Longitudinal Wide-Field Swept-Source OCT Angiography of Neovascularization in Proliferative Diabetic Retinopathy After Panretinal Photocoagulation

Overview

Journal Ophthalmol Retina

Specialty Ophthalmology

Date 2019 Apr 25

PMID 31014688

Citations 48

Authors

Jonathan F Russell

Yingying Shi

John W Hinkle

Nathan L Scott

Kenneth C Fan

Cancan Lyu

Giovanni Gregori

Philip J Rosenfeld

Affiliations

Soon will be listed here.

Abstract

Purpose: Wide-field swept-source (SS) OCT angiography (OCTA) was compared with ultrawide-field (UWF) fluorescein angiography (FA) for evaluating neovascularization (NV) before and after panretinal photocoagulation (PRP) in eyes with treatment-naive proliferative diabetic retinopathy (PDR).

Design: Prospective, observational, consecutive case series.

Participants: Patients with treatment-naive PDR.

Methods: Patients were imaged using the SS OCTA 12 × 12-mm field of view (PLEX Elite 9000; Carl Zeiss Meditec, Inc, Dublin, CA) at baseline and at 1 week, 1 month, and 3 months after PRP. Select eyes were imaged with 5 SS OCTA 12 × 12-mm scans to create posterior pole montages. Ultrawide-field fundus photography and UWF FA were obtained at baseline and 3 months after PRP.

Main Outcome Measures: Neovascularization visualized using wide-field SS OCTA and UWF FA.

Results: From January through May 2018, wide-field SS OCTA was performed on 20 eyes with treatment-naive PDR from 15 patients. The en face SS OCTA 12 × 12-mm vitreoretinal interface (VRI) slab images showed NV at baseline in 18 of 20 eyes (90%). Of the remaining 2 eyes, the posterior pole montage captured peripheral NV in one eye, and in the other eye, no evidence of NV was detected with either UWF FA or SS OCTA. After PRP, both SS OCTA and FA demonstrated similar progression or regression of NV, but SS OCTA provided more detailed visualization of the vascular changes.

Conclusions: Neovascularization in PDR can be identified at baseline and imaged serially after PRP using wide-field SS OCTA. In patients with a high clinical suspicion for PDR, wide-field SS OCTA likely will be the only imaging method needed for diagnosis and longitudinal evaluation of NV.

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References

Taylor E, Dobree J . Proliferative diabetic retinopathy. Site and size of initial lesions. Br J Ophthalmol. 1970; 54(1):11-8. PMC: 1207577. DOI: 10.1136/bjo.54.1.11. View

Zhang X, Saaddine J, Chou C, Cotch M, Cheng Y, Geiss L . Prevalence of diabetic retinopathy in the United States, 2005-2008. JAMA. 2010; 304(6):649-56. PMC: 2945293. DOI: 10.1001/jama.2010.1111. View

Moein H, Novais E, Rebhun C, Cole E, Louzada R, Witkin A . OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY TO DETECT MACULAR CAPILLARY ISCHEMIA IN PATIENTS WITH INNER RETINAL CHANGES AFTER RESOLVED DIABETIC MACULAR EDEMA. Retina. 2017; 38(12):2277-2284. DOI: 10.1097/IAE.0000000000001902. View

Agemy S, Scripsema N, Shah C, Chui T, Garcia P, Lee J . RETINAL VASCULAR PERFUSION DENSITY MAPPING USING OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY IN NORMALS AND DIABETIC RETINOPATHY PATIENTS. Retina. 2015; 35(11):2353-63. DOI: 10.1097/IAE.0000000000000862. View

GASS J, SEVER R, Sparks D, Goren J . A combined technique of fluorescein funduscopy and angiography of the eye. Arch Ophthalmol. 1967; 78(4):455-61. DOI: 10.1001/archopht.1967.00980030457009. View

Choi W, Mohler K, Potsaid B, Lu C, Liu J, Jayaraman V . Choriocapillaris and choroidal microvasculature imaging with ultrahigh speed OCT angiography. PLoS One. 2013; 8(12):e81499. PMC: 3859478. DOI: 10.1371/journal.pone.0081499. View

Huang Y, Zhang Q, Thorell M, An L, Durbin M, Laron M . Swept-source OCT angiography of the retinal vasculature using intensity differentiation-based optical microangiography algorithms. Ophthalmic Surg Lasers Imaging Retina. 2014; 45(5):382-9. PMC: 4286454. DOI: 10.3928/23258160-20140909-08. View

Wang J, Lains I, Providencia J, Armstrong G, Santos A, Gil P . Diabetic Choroidopathy: Choroidal Vascular Density and Volume in Diabetic Retinopathy With Swept-Source Optical Coherence Tomography. Am J Ophthalmol. 2017; 184:75-83. DOI: 10.1016/j.ajo.2017.09.030. View

Ting D, Wei Tan G, Agrawal R, Yanagi Y, Sie N, Wong C . Optical Coherence Tomographic Angiography in Type 2 Diabetes and Diabetic Retinopathy. JAMA Ophthalmol. 2017; 135(4):306-312. DOI: 10.1001/jamaophthalmol.2016.5877. View

10.

Sun J, Lin M, Lammer J, Prager S, Sarangi R, Silva P . Disorganization of the retinal inner layers as a predictor of visual acuity in eyes with center-involved diabetic macular edema. JAMA Ophthalmol. 2014; 132(11):1309-16. DOI: 10.1001/jamaophthalmol.2014.2350. View

11.

NOVOTNY H, ALVIS D . A method of photographing fluorescence in circulating blood in the human retina. Circulation. 1961; 24:82-6. DOI: 10.1161/01.cir.24.1.82. View

12.

Pedinielli A, Bonnin S, El Sanharawi M, Mane V, Erginay A, Couturier A . Three Different Optical Coherence Tomography Angiography Measurement Methods for Assessing Capillary Density Changes in Diabetic Retinopathy. Ophthalmic Surg Lasers Imaging Retina. 2017; 48(5):378-384. DOI: 10.3928/23258160-20170428-03. View

13.

Hwang T, Gao S, Liu L, Lauer A, Bailey S, Flaxel C . Automated Quantification of Capillary Nonperfusion Using Optical Coherence Tomography Angiography in Diabetic Retinopathy. JAMA Ophthalmol. 2016; 134(4):367-73. PMC: 4978127. DOI: 10.1001/jamaophthalmol.2015.5658. View

14.

Zhou A, Zhou C, Yao J, Quan Y, Ren B, Wang J . Panretinal photocoagulation versus panretinal photocoagulation plus intravitreal bevacizumab for high-risk proliferative diabetic retinopathy. Int J Ophthalmol. 2016; 9(12):1772-1778. PMC: 5154991. DOI: 10.18240/ijo.2016.12.12. View

15.

Schaal K, Legarreta A, Gregori G, Legarreta J, Cheng Q, Stetson P . Widefield En Face Optical Coherence Tomography Imaging of Subretinal Drusenoid Deposits. Ophthalmic Surg Lasers Imaging Retina. 2015; 46(5):550-9. DOI: 10.3928/23258160-20150521-06. View

16.

Norton E, Gutman F . Diabetic retinopathy studied by fluorescein angiography. Trans Am Ophthalmol Soc. 1965; 63:108-28. PMC: 1310188. View

17.

Zhang X, Wu C, Zhou L, Dai R . Observation of optic disc neovascularization using OCT angiography in proliferative diabetic retinopathy after intravitreal conbercept injections. Sci Rep. 2018; 8(1):3972. PMC: 5838089. DOI: 10.1038/s41598-018-22363-0. View

18.

Gill A, Cole E, Novais E, Louzada R, De Carlo T, Duker J . Visualization of changes in the foveal avascular zone in both observed and treated diabetic macular edema using optical coherence tomography angiography. Int J Retina Vitreous. 2017; 3:19. PMC: 5474852. DOI: 10.1186/s40942-017-0074-y. View

19.

Choi W, Waheed N, Moult E, Adhi M, Lee B, De Carlo T . ULTRAHIGH SPEED SWEPT SOURCE OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY OF RETINAL AND CHORIOCAPILLARIS ALTERATIONS IN DIABETIC PATIENTS WITH AND WITHOUT RETINOPATHY. Retina. 2016; 37(1):11-21. PMC: 5177496. DOI: 10.1097/IAE.0000000000001250. View

20.

Stanga P, Papayannis A, Tsamis E, Stringa F, Cole T, DSouza Y . New Findings in Diabetic Maculopathy and Proliferative Disease by Swept-Source Optical Coherence Tomography Angiography. Dev Ophthalmol. 2016; 56:113-21. DOI: 10.1159/000442802. View