Swept-source widefield (SS-WF) OCT angiography (OCT-A) can detect additional retinal nonperfusion areas in diabetic retinopathy (DR) patients compared with ultra widefield (UWF) fluorescein angiography (FA), according to a recent study conducted in Paris.

Researchers assessed changes after three monthly anti-VEGF injections in 10 eyes of nine patients. All eyes were imaged with UWF color fundus photographs, UWF FA and SS-WF OCT-A at baseline and one month after the third injection. The DR severity score improved by at least one stage in eight of 10 eyes, with a significant decrease in the mean number of microaneurysms and retinal hemorrhages on UWF color fundus photographs one month after treatment vs. baseline (40±28 vs. 121±57). The researchers also noted regression of fundus neovascularization when present.

All nonperfusion areas detected on FA were seen on SS-WF OCT-A, but SS-WF OCT-A detected additional areas at baseline in 29% (46/160) of the analyzed boxes. Researchers found that retinal capillaries were only visible on OCT-A and no reperfusion in areas of nonperfusion was observed even when a reduction in dark areas was visible on FA. 

Couturier A, Rey PA, Erginay A, et al. Swept-source wide-field OCT-angiography versus ultra-wide-field fluorescein angiography assessments of retinal non-perfusion in diabetic retinopathy and edema treated with anti-VEGF. Ophthalmology. June 26, 2019. [Epub ahead of print].