June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
Quantification of Abnormal Fluid Accumulation in the Diabetic Retina using OCT-Leakage
Author Affiliations & Notes
  • Torcato Santos
    AIBILI – Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
  • Cátia Gonçalves
    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
  • Ines 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
  • 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
  • João Figueira
    AIBILI – Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
    Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal
  • Conceicão F Lobo
    AIBILI – Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
    Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra (CHUC), 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   Torcato Santos EP3289565B1, US11234591B2, Code P (Patent); Cátia Gonçalves None; Débora Reste-Ferreira None; Ines Marques None; Ana Rita Santos None; João Figueira None; Conceicão Lobo None; Jose Cunha-Vaz EP3289565B1, US11234591B2, Code P (Patent)
  • Footnotes
    Support  Fundação Ciência e Tecnologia EXPL/EMD-EMD/1402/2021
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 2377. doi:
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    • Get Citation

      Torcato Santos, Cátia Gonçalves, Débora Reste-Ferreira, Ines Pereira Marques, Ana Rita Santos, João Figueira, Conceicão F Lobo, Jose G Cunha-Vaz; Quantification of Abnormal Fluid Accumulation in the Diabetic Retina using OCT-Leakage. Invest. Ophthalmol. Vis. Sci. 2023;64(8):2377.

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

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Abstract

Purpose : To demonstrate abnormal fluid accumulation in the retina using optical coherence tomography leakage (OCT-Leakage) in the initial stages of diabetic retinopathy during a 3-year follow-up period.

Methods : Seventy-four eyes from 74 type 2 diabetic patients were followed in a 3-year longitudinal study with 1-year intervals using OCT-Leakage. The OCT-Leakage algorithm is an image analysis algorithm based on the projection of low optical reflectivity (LOR) voxels to a plane perpendicular to the depth direction. LOR voxels are identified by thresholding the reflectivity intensity of CIRRUS™ HD-OCT 5000 with AngioPlex® OCT Angiography (ZEISS, Dublin, CA, USA) structural data by a reference value calculated from a normative database of healthy control subjects. Extracellular fluid distributions of a given area of the retina can be measured by the LOR area ratio. 3-dimensional distribution of extracellular fluid, amount, extent, and depth location was identified on each retinal layers to assess for abnormal accumulation of extracellular fluid. Central retinal thickness for each participant was collected at each visit to check for the development of center involved macular edema (CIME).

Results : CIME was identified in the first visit in 9% (n=2/23) of the eyes in ETDRS 10-20, 10% (n=3/31) of eyes in the ETDRS 35 and 15% (n=3/20) of eyes in ETDRS 43-47. The eyes with CIME and subclinical CIME showed progressive increase in retinal extracellular fluid during the 3-year period of follow-up. At the end of the 3-year period all eyes with CIME showed increased LOR ratios independently of the EDTRS level. Increase LOR ratio was also present in 60% of the eyes with subclinical macular edema. CIME with increased retinal extracellular fluid accumulation was shown to be associated with vision loss.

Conclusions : The prevalence of subclinical CIME and CIME in non-proliferative diabetic retinopathy occurs independently of the severity of the retinopathy. The accumulation of extracellular fluid can be monitored with the OCT-Leakage algorithm. OCT-Leakage demonstrates a progressive increase in extracellular fluid in long standing CIME. Variations in the increase of extracellular fluid are associated with vision loss.

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

 

Number and percentage of eyes with subclinical CIME and CIME by ETDRS group at baseline and at the 3-year follow-up visit

Number and percentage of eyes with subclinical CIME and CIME by ETDRS group at baseline and at the 3-year follow-up visit

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