Optical coherence tomography angiography in diabetic retinopathy

Waheed, Nadia K.; Rosen, Richard B.; Jia, Yali; Munk, Marion R.; Huang, David; Fawzi, Amani A.; Chong, Victor; Nguyen, Quan Dong; Sepah, Yasir J.; Pearce, Elizabeth

doi:10.1016/j.preteyeres.2023.101206

Cited by 9 publications

(5 citation statements)

References 167 publications

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“…To address this challenge, researchers need to establish correlations between various OCTA metrics, such as FAZ area and VD, and functional measures of visual function, such as visual acuity. Creating a formula to convert different metrics from various OCTA machines will enable better use of OCTA in a clinical setting and facilitate greater interchangeability between various OCTA devices [142]. Factors such as age [143,144], sex [145,146],…”

Section: Recommended Future Research Directionsmentioning

confidence: 99%

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Optical Coherence Tomography Angiography as a Diagnostic Tool for Diabetic Retinopathy

Wijesingha,

Tsai,

Keskin

et al. 2024

Diagnostics

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Diabetic retinopathy (DR) is the most common microvascular complication of diabetes mellitus, leading to visual impairment if left untreated. This review discusses the use of optical coherence tomography angiography (OCTA) as a diagnostic tool for the early detection and management of DR. OCTA is a fast, non-invasive, non-contact test that enables the detailed visualisation of the macular microvasculature in different plexuses. OCTA offers several advantages over fundus fluorescein angiography (FFA), notably offering quantitative data. OCTA is not without limitations, including the requirement for careful interpretation of artefacts and the limited region of interest that can be captured currently. We explore how OCTA has been instrumental in detecting early microvascular changes that precede clinical signs of DR. We also discuss the application of OCTA in the diagnosis and management of various stages of DR, including non-proliferative diabetic retinopathy (NPDR), proliferative diabetic retinopathy (PDR), diabetic macular oedema (DMO), diabetic macular ischaemia (DMI), and pre-diabetes. Finally, we discuss the future role of OCTA and how it may be used to enhance the clinical outcomes of DR.

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Section: Recommended Future Research Directionsmentioning

confidence: 99%

“…Such AI-based systems can be used as a more affordable evaluation tool for disease screening, especially in rural settings that may lack expert eye care providers. Larger population trials are essential to evaluate the potential of AI fully [142].…”

Section: Recommended Future Research Directionsmentioning

confidence: 99%

Optical Coherence Tomography Angiography as a Diagnostic Tool for Diabetic Retinopathy

Wijesingha,

Tsai,

Keskin

et al. 2024

Diagnostics

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“…Optical coherence tomography angiography is a new form of retinal imaging that promises to revolutionize the medical management of diabetic retinopathy in the coming years [ 71 , 72 ]. In generating three-dimensional graphics that show the retinal vascular pathology in considerable detail including before it is clinically apparent, the technology provides the opportunity for tailored early intervention.…”

Section: Diabetic Retinopathymentioning

confidence: 99%

Oxidative Stress and Its Regulation in Diabetic Retinopathy

Haydinger,

Oliver,

Ashander

et al. 2023

Antioxidants

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Diabetic retinopathy is the retinal disease associated with hyperglycemia in patients who suffer from type 1 or type 2 diabetes. It includes maculopathy, involving the central retina and characterized by ischemia and/or edema, and peripheral retinopathy that progresses to a proliferative stage with neovascularization. Approximately 10% of the global population is estimated to suffer from diabetes, and around one in 5 of these individuals have diabetic retinopathy. One of the major effects of hyperglycemia is oxidative stress, the pathological state in which elevated production of reactive oxygen species damages tissues, cells, and macromolecules. The retina is relatively prone to oxidative stress due to its high metabolic activity. This review provides a summary of the role of oxidative stress in diabetic retinopathy, including a description of the retinal cell players and the molecular mechanisms. It discusses pathological processes, including the formation and effects of advanced glycation end-products, the impact of metabolic memory, and involvements of non-coding RNA. The opportunities for the therapeutic blockade of oxidative stress in diabetic retinopathy are also considered.

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“…The reliable images make it competent to accurately evaluate all vascular layers of the retina through quantitative parameters such as the foveal avascular zone (FAZ) and the vessel density (VD). 14,15 In recent years, a growing body of evidence has shown that early vascular changes could be observed in patients with non-diabetic retinopathy (NDR) by OCTA. [16][17][18][19][20] However, the sensitivity of the application of OCTA for early detection is still controversial considering the diversity among different OCTA devices.…”

Section: Introductionmentioning

confidence: 99%

“…As a non‐invasive technology, optical coherence tomography angiography (OCTA) is easy to operate. The reliable images make it competent to accurately evaluate all vascular layers of the retina through quantitative parameters such as the foveal avascular zone (FAZ) and the vessel density (VD) 14,15 . In recent years, a growing body of evidence has shown that early vascular changes could be observed in patients with non‐diabetic retinopathy (NDR) by OCTA 16–20 .…”

Section: Introductionmentioning

confidence: 99%

Optical coherence tomography angiography for detection of microvascular changes in early diabetes: A systematic review and meta‐analysis

Yang,

Zou,

et al. 2024

Diabetes Metabolism Res

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AimsTo evaluate the effectiveness of optical coherence tomography angiography (OCTA) in detecting early intraocular microvascular changes in diabetic patients.Materials and MethodsA systematic study search was performed on PubMed, Medline, Embase, and the Cochrane Library, ranging from January 2012 to March 2023. Controlled studies compared diabetes mellitus (DM) patients with non‐diabetic retinopathy (NDR) or patients with mild non‐proliferative diabetic retinopathy (mild NPDR) to healthy people. These studies included parameters of OCTA such as foveal avascular zone (FAZ), vessel density of superficial capillary plexus (VDscp), vessel density of deep capillary plexus (VDdcp), and peripapillary VD. The relevant effect model was used according to the heterogeneity, and the mean difference and 95% confidence intervals were calculated.ResultsA total of 18 studies with 2101 eyes were eventually included in this meta‐analysis. Our results demonstrated that early alterations of VDscp, VDdcp, and peripapillary VD in NDR patients had a significant difference compared with healthy people by OCTA (VDscp: WMD = −1.34, 95% CI: −1.99 to −0.68, P < 0.0001. VDdcp: WMD = −2.00, 95% CI: −2.95 to −1.04, P < 0.0001. Peripapillary VD: WMD = −1.07, 95% CI: −1.70 to −0.43, P = 0.0010). However, there was no statistically significant difference in total FAZ between them (WMD = −0.00, 95% CI: −0.02–0.01, P = 0.84). In addition, for patients with mild NPDR, OCTA could illustrate prominent changes in VDscp, VDdcp, and total FAZ compared with healthy people (VDscp: WMD = −6.11, 95% CI: −9.90 to −2.32, P = 0.002. VDdcp: WMD = −4.26, 95% CI: −5.95 to −2.57, P < 0.00001. FAZ: WMD = 0.06, 95% CI: 0.01–0.11, P = 0.03).ConclusionsIn diabetic patients with or without retinopathy, the parameters of OCTA such as VDscp, VDdcp, and peripapillary vessel density were demonstrated as potential biomarkers in monitoring the early alterations of retinal microangiopathy, while total FAZ may have no significant changes in diabetic patients without retinopathy.

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Optical coherence tomography angiography in diabetic retinopathy

Cited by 9 publications

References 167 publications

Optical Coherence Tomography Angiography as a Diagnostic Tool for Diabetic Retinopathy

Optical Coherence Tomography Angiography as a Diagnostic Tool for Diabetic Retinopathy

Oxidative Stress and Its Regulation in Diabetic Retinopathy

Optical coherence tomography angiography for detection of microvascular changes in early diabetes: A systematic review and meta‐analysis

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