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Thomas S Hwang, Qisheng You, Yukun Guo, Christina J Flaxel, Steven Bailey, David Huang, Yali Jia; Monitoring proliferative diabetic retinopathy with optical coherence tomography angiography. Invest. Ophthalmol. Vis. Sci. 2021;62(8):1097.
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To assess the clinical value of optical coherence tomography angiography (OCTA) for monitoring proliferative diabetic retinopathy (PDR).
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.
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).
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.
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