OCT angiography’s advanced imaging capabilities are providing doctors a non-invasive look at several biological structures previously unseen. As investigators explore what information these new views can provide, doctors are getting more opportunities to provide earlier diagnosis, create narrower disease staging metrics and, ultimately, more targeted treatments. This is particularly true for one of the growing concerns in eye care: diabetes.

According to research recently published in Ophthalmology, three elements—the foveal avascular zone (FAZ), vessel density and fractal dimension of the superficial capillary plexus—can predict diabetic retinopathy (DR) progression. Additionally, vessel density measurements of the superficial capillary plexus can predict the development of diabetic macular edema (DME). OCT-A can provide all these measurements.

Researchers looked at 205 eyes of 129 diabetic patients over a span of at least two years. All of the subjects were evaluated with both swept-source OCT and OCT-A. A total of 28 eyes (13.66%) developed DR progression and 17 eyes (8.76%) developed DME. With OCT-A, researchers determined that those subjects with larger FAZ area, lower vessel density and lower fractal dimension of the superficial capillary plexus were more likely to see DR progression, even after adjusting for established risk factors such as duration of disease and age.

“OCT-A metrics improved the predictive discrimination of DR progression and DME development,” the report concluded.

Sun Z, Tang F, Wong R, et al. Optical coherence tomography angiography metrics predict progression of diabetic retinopathy and development of diabetic macular edema: a prospective study. Ophthalmol. June 25, 2019. [Epub ahead of print].