COMPARING FUNDUS FLUORESCEIN ANGIOGRAPHY AND SWEPT-SOURCE OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY IN THE EVALUATION OF DIABETIC MACULAR PERFUSION. Issue 5 (May 2019)

• Record Type: Journal Article
• Authors: La Mantia, Alberto; Kurt, Rengin A.; Mejor, Samantha; Egan, Catherine A.; Tufail, Adnan; Keane, Pearse A.; Sim, Dawn A.
• Is Part Of: Retina. Volume 39:Issue 5(2019)
• Publication Date: 2019-05
• Subjects: diabetic macular ischemia -- fluorescein angiography -- foveal avascular zone -- optical coherence -- tomography angiography -- swept-source; Retina -- Diseases -- Periodicals; Retinal Diseases; Vitreous Body; 617.735
• DOI: 10.1097/IAE.0000000000002045
• Languages: English
• ISSNs: 0275-004X

Abstract

Abstract : Purpose: To compare fundus fluorescein angiography (FFA) and swept-source optical coherence tomography angiography (SS-OCTA) in the evaluation of macular perfusion in diabetic patients. Methods: Forty-one eyes (21 diabetic patients) seen at Moorfields Eye Hospital (London) over a 1-month interval underwent color fundus photography, FFA, and SS-OCTA imaging of the capillary superficial plexus using 2 different protocols: 3 × 3 mm and 4.5 × 4.5 mm. Quantitative assessment (foveal avascular zone diameters and area), qualitative analysis (macroscopic and microscopic levels) and Early Treatment Diabetic Retinopathy Study diabetic macular ischemia grading were performed. Artifacts were recorded. Intraclass correlation coefficients and weighted kappa values were calculated. Results: Mean (SD) foveal avascular zone area was 0.695 (0.52) mm 2 on FFA, 0.627 (0.54) mm 2 on SS-OCTA 3 × 3 and 0.701 (0.54) mm 2 on SS-OCTA 4.5 × 4.5 protocol. Intraclass correlation coefficients showed good agreement between FFA and SS-OCTA for both vertical diameter and foveal avascular zone area measurements. The agreement between SS-OCTA 3 × 3 and 4.5 × 4.5 was good for all quantitative measurements. Weighted kappa for diabetic macular ischemia grading showed low to fair agreement between FFA and SS-OCTA, whereas the agreement was good between two different SS-OCTA protocols. Conclusion: Swept-source OCTA is a reproducible technique in the assessment of macular perfusion in diabetic patients with special regards to foveal avascular zone analysis. The agreement with FFA is limited especially for diabetic macular ischemia grading. Fundus fluorescein angiography is more sensitive in identifying microaneurysms. Abstract : This article compares fundus fluorescein angiography and swept-source optical coherence tomography angiography in the assessment of macular perfusion of diabetic patients.