DETECTION OF CLINICALLY UNSUSPECTED RETINAL NEOVASCULARIZATION WITH WIDE-FIELD OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY. Issue 5 (May 2020)

• Record Type: Journal Article
• Authors: You, Qi Sheng; Guo, Yukun; Wang, Jie; Wei, Xiang; Camino, Acner; Zang, Pengxiao; Flaxel, Christina J.; Bailey, Steven T.; Huang, David; Jia, Yali; Hwang, Thomas S.
• Is Part Of: Retina. Volume 40:Issue 5(2020)
• Publication Date: 2020-05
• Subjects: anti–vascular endothelial growth factor -- diabetic retinopathy -- optical coherence tomography angiography; Retina -- Diseases -- Periodicals; Retinal Diseases; Vitreous Body; 617.735
• DOI: 10.1097/IAE.0000000000002487
• Languages: English
• ISSNs: 0275-004X

Abstract

Abstract : Purpose: To evaluate wide-field optical coherence tomography angiography (OCTA) for detection of clinically unsuspected neovascularization (NV) in diabetic retinopathy (DR). Methods: This prospective observational single-center study included adult patients with a clinical diagnosis of nonproliferative DR. Participants underwent a clinical examination, standard 7-field color photography, and OCTA with commercial and prototype swept-source devices. The wide-field OCTA was achieved by montaging five 6 × 10-mm scans from a prototype device into a 25 × 10-mm image and three 6 × 6-mm scans from a commercial device into a 15 × 6-mm image. A masked grader determined the retinopathy severity from color photographs. Two trained readers examined conventional and wide-field OCTA images for the presence of NV. Results: Of 27 participants, photographic grading found 13 mild, 7 moderate, and 7 severe nonproliferative DR. Conventional 6 × 6-mm OCTA detected NV in 2 eyes (7%) and none with 3 × 3-mm scans. Both prototype and commercial wide-field OCTA detected NV in two additional eyes. The mean area of NV was 0.38 mm 2 (range 0.17–0.54 mm 2 ). All eyes with OCTA-detected NV were photographically graded as severe nonproliferative DR. Conclusion: Wide-field OCTA can detect small NV not seen on clinical examination or color photographs and may improve the clinical evaluation of DR. Abstract : Wide-field optical coherence tomography angiography can detect clinically unsuspected retinal neovascularization in diabetic retinopathy, providing a sensitive surveillance method that is amenable to routine clinical use.