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Qinqin Zhang, Cecilia S Lee, Yanping Huang, Kasra Attaran-Rezaei, Jennifer R Chao, Richard Munsen, James L Kinyoun, Ruikang K Wang; OCT-based microangiography of diabetic retinopathy. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):3336.
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© ARVO (1962-2015); The Authors (2016-present)
To perform a feasibility study using OCT-based microangiography (OMAG) to generate detailed retinal microvascular maps in human subjects with diabetic retinopathy (DR)
A 67 kHz Cirrus HD-OCT prototype system with motion tracking (Carl Zeiss Meditec, Dublin, CA) was used to generate retinal microvascular maps in 20 eyes of 10 subjects with DR by the use of OMAG algorithms. Phase compensation and cross-correlation methods were used to provide high quality capillary perfusion maps of the retina from the 3D dataset. We also used a segmentation algorithm to separate microvasculature within landmarked physiological depth layers of the retina as well as within the choroid. The layers include ganglion cell layer+ inner plexiform layer (Inner retinal layer), inner nuclear layer + outer plexiform layer (middle retinal layer) and outer nuclear layer (Outer retinal layer). For better visualization, color coding was used for different layers: red -- inner retinal layer; green -- middle retinal layer and blue -- outer retinal layer. Clinical fundus images and fluorescein angiograms (for most subjects) were acquired on the same day as the OCT scan and compared with resulting enface OMAG images
Retinal OMAG images generated from the Cirrus-5000 system showed clearer microvascular maps compared to fundus images and FA. In addition, OMAG provides depth-resolved information, allowing visualization of the three landmarked physiological layers. The microvascular features of typical DR observed include microaneurysms, capillary dropout, and dilated or tortuous vessels. The results also demonstrated the ability of OCT-angiography to distinguish different forms of microaneurysms, such as saccular, fusiform and focal bulges. Most of the microaneurysms (green dots) were observed in the deeper retinal capillary plexus, originating from locations between INL and OPL. Tortuous vessels were also observed in the temporal-superior region, which is a significant feature of DR. Fig.1 gives an example of an OMAG depiction of irregular enlargement of the foveal avascular zone, consistent with mild diabetic macular ischemia, compared with the corresponding fundus image
The OCT-angiography prototype system demonstrated the capability to generate detailed retinal OMAG microvascular maps that can be valuable in aiding the diagnosis and perhaps treatment of DR
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