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Neesurg Sunil Mehta, Jorge Andrade, Davis B. Zhou, Maria V. Castanos, Lalita Gupta, Toco Yuen Ping Chui, Jessica Lee, Richard B Rosen; Correlation of OCT-Angiography Vessel Densities and the Early Treatment Diabetic Retinopathy Study Grading Scale. Invest. Ophthalmol. Vis. Sci. 2019;60(9):3031.
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© ARVO (1962-2015); The Authors (2016-present)
To understand how OCT-angiography (OCT-A) measured vessel density values correlate with the traditional clinical classification system of diabetic retinopathy using the Early Treatment Diabetic Retinopathy Study (ETDRS) grading scale.
A retrospective, cross sectional clinical study comparing OCT-A vessel density values to traditional ETDRS grading scale scores in patients with diabetic retinopathy was performed. Subjects with diabetic retinopathy were imaged with a spectral domain OCT system (Avanti RTVue-XR; Optovue, Fremont, CA) and Optos wide-field fundus photography. Vessel densities of the 3x3mm superficial and deep OCT-A layers were measured using the built-in system software (Angiovue Version 2018.0.0.18). Vessel densities were measured at two regions of interest for each OCT-A layer: 1) whole image and 2) foveal region of 1mm in diameter. A standardized version of the ETDRS diabetic grading scale, the Digital Algorithmic Diabetic Retinopathy Severity Scoring System, was used to grade the wide-field fundus photos. Pearson correlation testing was used to compare the vessel densities to the scores provided by the digital ETDRS grading scale.
Seventy-two eyes of 72 diabetic patients were identified from 2015 to 2018. Mean age was 56.5 years and 79% patients were males. 38% eyes had an ETDRS score of 60, or had extensive old pan-retinal photocoagulation, and 22% with a score >60, or with neovascularization. Pearson correlations between vessel density and the digital ETDRS grading scale were -0.408 (p-value=0.01) for the whole superficial OCT-A layer, -0.195 (p-value=0.100) for the foveal region superficial OCT-A layer, -0.386 (p-value=0.01) for the whole deep OCT-A layer, and -0.241 (p-value=0.05) for the foveal region deep layer.
Vessel densities of the whole superficial, whole deep and foveal region deep OCT-A layers had a significant inverse correlation with the scores provided by the digital algorithmic diabetic retinopathy severity scoring system. OCT-A may be used in the future to accurately stratify diabetic retinopathy and guide treatment.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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