June 2020
Volume 61, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2020
Diagnostic Accuracy of Avascular Areas in 6x6-mm versus in 3x3-mm Field of View OCT Angiography for Diabetic Retinopathy
Author Affiliations & Notes
  • Thomas S Hwang
    Ophthalmology, Casey Eye Institute, Portland, Oregon, United States
  • Qisheng You
    Ophthalmology, Casey Eye Institute, Portland, Oregon, United States
  • Yukun Guo
    Ophthalmology, Casey Eye Institute, Portland, Oregon, United States
  • JIE WANG
    Ophthalmology, Casey Eye Institute, Portland, Oregon, United States
  • Christina J Flaxel
    Ophthalmology, Casey Eye Institute, Portland, Oregon, United States
  • David Huang
    Ophthalmology, Casey Eye Institute, Portland, Oregon, United States
  • Yali Jia
    Ophthalmology, Casey Eye Institute, Portland, Oregon, United States
  • Footnotes
    Commercial Relationships   Thomas Hwang, None; Qisheng You, None; Yukun Guo, None; JIE WANG, None; Christina Flaxel, None; David Huang, Optovue, Inc (F), Optovue, Inc. (I), Optovue, Inc. (P), Optovue, Inc. (R); Yali Jia, Optovue, Inc (F), Optovue, Inc. (P)
  • Footnotes
    Support  This work was supported by grant National Institutes of Health (R01 EY027833, R01 EY024544, P30 EY010572); Unrestricted Departmental Funding Grant and William & Mary Greve Special Scholar Award from Research to Prevent Blindness (New York, NY).
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 4843. doi:
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    • Get Citation

      Thomas S Hwang, Qisheng You, Yukun Guo, JIE WANG, Christina J Flaxel, David Huang, Yali Jia; Diagnostic Accuracy of Avascular Areas in 6x6-mm versus in 3x3-mm Field of View OCT Angiography for Diabetic Retinopathy. Invest. Ophthalmol. Vis. Sci. 2020;61(7):4843.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To compare the diagnostic accuracy of avascular areas in 6x6-mm versus 3x3-mm optical coherence tomography angiography (OCTA) for diabetic retinopathy (DR).

Methods : A masked grader graded 7-field color fundus photographs using the Early Treatment Diabetic Retinopathy Study scale. The 6x6-mm high-definition (400x400) and 3x3-mm (304x304) OCTA scans were acquired with a commercial system (RTVue XR Avanti, Optovue). Avascular areas (AA) in the superficial vascular complex (SVC) of 6x6-mm scans and SVC, intermediate capillary plexus (ICP), deep capillary plexus (DCP) of 3x3-mm scans were quantified using a deep-learning algorithm. After excluding the central 1-mm circle, extrafoveal avascular area (EAA) was computed (Figure 1). A deep-learning algorithm identified and excluded low-signal areas due to vitreous opacity or vignetting.

Results : We enrolled 139 diabetic patients (64 men), with a mean age of 55±15 years, including 25 healthy controls, 21 without DR, 28 mild non-proliferative DR (NPDR), 12 moderate NPDR, 17 severe NPDR, and 36 proliferative DR. The mean EAAs significantly increased with DR severity (Table 1). In 3x3-mm macular scans, the SVC EAA showed the highest diagnostic accuracy among the three plexuses. The areas under the receiver operating characteristic curve (AROC) of the SVC EAA for discriminating diabetes without DR, mild NPDR, moderate NPDR, severe NPDR and PDR from healthy control were 0.704, 0.929, 0.987, 0.998, and 0.996 for 3x3mm and 0.706, 0.946, 0.957, 1.000 and 1.000 for 6x6mm respectively. The differences between 3x3 and 6x6 were not significant (DeLong method. All P>0.05).

Conclusions : The diagnostic accuracy of SVC EAA in diabetic retinopathy were similar between 3x3 and 6x6 mm scans. The information acquired from wider OCTA scans may not improve the diagnostic power of avascular areas in diabetic retinopathy.

This is a 2020 ARVO Annual Meeting abstract.

 

Figure 1. A. 6x6-mm superficial vascular complex (SVC) scan of a proliferative diabetic retinopathy eye. B. Blue areas indicate detected avascular area (AA). C. 3x3-mm scan, corresponding to the white square region labeled in image A, D, E, & F. Blue area labeled EAA in SVC, intermediate and deep capillary plexuses of the 3x3-mm scan. The 3x3-mm scan detected more AA within the 3x3-mm region than the 6x6-mm scan.

Figure 1. A. 6x6-mm superficial vascular complex (SVC) scan of a proliferative diabetic retinopathy eye. B. Blue areas indicate detected avascular area (AA). C. 3x3-mm scan, corresponding to the white square region labeled in image A, D, E, & F. Blue area labeled EAA in SVC, intermediate and deep capillary plexuses of the 3x3-mm scan. The 3x3-mm scan detected more AA within the 3x3-mm region than the 6x6-mm scan.

 

Table 1. Correlation between avascular areas and diabetic retinopathy severity

Table 1. Correlation between avascular areas and diabetic retinopathy severity

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