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Christian Enders, Max Loidl, Alexandros Topalidis, Jens Ulrich Werner, Gerhard K Lang, Gabriele Elisabeth Lang; Evaluation of the retinal vasculature in patients with diabetic retinopathy using optical coherene tomography angiography. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1637.
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© ARVO (1962-2015); The Authors (2016-present)
Optical coherence tomography angiography (OCTA) is a novel, non-invasive imaging modality for retinal vascular diseases. This study evaluates the clincial use of OCTA in diabetic retinopathy (DR) by comparing OCTA images with fluorescein angiography (FA) findings, currently the gold-standard in the diagnosis of DR.
A total of 32 eyes of 16 patients were prospectively analyzed. 11/16 patients were male, 5/16 were female. 22/32 eyes showed non-proliferative DR (NPDR), 10/32 had proliferative DR (PDR). Each patient underwent a complete ohthalmological examination including FA, fundus fotography and OCTA (AngioPlex, Carl Zeiss Meditec, Inc.). In OCTA the vitreoretinal interface (VRI), the retinal capillary superficial (SCL) and the deep layer (DCL) were analyzed and compared with the findings in FA. Qualitative parameters were microaneurysms (MA), intraretinal microvascular abnormalities (IRMA), neovascularizations on the disc (NVD), neovascularizations elsewhere (NVE), areas of non-perfusion and vessel tortuosity.
The obtained images in OCTA showed good correlation with the images in FA. In 30/32 eyes OCTA visualized most but not all of the microaneurysms seen in FA. However, the DCL in OCTA showed additional microaneurysms not visible in FA in 24/32 eyes. IRMAs were equally detected in OCTA and FA. OCTA provided additional 3-dimensional information with regard to the exact localisation of the neovascularization in the vitreoretinal layers in all eyes with PDR. OCTA and FA showed areas of non-perfusion reliably with OCTA providing the exact localisation of non-perfusion in the retinal capillary layers and detecting areas of non-perfusion too small for detection in FA. Vessel tortuosity was visualized in OCTA and FA equally in all affected eyes.
The results of this study indicate that OCTA is a useful non-invasive tool in the examination of patients with DR. Advantages of OCTA are that it is non-invasive, can be segmented to specific vitreoretinal depths, can be obtained within seconds, provides accurate size and localization information and shows structural and blood flow information. Disadvantages of OCTA are its inability to view leakage, its potential for artefacts and its limited field of view. OCTA at present cannot replace FLA as a diagnostic procedure in patients with DR but provides relevant complementary information.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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