Widefield optical coherence tomography angiography in diabetic retinopathy

Mastropasqua, Rodolfo; D’Aloisio, Rossella; Antonio, Luca Di; Erroi, Emanuele; Borrelli, Enrico; Evangelista, Federica; D’Onofrio, Giada; Nicola, Marta Di; G, Di Martino; Toto, Lisa

doi:10.1007/s00592-019-01410-w

Cited by 35 publications

(35 citation statements)

References 30 publications

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“…However, the vast majority of studies have been performed in patients with type 2 DM, [7][8][9][10][11][12][13][14][15] and many of them do not distinguish between patients with type 1 DM and patients with type 2 DM. [16][17][18][19][20] The pathophysiology of both DM types is considerably different, and patients present well-differentiated clinical characteristics. Whereas type 1 DM is less frequent, commonly affects younger patients, and it is a lifelong standing disease, patients with type 2 DM are more prevalent, they tend to be older, and frequently present concomitant cardiovascular pathologies, such as blood hypertension, metabolic syndrome, or dyslipidemia.…”

Section: Discussionmentioning

confidence: 99%

Optical Coherence Tomography Angiography in Type 1 Diabetes Mellitus. Report 1: Diabetic Retinopathy

Barraso

Alé-Chilet

Hernandez

et al. 2020

Trans. Vis. Sci. Tech.

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The purpose of this study was to evaluate specifically in type 1 diabetes mellitus (DM) individuals the relationship between perifoveal superficial capillary plexus (SCP) parameters assessed by optical coherence tomography angiography (OCTA) and diabetic retinopathy (DR) grade. Methods: Cross-sectional analysis of a large scale prospective OCTA trial cohort (Clini-calTrials.gov NCT03422965). A total of 1186 eyes (593 individuals), 956 type 1 DM eyes (478 patients), and 230 control eyes (115 healthy volunteers) were included in this study. DR stage was graded according to the International Classification. OCTA imaging was performed with a commercially available device (Cirrus HD-OCT). Vessel density (VD), perfusion density (PD), and foveal avascular zone (FAZ) area, perimeter and circularity measurements were quantified in the SCP and receiver operating characteristic (ROC) curves were constructed for each OCTA parameter. Results: VD and PD (in both 3 × 3 and 6 × 6 mm captures) were inversely associated with DR stage (P < 0.001 in all cases) in a multiple regression analysis after controlling by age, gender, signal strength index, axial length, and DM duration. Greater FAZ area and perimeter and conversely lower circularity measurements were observed as DR severity increased in both scanning protocols (P < 0.05 in all cases). Conclusions: In type 1 DM individuals, OCTA provides an objective, continuous, and reliable method for accurate quantification of VD, PD, and FAZ parameters in the SCP, which ultimately correlate with DR stages. Translational Relevance: Objective OCTA measurements of the retinal microvasculature could substitute the clinical DR classification in patients with type 1 DM, identify patients at risk of DR progression, and inform treatment decisions to modify the evolution of the disease.

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Section: Discussionmentioning

confidence: 99%

Optical Coherence Tomography Angiography in Type 1 Diabetes Mellitus. Report 1: Diabetic Retinopathy

Barraso

Alé-Chilet

Hernandez

et al. 2020

Trans. Vis. Sci. Tech.

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“…Early stages of DR may be detected by abnormalities in retinal blood flow, changes in retinal vessel caliber, and changes in electroretinography [51,52]. However, clinical diagnosis is based mainly on the presence of fundus features detected by ophthalmoscopic examination.…”

Section: Diet-induced Models Of Diabetic Retinopathymentioning

confidence: 99%

Diet-Induced Rodent Models of Diabetic Peripheral Neuropathy, Retinopathy and Nephropathy

et al. 2020

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Unhealthy dietary habits are major modifiable risk factors for the development of type 2 diabetes mellitus, a metabolic disease with increasing prevalence and serious consequences. Microvascular complications of diabetes, namely diabetic peripheral neuropathy (DPN), retinopathy (DR), and nephropathy (DN), are associated with high morbidity rates and a heavy social and economic burden. Currently, available therapeutic options to counter the evolution of diabetic microvascular complications are clearly insufficient, which strongly recommends further research. Animal models are essential tools to dissect the molecular mechanisms underlying disease progression, to unravel new therapeutic targets, as well as to evaluate the efficacy of new drugs and/or novel therapeutic approaches. However, choosing the best animal model is challenging due to the large number of factors that need to be considered. This is particularly relevant for models induced by dietary modifications, which vary markedly in terms of macronutrient composition. In this article, we revisit the rodent models of diet-induced DPN, DR, and DN, critically comparing the main features of these microvascular complications in humans and the criteria for their diagnosis with the parameters that have been used in preclinical research using rodent models, considering the possible need for factors which can accelerate or aggravate these conditions.

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“…All selected images were carefully analyzed by the two retinal specialist independently to verify the correctness of segmentation as previously described. 18 If segmentation errors were detected, the two trained observers performed a manual correction using segmentation and propagation editing tools of the device.…”

Section: Workflow Protocol Imaging Protocol: Graders Review Quality mentioning

confidence: 99%

“…Some studies have investigated peripheral retina in diabetic eyes to asses retinal capillary nonperfusion and perfusion density using WFOCTA. [17][18][19][20] In addition, reversal of peripheral ischemia after intravitreal anti-VEGF treatment was investigated in DR using WFOCTA. 21 The aim of this study is to investigate the changes of retinal capillary nonperfusion areas and whole retinal vessel density of superficial capillary plexus (SCP) and deep capillary plexus (DCP) in patients with DR complicated by DME after intravitreal dexamethasone implant (IDI) using WFOCTA.…”

Section: Introductionmentioning

confidence: 99%

A Custom-Made Semiautomatic Analysis of Retinal Nonperfusion Areas After Dexamethasone for Diabetic Macular Edema

Toto

D’Aloisio

Chiarelli

et al. 2020

Trans. Vis. Sci. Tech.

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To evaluate the changes of retinal capillary nonperfusion areas and retinal capillary vessel density of the superficial capillary plexus (SCP) and deep capillary plexus in patients with diabetes with diabetic macular edema treated with an intravitreal dexamethasone implant (IDI). Methods: We enrolled 28 patients with diabetic retinopathy and diabetic macular edema candidates to IDI. All patients underwent widefield optical coherence tomography angiography with PLEX Elite 9000 device with 15 × 9 mm scans centered on the foveal center at baseline, 1 month, 2 months, and 4 months after IDI. In all the patients, the variation of the retinal capillary nonperfusion areas and of the retinal vessel density of the SCP and deep capillary plexus were calculated using an automatic software written in Matlab (MathWorks, Natick, MA). Results: During follow-up, SCP showed a statistically significant reduction of ischemic areas at 1 month after IDI (P = 0.04) and slightly increased not significantly thereafter (P = 0.15). The percentage of nonperfusion areas changed from 11.4% at baseline, to 6.3% at 1 month, 8.1%, at 2 months, and 10.2% at 4 months. The whole vessel density of SCP slightly increased (not significantly) from 35.30% at baseline to 38.00% at 1 month, and then decreased to 37.85% at 2 months and 36.04% at 4 months (P = 0.29). Retinal capillary nonperfusion areas and retinal vessel density at the deep capillary plexus did not change significantly (P = 0.31 and P = 0.73, respectively). Conclusions: Widefield optical coherence tomography angiography showed a decrease in retinal capillary nonperfusion areas after dexamethasone implant suggesting a possible drug-related reperfusion of retinal capillaries particularly evident in the early period. Translational Relevance: A custom-made automatic analysis of retinal nonperfusion areas may allow a better and precise evaluation of ischemic changes after intravitreal therapy.

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Widefield optical coherence tomography angiography in diabetic retinopathy

Cited by 35 publications

References 30 publications

Optical Coherence Tomography Angiography in Type 1 Diabetes Mellitus. Report 1: Diabetic Retinopathy

Optical Coherence Tomography Angiography in Type 1 Diabetes Mellitus. Report 1: Diabetic Retinopathy

Diet-Induced Rodent Models of Diabetic Peripheral Neuropathy, Retinopathy and Nephropathy

A Custom-Made Semiautomatic Analysis of Retinal Nonperfusion Areas After Dexamethasone for Diabetic Macular Edema

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