ULTRA-WIDE FIELD SWEPT-SOURCE OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY (UWF SS OCT-A) IN DIABETIC RETINOPATHY

Abstract

Purpose : To describe the Ultra Wide-field Swept-Source Optical Coherence Tomography Angiography (SS OCT-A) (UWF SS OCT-A) features of Diabetic Retinopathy (DR).

Methods : We describe features of DR in patients undergoing routine examination in a serial case report. Eighty six eyes (43 consecutive patients) underwent full ophthalmological evaluation, 45° Colour Fundus Photography (CFPh), Optos California® Ultra Wide-field Colour Fundus Photography (UWF CFPh) and SS OCT-A with both Topcon DRI OCT-1 Atlantis® and Topcon DRI OCT Triton® of the posterior pole and the mid peripheral retina. Where clinically necessary, Ultra Wide field Optos California® Fluorescein Fundus Angiography (UWF FFA) was performed (Figure a). Individual SS OCT-A images were montaged to create an UWF SS OCT-A image (Figure b). Two independent reviewers compared images as follows: CFPh vs UWF SS OCT-A, UWF CFPh vs UWF SS OCT-A, and UWF FFA vs UWF SS OCT-A.

Results : Diabetic Macula Oedema (DMO), posterior pole and mid-peripheral retinal non-perfusion and Neovascularization of the Disc (NVD) and elsewhere (NVE) were identified on UWF SS OCT-A with 100% inter-reviewer agreement. Microvascular lesions observed on CFPh and UWF CFPh were also observed on UWF SS OCT-A in 86/86 eyes. An enlarged Foveal Avascular Zone (eFAZ) was observed on both UWF FFA and UWF SS OCT-A in 36/36 eyes. Microvascular lesions, DMO, NVD and NVE were observed on UWF FFA and UWF SS OCT-A in 28/28 eyes. Within the central 100°, there was good correlation between sensitivity of both UWF FFA and UWF SS OCT-A in detecting NVE in 9/10 eyes.

Conclusions : UWF SS OCT-A is a sensitive and non-invasive imaging technique that can offer additional topographic information regarding the localization and the morphology of the vascular lesions in DR, not only within the posterior pole but also up to the mid-periphery.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

 

Figure a. OPTOS California® ultra wide-field FFA imaging. Red arrows indicate neovascularization elsewhere (NVE).
Figure b. UWF SS OCT-A composite image of the posterior pole and mid periphery. Red arrows indicate neovascularization elsewhere (NVE).