Optical Coherence Tomography Features Of Active And Inactive Retinal Neovascularization In Proliferative Diabetic Retinopathy

Abstract

In this exploratory study, the presence of vitreous hyperreflective dots, epiretinal membrane, inner retinal tissue contracture, vitreous invasion, and vitreous protrusion were identified as distinct signs of disease activity. Such parameters may be useful as a noninvasive imaging modality in eyes undergoing treatment for proliferative diabetic retinopathy.

Characteristics of Retinal Neovascularization in Proliferative Diabetic Retinopathy Imaged by Optical Coherence Tomography Angiography

“…However, in those three eyes, pruned new vessels on OCT angiograms were observed as whitish fibrovascular membranes with no obvious red blood columns on fundoscopy and were clinically diagnosed as inactive new vessels. 1,10 A third limitation was the classification of buds (sprouts) of new vessels that could sometimes be detected using FA and OCT angiography. The morphology of the vascular buds observed with OCT angiography did not resemble an exuberant form, but instead was shaped like a tuft or a small loop; thus, buds could potentially have been classified as small new vessels without EVP in this study.…”

“…5 Several groups have reported features of neovascularization at the disc (NVD) and neovascularization elsewhere (NVE), as well as the associated changes at the vitreoretinal interface, using cross-sectional OCT images. [6][7][8][9][10] However, B-scan OCT images cannot directly visualize newly formed vessels; thus, concise morphologic evaluation of NVD and NVE remains restricted.…”

<p>Optical Coherence Tomography Angiography Features of Neovascularization in Proliferative Diabetic Retinopathy</p>

“…OCT is used routinely in diabetic retinopathy to evaluate macular edema, [7][8][9][10][11] but can also be helpful in evaluating morphologic changes in PDR related to neovascularization. [12][13][14][15][16][17][18] With OCT, it is possible to evaluate neovascular complexes (NVCs) in their earliest stages and to identify associated vitreoretinal interface changes. 13,14,[16][17][18] Prior reports describe NVD as hyperreflective lesions over the optic disc with NVE appearing as flat vessels arising from the inner retina which then grow as hyperreflective loops.…”

“…[12][13][14][15][16][17][18] With OCT, it is possible to evaluate neovascular complexes (NVCs) in their earliest stages and to identify associated vitreoretinal interface changes. 13,14,[16][17][18] Prior reports describe NVD as hyperreflective lesions over the optic disc with NVE appearing as flat vessels arising from the inner retina which then grow as hyperreflective loops. 12,13,16,18 Also, NVCs can be differentiated from intraretinal microvascular abnormalities (IRMA) since the neovascularization breaches the internal limiting membrane (ILM) and grows into the posterior hyaloid.…”

“…13,14,[16][17][18] Prior reports describe NVD as hyperreflective lesions over the optic disc with NVE appearing as flat vessels arising from the inner retina which then grow as hyperreflective loops. 12,13,16,18 Also, NVCs can be differentiated from intraretinal microvascular abnormalities (IRMA) since the neovascularization breaches the internal limiting membrane (ILM) and grows into the posterior hyaloid. 15,17,18 One study described the use of spectral-domain OCT to distinguish quiescent from active NVCs, since active NVCs had a higher presence of vitreous hyperreflective dots whereas quiescent NVCs were associated with features more suggestive of fibrotic changes, including adjacent epiretinal membrane, inner retinal tissue contracture, protrusion towards the vitreous and frank vitreous invasion.…”