Optical Coherence Tomography Angiography as a Diagnostic Tool for Diabetic Retinopathy

Wijesingha, Naomi; Tsai, Wei-Shan; Keskin, Ayse Merve; Holmes, Christopher; Kazantzis, Dimitrios; Chandak, Swati; Kubravi, Heena; Sivaprasad, Sobha

doi:10.3390/diagnostics14030326

Cited by 5 publications

(2 citation statements)

References 154 publications

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“…11 OCTA has demonstrated signi cant sensitivity and speci city for the early detection and characterization of CNV in numerous pathologies. 23,24 However, the common occurrence of atrophic and brotic changes associated with AS-CNV progression makes the early detection of recurrences especially challenging, even when OCTA imaging is available. 3,11 These changes could also be responsible for the apparent failure of anti-VEGF therapy in AS-CNV patients.…”

Section: Discussionmentioning

confidence: 99%

Qualitative analysis by OCTA in patients with choroidal neovascularization secondary to angioid streaks as predictors of disease recurrences over time

Velez-Montoya,

Osorio-Landa,

Franco-Ramirez

et al. 2024

Preprint

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Background: To report the risk of exudation recurrence and long-term outcomes in patients with choroidal neovascularization secondary to angioid streaks, according to its morphology and characteristics by optical coherence tomography angiography. Methods: Retrospective analysis of electronic medical records from three hospitals. We enrolled patients with a clinical diagnosis of angioid streaks choroidal neovascularization that had a minimum follow-up of 12 months. From each record, we extracted general demographic data, best corrected visual acuity (baseline, before and after each disease recurrence and last on file), type of treatment, time between last intravitreal injection and disease recurrence, and classification of the neovascular lesion morphology by optical coherence tomography, and optical coherence tomography angiography. Patients with myopic choroidal neovascularization were used as controls. Interobserver agreement was assessed with a Cohen-Kappa test. The Odds ratio was calculated with a chi2 test for significance. Visual acuity change through time was assessed with an ANOVA for repeated measurements with an alpha value of 0.05 for statistical significance. Results: We enrolled 30 patients in the study group and 14 in the control group. In the study group, the baseline and final BCVA was 0.861 ± 0.59 and 1.095 ± 0.61 logMAR (p=0.1). Control group: 1.045 ± 0.57 and 0.617 ± 0.53 logMAR (p<0.05). In the study group, the predominant CNV type by OCTA was mixed (37%), and interlacing (57%) in the control group. Mixed and cog-wheel patterns at baseline had increased Odds for recurrence in the study group (1.2 to 7.4) although it was not significant. Patients in the study group required fewer intravitreal injections on each recurrence episode to achieve disease control (3.5±1.5 vs.1.4±0.2, p<0.01). Conclusions: The benefits of anti-VEGF treatment are lost over time in patients with angioid streaks and CNV. Lesion characteristics by optical coherence tomography angiography could help physicians predict the risk of recurrence. Trial Registration:Retrospective registered, and IRB approved.

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Section: Discussionmentioning

confidence: 99%

Qualitative analysis by OCTA in patients with choroidal neovascularization secondary to angioid streaks as predictors of disease recurrences over time

Velez-Montoya,

Osorio-Landa,

Franco-Ramirez

et al. 2024

Preprint

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“…In contrast to fundus fluorescein angiography (FFA), which necessitates intravenous injection of a contrast agent, OCTA is a non-invasive, dye-free, three-dimensional imaging technique [72]. It not only allows visualization of capillaries across all retinal layers but also provides a broader perspective of the fundus, facilitating comprehensive examination and quantitative analysis [73].…”

Section: Vascular Changes In Early Drmentioning

confidence: 99%

Advances in Structural and Functional Retinal Imaging and Biomarkers for Early Detection of Diabetic Retinopathy

Zhang,

Deng,

Paulus

2024

Biomedicines

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Diabetic retinopathy (DR), a vision-threatening microvascular complication of diabetes mellitus (DM), is a leading cause of blindness worldwide that requires early detection and intervention. However, diagnosing DR early remains challenging due to the subtle nature of initial pathological changes. This review explores developments in multimodal imaging and functional tests for early DR detection. Where conventional color fundus photography is limited in the field of view and resolution, advanced quantitative analysis of retinal vessel traits such as retinal microvascular caliber, tortuosity, and fractal dimension (FD) can provide additional prognostic value. Optical coherence tomography (OCT) has also emerged as a reliable structural imaging tool for assessing retinal and choroidal neurodegenerative changes, which show potential as early DR biomarkers. Optical coherence tomography angiography (OCTA) enables the evaluation of vascular perfusion and the contours of the foveal avascular zone (FAZ), providing valuable insights into early retinal and choroidal vascular changes. Functional tests, including multifocal electroretinography (mfERG), visual evoked potential (VEP), multifocal pupillographic objective perimetry (mfPOP), microperimetry, and contrast sensitivity (CS), offer complementary data on early functional deficits in DR. More importantly, combining structural and functional imaging data may facilitate earlier detection of DR and targeted management strategies based on disease progression. Artificial intelligence (AI) techniques show promise for automated lesion detection, risk stratification, and biomarker discovery from various imaging data. Additionally, hematological parameters, such as neutrophil–lymphocyte ratio (NLR) and neutrophil extracellular traps (NETs), may be useful in predicting DR risk and progression. Although current methods can detect early DR, there is still a need for further research and development of reliable, cost-effective methods for large-scale screening and monitoring of individuals with DM.

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A Comparison of Optical Coherence Tomography Angiography Metrics and Artifacts on Scans of Different Sizes in Diabetic Macular Ischemia

Tsai,

Thottarath,

Gurudas

et al. 2024

American Journal of Ophthalmology

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Optical Coherence Tomography Angiography as a Diagnostic Tool for Diabetic Retinopathy

Cited by 5 publications

References 154 publications

Qualitative analysis by OCTA in patients with choroidal neovascularization secondary to angioid streaks as predictors of disease recurrences over time

Qualitative analysis by OCTA in patients with choroidal neovascularization secondary to angioid streaks as predictors of disease recurrences over time

Advances in Structural and Functional Retinal Imaging and Biomarkers for Early Detection of Diabetic Retinopathy

A Comparison of Optical Coherence Tomography Angiography Metrics and Artifacts on Scans of Different Sizes in Diabetic Macular Ischemia

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