Distinguishing Diabetic Macular Edema From Capillary Nonperfusion Using Optical Coherence Tomography Angiography

Carlo, Talisa E de; Chin, Adam T; Joseph, Tony; Baumal, Caroline R.; Witkin, André J.; Duker, Jay S.; Waheed, Nadia K.

doi:10.3928/23258160-20160126-02

Cited by 70 publications

(63 citation statements)

References 16 publications

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“…We speculate that this difference may be related to the presence of cystoid changes, which appear as areas of no-flow and are included in the nonperfusion computation. Such an effect has been demonstrated by de Carlo et al 28 However, if the vessels are simply displaced by the cysts and not actually lost, creating a thicker en face slab that includes the entire cyst and surrounding tissue may allow this question to be explored further.…”

Section: Discussionmentioning

confidence: 87%

Swept-Source OCT Angiography Imaging of the Foveal Avascular Zone and Macular Capillary Network Density in Diabetic Retinopathy

Al-Sheikh

Akıl

Pfau

et al. 2016

Invest. Ophthalmol. Vis. Sci.

198

157

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Section: Discussionmentioning

confidence: 87%

Swept-Source OCT Angiography Imaging of the Foveal Avascular Zone and Macular Capillary Network Density in Diabetic Retinopathy

Al-Sheikh

Akıl

Pfau

et al. 2016

Invest. Ophthalmol. Vis. Sci.

198

157

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“…Suzuki et al 28 have reported decreased nonperfusion after anti-VEGF therapy in patients with RVO. de Carlo et al 39 also have reported the reappearance of retinal microvasculature after anti-VEGF treatment in the areas previously shown to have flow voids due to intraretinal fluid in diabetic macular edema (DME). They speculated that either the vessels that were poorly perfused prior to treatment, were re-perfused after an anti-VEGF treatment or the retinal vessels displaced or masked by the cystoid spaces reappeared after fluid resolution.…”

Section: Discussionmentioning

confidence: 97%

Changes in Retinal Microvasculature and Visual Acuity After Antivascular Endothelial Growth Factor Therapy in Retinal Vein Occlusion

Winegarner

Wakabayashi

Fukushima

et al. 2018

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. To investigate the changes in the retinal microvasculature during the course of anti-VEGF therapy in eyes with macular edema due to retinal vein occlusion (RVO) and their association with visual outcomes.METHODS. The vessel density (VD) and foveal avascular zone (FAZ) area in the superficial capillary plexus (SCP) and deep capillary plexus (DCP) were quantitatively measured by optical coherence tomography angiography (OCTA) in 48 consecutive eyes with RVO before and 1, 3, 6, 9, and 12 months after anti-VEGF therapy. Anti-VEGF therapy was performed either with ranibizumab or aflibercept following a pro re nata (PRN) regimen. The correlation between post-treatment best-corrected visual acuity (BCVA) and changes in the retinal microvasculature evaluated by OCTA were assessed.RESULTS. The BCVA improved significantly at 12 months (P < 0.001). Better BCVA at 12 months was significantly associated with a better VD in the SCP and DCP both at baseline (R 2 ¼ 0.524, P < 0.001 and R 2 ¼ 0.457, P < 0.001, respectively) and at 12 months (R 2 ¼ 0.521, P < 0.001 and R 2 ¼ 0.662, P < 0.001, respectively). Overall, both VD and FAZ did not change significantly during the 12 months. However, the progression of nonperfusion was observed in the SCP in 6 (13%) eyes and in the DCP in 10 (21%) eyes. The number of macular edema recurrence was significantly associated with a decrease in the VD (P ¼ 0.006 [SCP] and P < 0.001 [DCP]) and less visual gain (P ¼ 0.02) after treatment.CONCLUSIONS. Anti-VEGF therapy maintains retinal perfusion in most patients with RVO. Preserving retinal perfusion is crucial for better visual outcomes.

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“…Diabetic macular edema (DME), the leading cause of vision loss in patients with DR, is visualized in en face OCTA as areas completely devoid of flow signal with smooth borders that do not follow the surrounding vessels (de Carlo, et al, 2016b, Matsunaga, et al, 2015). Eyes with DR and DME have increased FAZ and reduced vessel density in OCTA compared to those with DR without DME (Di et al, 2016, Kim et al, 2016).…”

Section: 6 Diabetic Macular Edema and Microaneurysmsmentioning

confidence: 99%

OCT angiography and visible-light OCT in diabetic retinopathy

et al. 2017

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In recent years, advances in optical coherence tomography (OCT) techniques have increased our understanding of diabetic retinopathy, an important microvascular complication of diabetes. OCT angiography is a non-invasive method that visualizes the retinal vasculature by detecting motion contrast from flowing blood. Visible-light OCT shows promise as a novel technique for quantifying retinal hypoxia by measuring the retinal oxygen delivery and metabolic rates. In this article, we discuss recent insights provided by these techniques into the vascular pathophysiology of diabetic retinopathy. The next milestones for these modalities are large multicenter studies to establish consensus on the most reliable and consistent outcome parameters to study diabetic retinopathy.

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Distinguishing Diabetic Macular Edema From Capillary Nonperfusion Using Optical Coherence Tomography Angiography

Abstract: The cystoid spaces in DME can be differentiated from capillary nonperfusion using OCTA. OCTA may help to guide treatment decisions in the future.

Cited by 70 publications

References 16 publications

Swept-Source OCT Angiography Imaging of the Foveal Avascular Zone and Macular Capillary Network Density in Diabetic Retinopathy

Swept-Source OCT Angiography Imaging of the Foveal Avascular Zone and Macular Capillary Network Density in Diabetic Retinopathy

Changes in Retinal Microvasculature and Visual Acuity After Antivascular Endothelial Growth Factor Therapy in Retinal Vein Occlusion

OCT angiography and visible-light OCT in diabetic retinopathy

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