Detection rate of diabetic macular microaneurysms comparing dye-based angiography and optical coherence tomography angiography

Stattin, Martin; Haas, Anna-Maria; Ahmed, Daniel; Stolba, U.; Gráf, Alexandra; Krepler, Katharina; Ansari-Shahrezaei, Siamak

doi:10.1038/s41598-020-73516-z

Cited by 14 publications

(14 citation statements)

References 32 publications

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“…[ 60 ]. These results have been supported by other studies [ 19 , 61 ]. Soares and colleagues compared FA and OCTA AngioVue and AngioPlex, with FA being superior to both for detecting MAs in both the SCP and total retina slab [ 28 ].…”

Section: Resultssupporting

confidence: 91%

Optical Coherence Tomography Angiography in Diabetic Patients: A Systematic Review

et al. 2021

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Background: Diabetic retinopathy (DR) is the leading cause of legal blindness in the working population in developed countries. Optical coherence tomography (OCT) angiography (OCTA) has risen as an essential tool in the diagnosis and control of diabetic patients, with and without DR, allowing visualisation of the retinal and choroidal microvasculature, their qualitative and quantitative changes, the progression of vascular disease, quantification of ischaemic areas, and the detection of preclinical changes. The aim of this article is to analyse the current applications of OCTA and provide an updated overview of them in the evaluation of DR. Methods: A systematic literature search was performed in PubMed and Embase, including the keywords “OCTA” OR “OCT angiography” OR “optical coherence tomography angiography” AND “diabetes” OR “diabetes mellitus” OR “diabetic retinopathy” OR “diabetic maculopathy” OR “diabetic macular oedema” OR “diabetic macular ischaemia”. Of the 1456 studies initially identified, 107 studies were screened after duplication, and those articles that did not meet the selection criteria were removed. Finally, after looking for missing data, we included 135 studies in this review. Results: We present the common and distinctive findings in the analysed papers after the literature search including the diagnostic use of OCTA in diabetes mellitus (DM) patients. We describe previous findings in retinal vascularization, including microaneurysms, foveal avascular zone (FAZ) changes in both size and morphology, changes in vascular perfusion, the appearance of retinal microvascular abnormalities or new vessels, and diabetic macular oedema (DME) and the use of deep learning technology applied to this disease. Conclusion: OCTA findings enable the diagnosis and follow-up of DM patients, including those with no detectable lesions with other devices. The evaluation of retinal and choroidal plexuses using OCTA is a fundamental tool for the diagnosis and prognosis of DR.

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Section: Resultssupporting

confidence: 91%

Optical Coherence Tomography Angiography in Diabetic Patients: A Systematic Review

et al. 2021

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“…MAs are generally the earliest signs of clinically visible retinal damage and are a hallmark of DME. Accurate identification is important because their distribution and number provide prognostic information about the severity of DM and are also clinically relevant as a guide for the treatment of DME [ 18 ]. Indeed, the reduction of macular oedema is associated with the non-perfusion area, neovascularization, and number of MAs [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

“…There are various reports on the characteristics of MAs in patients with DME as detected by angiography. FA is more sensitive at detecting MAs than is IA or OCTA, and the former can detect leakage from MAs, the cause of retinal oedema [ 11 , 18 ]. IA can easily detect large MAs with high clinical significance [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

“…IA can easily detect large MAs with high clinical significance [ 19 ]. MA-detection sensitivity of OCTA is same as that of IA and FA [ 18 , 20 ], and the former method can detect MAs in the retinal capillary plexus by stratified analysis [ 21 ]. However, OCTA has some limitations associated with artefacts and segmentation errors when evaluating an oedematous retinal layer in patients with DME [ 22 ].…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of microaneurysms as predictors of therapeutic response to anti-VEGF therapy in patients with DME

et al. 2022

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Administration of intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy is the first-line therapy for diabetic macular oedema (DME). However, some patients show no or insufficient response to repeated anti-VEGF injections. Therefore, it is necessary to identify factors that can predict this resistance against anti-VEGF treatment. Presence of microaneurysms (MAs) is a predictor of the development and progression of DME, but its relationship with the treatment response to the anti-VEGF agents is not well known. Therefore, we aimed to elucidate the relationship between the distribution of MAs and the response to anti-VEGF therapy in patients with DME. The number of MAs was measured before anti-VEGF therapy in each region using fluorescein angiography, indocyanine green angiography (IA), and optical coherence tomography angiography. Patients with DME were divided into the responder and non-responder groups after three loading phases. Differences in the distribution of MAs between the groups were investigated. Pre-treatment IA revealed more MAs in the nasal area in the non-responder group than in the responder group (10.7 ± 10.7 and 5.7 ± 5.7, respectively, in the nasal macula) (1.4 ± 2.1 and 0.4 ± 0.7, respectively, in the nasal fovea). Whereas, pre-treatment FA and OCTA could not reveal significantly difference between the groups. Detection of MAs in the nasal macula using pre-treatment IA may indicate resistance to anti-VEGF therapy. We recommend the clinicians confirm the presence of MAs in the nasal macula, as shown by IA, as a predictor of therapeutic response to anti-VEGF therapy in patients with treatment naive DME.

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“…Finally, in relation to our case study, the FA and OCTA image registration problem has been addressed manually or semi-automatically [24][25][26][27], but it has recently started to be solved automatically [17,28,29]. However, all existing automated approaches in the related medical literature are based on rigid transformations.…”

Section: Related Workmentioning

confidence: 99%

Deformable registration of multimodal retinal images using a weakly supervised deep learning approach

Martínez-Río

Carmona

Cancelas

et al. 2023

Neural Comput & Applic

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There are different retinal vascular imaging modalities widely used in clinical practice to diagnose different retinal pathologies. The joint analysis of these multimodal images is of increasing interest since each of them provides common and complementary visual information. However, if we want to facilitate the comparison of two images, obtained with different techniques and containing the same retinal region of interest, it will be necessary to make a previous registration of both images. Here, we present a weakly supervised deep learning methodology for robust deformable registration of multimodal retinal images, which is applied to implement a method for the registration of fluorescein angiography (FA) and optical coherence tomography angiography (OCTA) images. This methodology is strongly inspired by VoxelMorph, a general unsupervised deep learning framework of the state of the art for deformable registration of unimodal medical images. The method was evaluated in a public dataset with 172 pairs of FA and superficial plexus OCTA images. The degree of alignment of the common information (blood vessels) and preservation of the non-common information (image background) in the transformed image were measured using the Dice coefficient (DC) and zero-normalized cross-correlation (ZNCC), respectively. The average values of the mentioned metrics, including the standard deviations, were DC = 0.72 ± 0.10 and ZNCC = 0.82 ± 0.04. The time required to obtain each pair of registered images was 0.12 s. These results outperform rigid and deformable registration methods with which our method was compared.

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Detection rate of diabetic macular microaneurysms comparing dye-based angiography and optical coherence tomography angiography

Cited by 14 publications

References 32 publications

Optical Coherence Tomography Angiography in Diabetic Patients: A Systematic Review

Optical Coherence Tomography Angiography in Diabetic Patients: A Systematic Review

Evaluation of microaneurysms as predictors of therapeutic response to anti-VEGF therapy in patients with DME

Deformable registration of multimodal retinal images using a weakly supervised deep learning approach

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