Abstract
Purpose :
Early detection of diabetic retinopathy may facilitate prompt diagnosis and treatment of diabetic retinopathy or macular edema. The goal of this retrospective case series was to evaluate and characterize changes present on optical coherence tomography angiography (OCT-A) in eyes with no clinical evidence of retinopathy on dilated funduscopic examination.
Methods :
Patients with history of type 1 or type 2 diabetes mellitus as noted by medical record review or primary care physician referral were included for analysis. Patients were examined at a single academic institution by a vitreoretinal practice comprised of six retinal surgeons. Eyes with no evidence of retinopathy on dilated funduscopic examination and who underwent OCT-A of the macula and optic nerve were included for analysis. Exclusion criteria included: prior history of retinopathy, macular edema, any macular diseases or presence of epiretinal membrane. Best-corrected visual acuity and baseline ocular vitals were noted. A single grader noted the presence and absence of the following parameters: number of microaneurysms; venous abnormalities such as dilation, beading or loops; intraretinal microvascular abnormalities; and presence of peripheral retinal ischemia.
Results :
80 eyes from 42 patients met all inclusion criteria, including 20 females and 22 males with mean age 54.55 years. Mean LogMAR visual acuity was 0.36 (Snellen acuity equivalent, 20/46). Twenty-five eyes were pseudophakic and 55 eyes were phakic. Microaneuryms were noted in 4/80 eyes (5.0%) and venous abnormalities in 1/80 (1.25%) eyes. No intraretinal microvascular abnormalities or peripheral retinal ischemia was noted on image review.
Conclusions :
OCT-A may allow for detection of background diabetic or hypertensive retinopathy not evident on clinical screening exams. Possible implementation as an adjunct tool to clinical examination may provide improved screening methods for early diabetic retinopathy and facilitate prompt diagnosis and clinical follow up.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.