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Mary K Durbin, Scott Lee, Cecilia Lee, Qinqin Zhang, Patty Chung, Kasra Attaran Rezaei, Michal Laron, Lin An, Ruikang K Wang; Evaluation of Neovascularization Elsewhere using Optical Coherence Tomography based Microangiography. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):5963.
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OCT based microangiography (OMAG) is a non-invasive imaging technique that allows 3D images of dynamic blood perfusion within the retina. This study describes the OMAG imaging characteristics of neovascularization elsewhere (NVE) in cases of proliferative diabetic retinopathy (PDR).
Three patients with PDR, diagnosed by fundus examination and fluorescein angiography (FA), were imaged with OMAG, and depth encoded en face images were generated, including an en face image located just internal to the internal limiting membrane (ILM). Clinical characteristics and funduscopic findings of NVE were correlated to OMAG images.
Three cases were imaged, two with type 1 and one with type 2 diabetes. In one case, clinical exam revealed neovascularization elsewhere (NVE) in temporal macula of the left eye. OMAG of the left eye revealed multiple lesions that breached the ILM and blood flow was detected in all NVEs (Figure 1, left). In a second case, multiple NVEs appeared inactive on clinical exam, and OMAG revealed multiple NVEs without blood flow (Figure 1, right). In a third case, clinical exam showed new active neovascularization superotemporal and temporal to the macula. Late FA showed profuse leakage from both areas of NVE. OMAG confirmed the presence of a “bow-tie” shaped frond of neovascularization with active blood flow superotemporal to the macula and an irregular branching network also with active blood flow temporal to the macula.
This study highlights the OMAG characteristics of diabetic neovascularization elsewhere. With blood perfusion information, OMAG supports the clinical diagnosis of either active or inactive NVEs, suggesting that OMAG can provide information on PDR including the blood flow characteristics within the neovascular complex.
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