Appearance of cysts and capillary non perfusion areas in diabetic macular edema using two different OCTA devices

Abstract

the aim of this paper was to distinguish the appearance of cysts and non-perfusion areas (npAs) in diabetic macular edema (DME) using two different Optical Coherence Tomography Angiography (OCTA) devices. in this study, patients underwent octA using the AngioVue XR Avanti Spectral Domain (SD) OCTA and the PLEX Elite 9000 Swept-Source (SS) OCTA. Foveal and extrafoveal regions of interest (ROI), defined as any area with an altered flow signal comparing to the surrounding retina, were selected in superficial and deep capillary plexus (SCP and DCP). ROI reflectivity were classified as hypo-reflective or hyper-reflective. Foveal ROI were analyzed to detect suspended scattering particles in motion (SSpiM). thirty-seven DMe eyes were included. A larger number of Rois were found in Scp (55 vs 39) and DCP (60 vs 49) using PLEX Elite 9000 vs AngioVue. The majority of ROIs were hyporeflective with both instruments, while slightly more hyper-reflective ROIs (grey) were detected with the PLEX Elite, more likely to be cysts. The hyporeflective ROIs could be NPAs or cysts with both devices. Moreover, PLEX Elite 9000 identified SSPiM in more foveal ROIs than the AngioVue in the SCP (p = 0.005) and in the DCP (p = 0.027). In conclusion, NPAs and cysts may show variable appearances using different OCTA devices. Hyperreflective ROIs generally correspond to cysts, hyporeflective ROIs can be either cysts or npAs. the SS-octA seems to detect SSpiM more frequently than the SD-octA.

Optical Coherence Tomography Angiography of Macular Perfusion Changes after Anti-VEGF Therapy for Diabetic Macular Edema: A Systematic Review

“…The presence of cystoid spaces in chronic diabetic macular edema may resemble areas of capillary nonperfusion on enface OCTA since both may appear as black or grey areas [68,69]. The appearance of these areas, however, can be variable depending on which OCTA machine is used [69,70].…”

A Swept source optical coherence tomography angiography study: Imaging artifacts and comparison of non-perfusion areas with fluorescein angiography in diabetic macular edema

“…It was demonstrated that parameters derived from different devices are not necessarily equivalent due to different applied wavelengths and algorithms for perfusion detection [ 34 ]. In a recent study SSPiM were detected more frequently detected using the Plex Elite 9000 than the Optovue OCT-A [ 35 ]. Therefore the number of detected artifacts in our patient cohort may be higher if comparing it with other SS-OCTA devices.…”

Quantification of diabetic macular ischemia using novel three‐dimensional optical coherence tomography angiography metrics

“…We also obtained the en face OCTA images of the SCP and DVC slabs at the instrument's default setting [37]. These images were exported and then imported into Fiji distribution of ImageJ as 1024 × 1024 pixels images [29].…”