Optical coherence tomography angiography versus fluorescein angiography in the diagnosis of ischaemic diabetic maculopathy

Abstract

ABSTRACT.Purpose: To evaluate the efficacy of optical coherence tomography (OCT) angiography versus fluorescein angiography (FA) in terms of retinal vessel imaging in ischaemic diabetic maculopathy defined according to the Early Treatment Diabetic Retinopathy Study (ETDRS) classification. Methods: Twenty patients (31 eyes) with ischaemic diabetic maculopathy and 17 control subjects (27 eyes) were enrolled in this prospective study. Patients and control subjects underwent complete ophthalmic examination, including bestcorrected visual acuity (BCVA), intraocular pressure, FA, Fourier domain optical coherence tomography (FD-OCT) and OCT angiography. Fluorescein angiograms and OCT angiography images were graded according to the foveal avascular zone (FAZ) of the ETDRS group. Ganglion cell complex (GCC) thickness was evaluated with FD-OCT. Results: Optical coherence tomography (OCT) angiography images closely correlated with FA in terms of FAZ parameters. The correlation was strongest with OCT angiography deep imaging. The average GCC thickness was smaller in patients than in controls. Neither GCC parameters nor FAZ was correlated to BCVA. Conclusions: Given the correlation between FA and OCT angiography in terms of FAZ parameters, the newer method can be considered a valid, reliable and easy-to-perform method with which to evaluate ischaemic diabetic maculopathy without contrast injection, and thus to visualize and quantify non-perfusion areas without risks of anaphylactic reactions.

OCT angiography and visible-light OCT in diabetic retinopathy

“…While there is a significant correlation between FAZ size on OCTA versus FA (Cennamo, et al, 2016), OCTA may be a more suitable technique than conventional FA for evaluating the FAZ because 1) OCTA images are not occluded by dye leakage, and 2) the non-invasive nature of OCTA allows earlier and more frequent imaging for following disease progression. Numerous OCTA studies show that patients with diabetes without clinical DR have a significantly enlarged FAZ compared to healthy controls (de Carlo et al, 2015, Di et al, 2016, Takase et al, 2015).…”

The diagnostic value of optical coherence tomography angiography in diabetic retinopathy: a systematic review

“…A number of studies have investigated the ability of OCTA to grade DMI [45][46][47][48]. Currently, DMI is graded with FA images using the ETDRS protocols as; absent (no FAZ disruption), questionable (FAZ not smooth/oval, but no clear pathology), mild (\ half FAZ circumference destroyed), moderate ([ half FAZ circumference destroyed), severe (FAZ outline completely destroyed), or ungradable [49].…”

Can Foveal Avascular Zone (FAZ) Assessment By OCT Angiography, Used For Grading Of Diabetic Retinopathy?

“…Our center reviewed literature regarding the OCTA applications in diabetics which is going to be published soon. Available reports are few, but interesting facts regarding the FAZ is published [7][8][9][10][11][12][13][14][15][16][17][18]. The FAZ in normal individual was described in the OCTA as an intact well-demarcated round or oval area of reduced capillary density with a border without gaps, holes or interruption of the capillary network in both superficial and deep plexuses.…”

“…This finding may also add to our knowledge regarding pathophysiology behind the ischemic changes in DR. The OCTA has increased feasibility of qualitative FAZ assessment; but the most impressing are regarding the quantitative FAZ assessments the FAZ size increased significantly by progression of retinopathy grade in almost all reports [9][10][11][12][13][14][15][16][17]. (Table 1) has summarized current available range of the mean FAZ size values in different grades of disease.…”