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

Sawada, Osamu; Ichiyama, Yusuke; Obata, Syunpei; Ito, Y.; Kakinoki, Masashi; Sawada, Tomoko; Saishin, Yoshitsugu; Ohji, Masahito

doi:10.1007/s00417-018-3992-y

Cited by 124 publications

(104 citation statements)

References 10 publications

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“…Sawada and associates reported the usefulness of OCTA with five 12 × 12‐mm images, which was similar to the current study, and detected retinal nonperfusion or neovascularization in patients with DR (Sawada et al. ). The current study extended the field of view to 12 × 12 mm and the additional OCTA images at four fixation positions of the visual field (inferonasal, superonasal, inferotemporal, and superotemporal), which made possible the approximately 2.4‐time enlargement of the single‐centre OCTA field of view.…”

Section: Discussionsupporting

confidence: 89%

“…The width of the field of view of the panoramic OCTA image was approximately nine times that of the 6 × 6‐mm conventional OCTA images (Sawada et al. ). The current study was the first to quantify wide‐field OCTA images with skeletonized VL density and showed that the VL was correlated with the area of retinal nonperfusion.…”

Section: Discussionmentioning

confidence: 99%

“…The SS‐based, wide‐angle OCTA scans of 12 × 12‐mm regions were acquired using the SS‐OCT PLEX Elite 9000 ® instrument (Carl Zeiss Meditec), as previously described (Sawada et al. ), to obtain images of sufficient quality from patients with symptom durations of less than 3 months. BRVO was diagnosed based on a comprehensive ophthalmologic examination that included indirect ophthalmoscopy, slit‐lamp biomicroscopy with a contact lens, FA and spectral‐domain OCT (Cirrus HD‐OCT, Carl Zeiss Meditec, Jena, Germany).…”

Section: Methodsmentioning

confidence: 99%

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Evaluation of retinal nonperfusion in branch retinal vein occlusion using wide‐field optical coherence tomography angiography

Shiraki

Sakimoto

Tsuboi

et al. 2019

Acta Ophthalmologica

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Purpose: To characterize wide-field optical coherence tomography angiography (OCTA) features of retinal nonperfusion in eyes with branch retinal vein occlusion (BRVO). Methods: Automated scanning of five 12 3 12-mm areas of swept-source OCTA and wide-field fluorescein angiography (FA) images was performed in a consecutive case series of 27 eyes in 27 patients with BRVO in this institutional cross-sectional study. The correlation between the areas of retinal nonperfusion detected by both examinations was assessed. Panoramic images obtained in five 12 3 12-mm OCTA scans in eyes with retinal nonperfusion were binarized or skeletonized, and the associations between vascular parameters such as vascular density (VD) and vascular length (VL) with the wide-field FA characteristics were evaluated. Results: The mean area of retinal nonperfusion in the OCTA images was 81.0 AE 66.8 mm 2 (range, 0.0-188.8). The mean areas of retinal nonperfusion in FA and the total FA images were, respectively, 84.7 AE 72.5 mm 2 (range, 0.0-221.9) and 184.1 AE 167.7 mm 2 (range, 0.0-515.0). The mean VD was 27.6 AE 3.5% (range, 19.6-33.7), and the mean VL was 12.4 AE 8.5% (range, 5.4-31.3). Separate regression analyses of the areas of retinal nonperfusion in FA (p = 0.0004, R 2 = 0.4627) and the total FA (p = 0.0008, R 2 = 0.4214) images showed a significant association with the VL. Conclusions: OCTA images based on wide-field technologies can quantitatively evaluate retinal nonperfusion in eyes with BRVO.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Evaluation of retinal nonperfusion in branch retinal vein occlusion using wide‐field optical coherence tomography angiography

Shiraki

Sakimoto

Tsuboi

et al. 2019

Acta Ophthalmologica

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“…14 Additionally, wide-field OCTA has high sensitivity and specificity for the detection of the NPA and NVs. 14,[21][22][23] In our study, OCTA clearly visualized NV, IRMAs, and the NPA without being affected by PC scars. Moreover, it was possible to distinguish NVs from IRMAs by confirming B-scans.…”

Section: Discussionsupporting

confidence: 64%

A Proposed Classification of Intraretinal Microvascular Abnormalities in Diabetic Retinopathy Following Panretinal Photocoagulation

Shimouchi

Ishibazawa

Ishiko

et al. 2020

Invest. Ophthalmol. Vis. Sci.

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Citation: Shimouchi A, Ishibazawa A, Ishiko S, et al. A proposed classification of intraretinal microvascular abnormalities in diabetic retinopathy following panretinal photocoagulation. Invest Ophthalmol Vis Sci. 2020;61(3):34. https://doi.org/10.1167/iovs.61.3.34 PURPOSE.To investigate the characteristics of intraretinal microvascular abnormalities (IRMAs) before and after panretinal photocoagulation (PRP) for diabetic retinopathy (DR) by using optical coherence tomography angiography (OCTA). METHODS.Forty-six eyes of 29 patients with DR were included (26 eyes with severe nonproliferative diabetic retinopathy [SNPDR] and 20 eyes with proliferative diabetic retinopathy [PDR]). En face OCTA images of IRMAs in a 6 × 6-mm area were acquired by using Cirrus 5000 with AngioPlex. The morphological changes in IRMAs were evaluated before and after PRP. The changes in the IRMAs were divided into five subtypes: unchanged; tuft regression; reperfusion; mixed (combined tuft regression/reperfusion); and worsening (new appearance of tuft). RESULTS.Unchanged IRMAs were identified in 15 SNPDR eyes and 2 PDR eyes; all neovascularization (NV) had regressed after PRP. Tufts were more frequently observed in the PDR eyes (15/20, 75%) than in the SNPDR eyes (8/26, 31%) (P = 0.003), and two tufts tended to exceed the inner limiting membrane, which showed progression to NV before PRP. The reperfusion phenomenon was observed in 7/26 SNPDR eyes and 4/20 PDR eyes, including the mixed type, and showed two vascular patterns: abnormal (dilated, tortuous, and twisted) and normal vessels. The worsening type was observed in 1/26 SNPDR eye and 2/20 PDR eyes. CONCLUSIONS.OCTA enabled classification of IRMA into more detailed types. The unchanged and reperfusion types suggested that IRMAs had aspects of remodeling. However, IRMAs with tufts were observed in 75% of the PDR eyes, and the tufts had aspects of NV.

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“…Montaged images were generated from these five images using built-in software on the instrument. 15 En face OCTA images of the full retinal thickness, generated by automatically segmenting the inner limiting membrane to 70 lm above the retinal pigment epithelium, were used for analyses. OCTA imaging was performed by trained ophthalmic photographers who repeated image acquisitions several times if necessary to ensure that images with good OCT signal penetration (signal strength þ7) and minimal motion artifacts were obtained.…”

Section: Octa Imagingmentioning

confidence: 99%

Retinal Nonperfusion Relationship to Arteries or Veins Observed on Widefield Optical Coherence Tomography Angiography in Diabetic Retinopathy

Ishibazawa

Pretto

Alibhai

et al. 2019

Invest. Ophthalmol. Vis. Sci.

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Citation: Ishibazawa A, De Pretto LR, Alibhai AY, et al. Retinal nonperfusion relationship to arteries or veins observed on widefield optical coherence tomography angiography in diabetic retinopathy. Invest Ophthalmol Vis Sci. 2019;60:4310-4318. https:// doi.org/10.1167/iovs.19-26653 PURPOSE.To evaluate whether retinal capillary nonperfusion is found predominantly adjacent to arteries or veins in eyes with diabetic retinopathy (DR). METHODS.Sixty-three eyes from 44 patients with proliferative DR (PDR) or non-PDR (NPDR) were included. Images (12 3 12-mm) foveal-centered optical coherence tomography (OCT) angiography (OCTA) images were taken using the Zeiss Plex Elite 9000. In 37 eyes, widefield montages with five fixation points were also obtained. A semiautomatic algorithm that detects nonperfusion in full-retina OCT slabs was developed, and the percentages of capillary nonperfusion within the total image area were calculated. Retinal arteries and veins were manually traced. Based on the shortest distance, nonperfusion pixels were labeled as either arterial-side or venous-side. Arterial-adjacent and venous-adjacent nonperfusion and the A/V ratio (arterial-adjacent nonperfusion divided by venous-adjacent nonperfusion) were quantified.RESULTS. Twenty-two eyes with moderate NPDR, 16 eyes with severe NPDR, and 25 eyes with PDR were scanned. Total nonperfusion area in PDR (median: 8.93%) was greater than in moderate NPDR (3.49%, P < 0.01). Arterial-adjacent nonperfusion was greater than venousadjacent nonperfusion for all stages of DR (P < 0.001). The median A/V ratios were 1.93 in moderate NPDR, 1.84 in severe NPDR, and 1.78 in PDR. The A/V ratio was negatively correlated with the total nonperfusion area (r ¼ À0.600, P < 0.0001). The results from the widefield montages showed similar patterns.CONCLUSIONS. OCTA images with arteries and veins traced allowed us to estimate the nonperfusion distribution. In DR, smaller nonperfusion tends to be arterial-adjacent, while larger nonperfusion tends toward veins.

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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

Abstract: The wide-angle OCTA seems to be clinically useful for the detection of NPAs or NV.

Cited by 124 publications

References 10 publications

Evaluation of retinal nonperfusion in branch retinal vein occlusion using wide‐field optical coherence tomography angiography

Evaluation of retinal nonperfusion in branch retinal vein occlusion using wide‐field optical coherence tomography angiography

A Proposed Classification of Intraretinal Microvascular Abnormalities in Diabetic Retinopathy Following Panretinal Photocoagulation

Retinal Nonperfusion Relationship to Arteries or Veins Observed on Widefield Optical Coherence Tomography Angiography in Diabetic Retinopathy

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