Abstract
Purpose :
To evaluate the six-month progression of retinal capillary nonperfusion in eyes with moderate-severe nonproliferative diabetic retinopathy (NPDR) focusing on Early Treatment Diabetic Retinopathy Study (ETDRS) diabetic retinopathy severity scale (DRSS) levels 43, 47 and 53, and comparing evaluation with different optical coherence tomography angiography (OCTA) devices.
Methods :
Analysis of the initial six-month progression of subjects enrolled in the two-year observational prospective RICHARD study (NCT05112445). Fifty-one eyes from 51 patients with type 2 diabetes were analyzed at baseline and at 6-month follow-up visits. Eyes at baseline were classified using the ETDRS DRSS with seven-field color fundus photographs obtained from a Topcon TRC-50DX camera (Topcon Medical Systems, Tokyo, Japan) and complemented with Optos California (Optos plc, Dunfermline, UK) ultra widefield fundus angiography. Eyes graded with DR severity levels 43, 47 and 53 were included. All subjects were also examined using swept-source OCTA (SS-OCTA) (PLEX® Elite 9000, ZEISS, Dublin, CA, USA), spectral-domain OCTA (SD-OCTA) (CIRRUSTM HD-OCT 5000 Angioplex, Zeiss, Dublin, CA, USA) and AngioVue (Optovue RTVue, Optovue Inc, CA, USA). Skeletonized vessel density (SVD) and perfusion density (PD) metrics for superficial and deep capillary plexuses (SCP and DCP) were evaluated.
Results :
Six-month progression in SVD and PD was identified in eyes classified as DRSS levels 43, 47 and 53 using different OCTA devices. SS-OCTA PLEX Elite using Angiography 6x6 mm and 15x15 mm show statistically significant differences in the inner ring (SVD, DCP: p=0.041), outer ring (SVD, DCP: p=0.046) and midperiphery (SVD SCP, Ext1: p=0.002 and Ext2: p=0.015). Furthermore, SD-OCTA Cirrus Angioplex using 3x3 mm and 6x6 mm acquisitions show statistically significant differences in the inner ring (SVD, SCP: p<0.001, DCP: p=0.036) and outer ring areas (SVD, SCP: p=0.029, DCP: p=0.022). Finally, SD-OCTA AngioVue using 3x3 mm only identified changes in the inner ring (PD for SCP: p=0.036).
Conclusions :
In a six-month period, disease progression in moderate-severe NPDR (DRSS levels 43, 47 and 53) can be identified in the superficial and deep retinal capillary plexuses in the retinal midperiphery and in the inner and outer rings of central retina by performing OCTA examinations.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.