The findings from a retrospective study based at the Bascom Palmer Eye Institute in Miami have suggested that widefield swept-source OCT angiography (OCT-A) may be the only imaging method needed for baseline and longitudinal management of proliferative diabetic retinopathy (PDR). A simulated OCT-A field of view focused on the fovea superimposed on ultra widefield fluorescein angiography (FA) images detected neovascularization in 99.4% of treatment-naive eyes and 97.2% of previously treated eyes of PDR patients.
Researchers analyzed 651 eyes from 433 PDR patients, of whom 50% were treatment-naïve, 9.8% had neovascularization of the optic disc (NVD) only, 41.8% had neovascularization elsewhere (NVE) only and 48.4% had both. The study noticed that NVE was most prevalent in the superotemporal quadrant and least prevalent in the nasal quadrants. When the simulated OCT-A field of view was overlaid on the FA images, 98.3% of all eyes had neovascularization. When researchers compared the simulated field of view images to actual widefield swept-source OCT-A images obtained from the same patients, the simulated images appeared to cover a nearly identical area of retina.
The study concluded that swept-source OCT-A and its coincident cross-sectional B-scans simultaneously allow for detection of diabetic macular edema, encompassing all of the imaging data that a clinician needs to tailor treatment in PDR and possibly all forms of diabetic retinopathy.
|Russell JF, Flynn HW, Sridhar J, et al. Distribution of diabetic neovascularization on ultra-widefield fluorescein angiography and on simulated widefield OCT angiography. Am J Ophthalmol. June 10, 2019. [Epub ahead of print].|