorsmentioning

confidence: 99%

Morphological and functional changes in the macular area in diabetic macular edema after a single intravitreal injection of aflibercept

Zhang¹,

Huang²,

Shu³

et al. 2023

Int J Ophthalmol

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AIM: To evaluate the changes in macular morphology and function after a single intravitreal injection of aflibercept in diabetic macular edema (DME) using optical coherence tomography angiography (OCTA) and MP-3 microperimetry. METHODS: Twenty-eight patients (42 eyes) diagnosed with DME were treated with intravitreal injection of aflibercept. The changes in best corrected visual acuity (BCVA), central retinal thickness (CRT), foveal avascular zone (FAZ) area, vessel density of superficial retinal capillary plexus (SVD), vessel density of deep retinal capillary plexus (DVD), mean light sensitivity (MLS), 2° fixation rate (P1), 4° fixation rate (P2), and other indicators 1mo after treatment were compared; of these, BCVA was converted into logarithm of the minimum angle of resolution (logMAR), and the correlation among the factors was analyzed. RESULTS: After treatment, logMAR BCVA was 0.47±0.24, which was significantly better than that before treatment (0.63±0.28, P<0.001). The CRT was 359.21±107.87 μm after treatment, which was significantly lower than before treatment (474.10±138.20 μm, P<0.001). The FAZ area, SVD, and DVD were not significantly changed after treatment compared with the baseline. MLS was 22.16±4.20 dB after treatment, which was significantly higher than before treatment (19.63±4.23 dB, P<0.001). P2 significantly increased after treatment than before treatment (P=0.007). P1 had no significant change after treatment than before treatment (P=0.086). CONCLUSION: A single intravitreal injection of aflibercept effectively reduces macular edema and improves retinal sensitivity, fixation stability, and visual acuity, possibly without causing significant changes in the retinal vascular condition in a short time.

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“…Yalçın and Özdek ( 59 ) found that patients with more severe DME had a 1.04-fold greater chance of having macular ischemia on FA, and postulated that macular ischemia would become more likely as the cyst’s diameter grows. Furthermore, Mirshahi et al ( 60 ) found that the presence of DME was associated with more extensive CNP when compared to DR eyes with no macular edema.…”

Section: The Role Of Capillary Non-perfusionmentioning

confidence: 99%

Peripheral and central capillary non-perfusion in diabetic retinopathy: An updated overview

et al. 2023

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Capillary non-perfusion (CNP) is one of the key hallmarks of diabetic retinopathy (DR), which may develop both in the periphery and at the posterior pole. Our perspectives on CNP have extended with the introduction of optical coherence tomography angiography (OCTA) and ultra-widefield imaging, and the clinical consequences of peripheral and macular CNP have been well characterized. Fluorescein angiography (FA) continues to be the gold standard for detecting and measuring CNP, particularly when ultra-widefield imaging is available. OCTA, on the other hand, is a quicker, non-invasive approach that allows for a three-dimensional examination of CNP and may soon be regarded as an useful alternative to FA. In this review, we provide an updated scenario regarding the characteristics, clinical impact, and management of central and peripheral CNP in DR.

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Differentiating features of OCT angiography in diabetic macular edema

Cited by 12 publications

References 34 publications

Neurodegeneration with Brain Iron Accumulation Disorders and Retinal Neurovascular Structure

Neurodegeneration with Brain Iron Accumulation Disorders and Retinal Neurovascular Structure

Morphological and functional changes in the macular area in diabetic macular edema after a single intravitreal injection of aflibercept

Peripheral and central capillary non-perfusion in diabetic retinopathy: An updated overview

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