Monitoring proliferative diabetic retinopathy with optical coherence tomography angiography

Abstract

Purpose : To assess the clinical value of optical coherence tomography angiography (OCTA) for monitoring proliferative diabetic retinopathy (PDR).

Methods : In this prospective cohort study, we enrolled PDR patients with neovascularization (NV) within the Early Treatment Diabetic Retinopathy Study fields 1 or 2. Clinicians treated the eyes per standard of care. Participants underwent high-definition (400x400) 6x6-mm OCTA scans centered on disc, fovea, and temporal retina consecutively with ~0.5mm overlap using a commercial spectral-domain OCTA system. A custom algorithm measured the NV vessel area and the central non-perfusion area (NPA) on en face OCTA. The OCTA images of baseline and 1-year follow-up visits were registered for comparison.

Results : We included 10 eyes of 9 PDR patients (6 male) with 13 NVs (2 NVs/eye in 3 eyes), including 1 NV at the disc and 12 NV elsewhere, detected on OCTA scans. The clinical characteristics of the study participants were summarized in table 1. From baseline to one-year follow-up visit, the macular NPA increased on average 8.6% (P=0.25); while the NV vessel area decreased on average 25.5% (P=0.37) (Figure 1). Four eyes did not receive any treatment during the follow-up, while 6 eyes were treated with multiple anti-VEGF injections. The NV vessel area in untreated eyes enlarged significantly more than that in treated eyes (increased 9.4% vs. decreased 48.7%, P=0.017). The NPA changes were similar in treated and untreated eyes (9.9% vs. 7.8%, P=0.96).

Conclusions : OCTA is useful for quantifying and monitoring NV in PDR. Anti-VEGF treatment reduces NV growth, but does not affect NPA enlargement.

This is a 2021 ARVO Annual Meeting abstract.