June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
Combination of Ultra-widefield Colour Fundus Photography and Optical Coherence Tomography Angiography identify different subtypes of non-proliferative diabetic retinopathy
Author Affiliations & Notes
  • Ana Rita Santos
    AIBILI – Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
    Department of Orthoptics, School of Health, Polytechnic of Porto, Porto, Portugal
  • Ana Catarina Almeida
    AIBILI – Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
  • Ana Cláudia Rocha
    AIBILI – Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
  • Débora Reste-Ferreira
    AIBILI – Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
  • Inês Pereira Marques
    AIBILI – Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
    Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
  • Torcato Santos
    AIBILI – Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
  • Jose G Cunha-Vaz
    AIBILI – Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
    Faculty of Medicine, University of Coimbra, Coimbra, Portugal
  • Footnotes
    Commercial Relationships   Ana Rita Santos None; Ana Almeida None; Ana Rocha None; Débora Reste-Ferreira None; Inês Marques None; Torcato Santos None; Jose Cunha-Vaz Zeiss Meditec, Dublin, CA, USA, Code C (Consultant/Contractor)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 2560. doi:
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      Ana Rita Santos, Ana Catarina Almeida, Ana Cláudia Rocha, Débora Reste-Ferreira, Inês Pereira Marques, Torcato Santos, Jose G Cunha-Vaz; Combination of Ultra-widefield Colour Fundus Photography and Optical Coherence Tomography Angiography identify different subtypes of non-proliferative diabetic retinopathy. Invest. Ophthalmol. Vis. Sci. 2023;64(8):2560.

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

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Abstract

Purpose : To identify changes in central vascular density using Optical Coherence Tomography Angiography (OCTA) in diabetic patients with and without peripheral lesions identified on ultra-widefield fundus photographs (UWF-FP).

Methods : A cross-sectional observational study in patients with Type I and II diabetes. All patients underwent UWF 200° examinations with OPTOS California (Optos, Dunfermline, UK) and 3x3mm acquisitions (CIRRUS™ HD-OCT 5000 with AngioPlex® OCT Angiography (ZEISS, Dublin, CA, USA). UWF images were graded based on the presence and location of retinal lesions: A-eyes without lesions; B-eyes with lesions inside the 7-ETDRS fields; C-eyes with lesions inside and outside the 7-ETDRS fields; and D-eyes with peripheral lesions only (outside 7-ETDRS fields). OCTA metrics like foveal avascular zone, vessel density (VD) and perfusion density (PD) were computed with Carl Zeiss Meditec Density Exerciser (version:10.0.12787).

Results : 729 diabetic eyes were observed. 131 (18%) presented visible lesions in UWF-FP, while 598 (82%) showed no visible lesions. According to the location of retinal lesions, 26 (19.9%) showed only lesions inside the 7-ETDRS fields, 46 (35.1%) presented visible lesions inside and outside the 7-ETDRS fields and 59 (45%) presented visible lesions only in the peripheral retina (outside the 7-ETDRS fields). OCTA metrics calculations were performed in all eyes with lesions (n=131) and in a sample of eyes without lesions (n=124). VD and PD values on SD-OCTA were significantly decreased in all groups when compared with an age matched healthy population (p<0.001). The group with lesions both inside and outside the 7-fields ETDRS area showed the most significant decrease of VD and PD (p<0.001).

Conclusions : Central retinal VD and PD show microvascular changes in all eyes with diabetes type 2 including eyes without visible lesions or with visible lesions only in the periphery of the retina. These findings suggest the relevance of OCTA to identify macular microvascular changes in the initial stages of DR and confirm that there are different phenotypes and subtypes of DR, confirming the value of OCTA and midfield imaging for their characterization.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

 

Comparison of OCTA vascular metrics of the healthy control population against the groups of patients without lesions or having lesions on different retina locations

Comparison of OCTA vascular metrics of the healthy control population against the groups of patients without lesions or having lesions on different retina locations

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