Wide-field optical coherence tomography angiography for the detection of proliferative diabetic retinopathy.
Optical coherence tomography angiography
Proliferative diabetic retinopathy
Ultra-wide-field fluorescein angiography
Journal
Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie
ISSN: 1435-702X
Titre abrégé: Graefes Arch Clin Exp Ophthalmol
Pays: Germany
ID NLM: 8205248
Informations de publication
Date de publication:
Sep 2020
Sep 2020
Historique:
received:
22
04
2020
accepted:
25
05
2020
revised:
21
05
2020
pubmed:
1
6
2020
medline:
23
6
2021
entrez:
1
6
2020
Statut:
ppublish
Résumé
To compare the ability of wide-field optical coherence tomography angiography (WF-OCTA) to that of ultra-wide field fluorescein angiography (UWF-FA) and ultra-wide-field color fundus photography (UWF-CP) to detect retinal neovascularization (NV) in eyes with proliferative diabetic retinopathy (PDR). In this cross-sectional study, naïve patients with active PDR underwent UWF-FA and UWF-CP using the Optos 200Tx and WF-OCTA with 12 × 12 mm fields of five visual fixations using the PLEX Elite 9000. NV was defined on OCTA when the co-registered B-scan with flow overlay of the vitreoretinal interface (VRI) segmentation showed extraretinal proliferation. Three masked readers examined the UWF-FA, UWF-CP, and WF-OCTA independently for the presence of NV. Statistical analysis was performed to compare the diagnostic accuracy of the 3 wide-field imaging modalities using OCT B-scan as the reference standard. In 82 eyes with PDR, neovascularization of the disc (NVD) was detected in 13 eyes by UWF-CP, 35 eyes with UWF-FA, and 37 eyes with OCTA using the VRI slab. Upon review of the 2500 OCT B-scans with superimposed flow overlay of each eye, NVD was confirmed in 37 eyes. The sensitivity and specificity of NVD detection were 35.1% and 97.8%, respectively for UWF-CP; 94.6% and 100%, respectively, for UWF-FA; and 100% and 100% for WF-OCTA. One hundred ninety-six foci of neovascularization elsewhere (NVE) were identified with the OCT B-scan with superimposed flow overlay. UWF-CP analysis was able to detect 62 foci of NVE of the 196 confirmed by B-scan (31.6% detection rate). An additional 11 foci of NVE seen on UWF-CP were not confirmed by B-Scan (15% false positive rate). There were 182 foci of NVE identified by UWF-FA (detection rate 91.3%), while WF-OCTA detected 196 retinal NVEs (detection rate 100%). The rate of false positives for both UWF-FA and WF-OCTA was low (< 2%). WF-OCTA can identify NV that is not evident in UWF-CP and represents a faster and safer alternative to UWF-FA for surveillance of PDR with comparable diagnostic accuracy.
Identifiants
pubmed: 32474692
doi: 10.1007/s00417-020-04773-x
pii: 10.1007/s00417-020-04773-x
doi:
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
1901-1909Références
Aiello LP, Avery RL, Arrigg PG et al (1994) Vascular endothelial growth factor in ocular fluid of patients with diabetic retinopathy and other retinal disorders. N Engl J Med 331:1480–1487
pubmed: 7526212
doi: 10.1056/NEJM199412013312203
Antonetti DA, Klein R, Gardner TW (2012) Diabetic retinopathy. N Engl J Med 366:1227–1239
doi: 10.1056/NEJMra1005073
Wong TY, Sun J, Kawasaki R et al (2018) Guidelines on diabetic eye care: the International Council of Ophthalmology recommendations for screening, follow-up, referral, and treatment based on resource settings. Ophthalmology 125:1608–1622
pubmed: 29776671
doi: 10.1016/j.ophtha.2018.04.007
Kishi S, Shimizu K (1993) Clinical manifestations of posterior precortical vitreous pocket in proliferative diabetic retinopathy. Ophthalmology 100:225–229
pubmed: 8437831
doi: 10.1016/S0161-6420(93)31666-0
Muqit MM, Stanga PE (2014) Fourier-domain optical coherence tomography evaluation of retinal and optic nerve head neovascularization in proliferative diabetic retinopathy. Br J Ophthalmol 98(1):65–72
pubmed: 24158844
doi: 10.1136/bjophthalmol-2013-303941
Classification of diabetic retinopathy from fluorescein angiograms (1991) ETDRS report number 11. Early Treatment Diabetic Retinopathy Study Research Group. Ophthalmology 98:807–822
doi: 10.1016/S0161-6420(13)38013-0
Wessel MM, Aaker GD, Parlitsis G, Cho M, D'Amico DJ, Kiss S (2012) Ultra-wide-field angiography improves the detection and classification of diabetic retinopathy. Retina 32:785–791
pubmed: 22080911
doi: 10.1097/IAE.0b013e3182278b64
Silva PS, Cavallerano JD, Sun JK, Soliman AZ, Aiello LM, Aiello LP (2013) Peripheral lesions identified by mydriatic ultrawide field imaging: distribution and potential impact on diabetic retinopathy severity. Ophthalmology 120:2587–2595
pubmed: 23778092
doi: 10.1016/j.ophtha.2013.05.004
Tan CS, Sadda SR, Hariprasad SM (2014) Ultra-wide retinal imaging in the management of diabetic eye diseases. Ophthalmic Surg Lasers Imaging Retina 45:363–366
pubmed: 25291782
doi: 10.3928/23258160-20140909-07
Yannuzzi LA, Rohrer KT, Tindel LJ et al (1986) Fluorescein angiography complication survey. Ophthalmology 93:611–617
pubmed: 3523356
doi: 10.1016/S0161-6420(86)33697-2
American Academy of Ophthalmology Retina/Vitreous Panel (2016) Preferred practice pattern guidelines. Diabetic Retinopathy. San Francisco, CA: American Academy of Ophthalmology. Available at: www.aao.org/ppp . Accessed on December 6, 2018
Schaal KB, Munk MR, Wyssmueller I, Berger LE, Zinkernagel MS, Wolf S (2019) Vascular abnormalities in diabetic retinopathy assessed with swept-source optical coherence tomography angiography widefield imaging. Retina 39(1):79–87
pubmed: 29135803
doi: 10.1097/IAE.0000000000001938
Elbendary AM, Abouelkheir HY (2018) Bimodal imaging of proliferative diabetic retinopathy vascular features using swept source optical coherence tomography angiography. Int J Ophthalmol 11(9):1528–1533
pubmed: 30225229
pmcid: 6133897
Spaide RF, Klancnik JM Jr, Cooney MJ (2015) Retinal vascular layers imaged by fluorescein angiography and optical coherence tomography angiography. JAMA Ophthalmol 133:45–50
pubmed: 25317632
doi: 10.1001/jamaophthalmol.2014.3616
Lee CS, Lee AY, Sim DA et al (2015) Reevaluating the definition of intraretinal microvascular abnormalities and neovascularization elsewhere in diabetic retinopathy using optical coherence tomography and fluorescein angiography. Am J Ophthalmol 159(1):101–110.e1
pubmed: 25284762
doi: 10.1016/j.ajo.2014.09.041
Hwang TS, Jia Y, Gao SS et al (2015) Optical coherence tomography angiography features of diabetic retinopathy. Retina 35:2371–2376
pubmed: 26308529
pmcid: 4623938
doi: 10.1097/IAE.0000000000000716
Wilkinson CP, Ferris FL III, Klein RE et al (2003) Proposed international clinical diabetic retinopathy and diabetic macular edema disease severity scales. Ophthalmology 110:1677–1682
pubmed: 13129861
doi: 10.1016/S0161-6420(03)00475-5
Yin X, Chao JR, Wang RK (2014) User-guided segmentation for volumetric retinal optical coherence tomography images. J Biomed Opt 19:086020
pubmed: 25147962
pmcid: 4407675
doi: 10.1117/1.JBO.19.8.086020
De Venecia G, Davis M, Engerman R (1976) Clinicopathologic correlations in diabetic retinopathy. I. Histology and fluorescein angiography of microaneurysms. Arch Ophthalmol 94(10):1766–1773
pubmed: 973822
doi: 10.1001/archopht.1976.03910040540013
Archer DB (1976) Neovascularization of the retina. Trans Ophthalmol Soc U K 96(4):471–493
pubmed: 829290
Davis MD, Blodi BA (2006) Proliferative diabetic retinopathy, 4th edn. Elsevier, Philadelphia
Miller H, Miller B, Zonis S, Nir I (1984) Diabetic neovascularization: permeability and ultrastructure. Invest Ophthalmol Vis Sci 25:1338–1342
pubmed: 6208163
Silva PS, Cavallerano JD, Haddad NM et al (2015) Peripheral lesions identified on ultrawide field imaging predict increased risk of diabetic retinopathy progression over 4 years. Ophthalmology 122:949–956
pubmed: 25704318
doi: 10.1016/j.ophtha.2015.01.008
Salz DA, de Carlo TE, Adhi M et al (2016) Select features of diabetic retinopathy on swept source optical coherence tomographic angiography compared with fluorescein angiography and normal eyes. JAMA Ophthalmol 134:644–650
pubmed: 27055248
pmcid: 5312730
doi: 10.1001/jamaophthalmol.2016.0600
Ishibazawa A, Nagaoka T, Takahashi A et al (2015) Optical coherence tomography angiography in diabetic retinopathy: a prospective pilot study. Am J Ophthalmol 160:35–44 e31
pubmed: 25896459
doi: 10.1016/j.ajo.2015.04.021
Sawada O, Ichiyama Y, Obata S et al (2018) Comparison between wide-angle OCT angiography and ultra-wide field fluorescein angiography for detecting non-perfusion areas and retinal neovascularization in eyes with diabetic retinopathy. Graefes Arch Clin Exp Ophthalmol 256:1275–1280
pubmed: 29713816
doi: 10.1007/s00417-018-3992-y
Spaide RF (2011) Peripheral areas of nonperfusion in treated central retinal vein occlusion as imaged by wide-field fluorescein angiography. Retina 31:829–837
pubmed: 21487338
doi: 10.1097/IAE.0b013e31820c841e
Arya M, Sorour O, Chaudhri J et al (2019) Distinguishing intraretinal microvascular abnormalities from retinal neovascularization using optical coherence tomography angiography. Retina. https://doi.org/10.1097/IAE.0000000000002671
Stanga PE, Papayannis A, Tsamis E et al (2016) New findings in diabetic maculopathy and proliferative disease by swept-source optical coherence tomography angiography. Dev Ophthalmol 56:113–121
pubmed: 27023703
doi: 10.1159/000442802
Matsunaga DR, Yi JJ, De Koo LO, Ameri H, Puliafito CA, Kashani AH (2015) Optical coherence tomography angiography of diabetic retinopathy in human subjects. Ophthalmic Surg Lasers Imaging 46:796–805
doi: 10.3928/23258160-20150909-03