Early changes to retinal structure in patients with diabetic retinopathy as determined by ultrawide swept-source optical coherence tomography-angiography

Abstract

PurposeTo investigate retinal vascular changes in patients with diabetic retinopathy (DR) using the newly developed ultrawide rapid scanning swept-source optical coherence tomography angiography (SS-OCTA) device.MethodsThis cross-sectional, observational study enrolled 24 patients (47 eyes) with DR, 45 patients (87 eyes) with diabetes mellitus (DM) without DR, and 36 control subjects (71 eyes). All subjects underwent 24 × 20 mm SS-OCTA examination. Vascular density (VD) and the thickness of the central macula (CM; 1 mm diameter) and temporal fan-shaped areas of 1–3 mm (T3), 3–6 mm (T6), 6–11 mm (T11), 11–16 mm (T16), and 16–21 mm (T21) were compared among groups. The VD and the thicknesses of the superficial vascular complex (SVC) and deep vascular complex (DVC) were analyzed separately. The predictive values of VD and thickness changes in DM and DR patients were evaluated by receiver operating characteristic (ROC) curve analysis.ResultsThe average VDs of the SVC in the CM and the T3, T6, T11, T16, and T21 areas were significantly lower in the DR than in the control group, whereas only the average VD of the SVC in the T21 area was significantly lower in the DM group. The average VD of the DVC in the CM was significantly increased in the DR group, whereas the average VDs of the DVC in the CM and T21 area were significantly decreased in the DM group. Evaluation of the DR group showed significant increases in the thicknesses of SVC-nourishing segments in the CM and T3, T6, and T11 areas and significant increases in the thicknesses of DVC-nourishing segments in the CM and T3 and T6 areas. In contrast, none of these parameters showed significant changes in the DM group. ROC curve analysis showed that the average VD of the SVC in the CM, T3, and T21 had better ability to predict DR, with areas under the ROC curves (AUCs) of 0.8608, 0.8505, and 0.8353, respectively. The average VD of the DVC in the CM was also predictive of DR, with an AUC of 0.8407.ConclusionsThe newly developed ultrawide SS-OCTA device was better able to reveal early peripheral retinal vascular changes than traditional devices.

Optical coherence tomography angiography for detection of microvascular changes in early diabetes: A systematic review and meta‐analysis

“…Using the newly developed ultra-wide field rapid scanning sweptsource optical coherence tomography angiography (SS-OCTA) device, Zeng et al 48 significant changes in the other regions. In addition, using wide-field OCTA, Xu et al 49 observed that the decrease in retinal vessel density was more marked in peripheral concentric rings with a radius of 0.9-1.2 cm.…”

“…However, the fact that the total FAZ area does not alter significantly cannot describe the absence of early DR changes. Using the newly developed ultra‐wide field rapid scanning swept‐source optical coherence tomography angiography (SS‐OCTA) device, Zeng et al 48 . had analysed the vessel density in the central macula and five peripheral concentric rings of 1–21 mm in patients with diabetes mellitus without DR.…”

Advantages of the Utilization of Wide-Field OCT and Wide-Field OCT Angiography in Clinical Practice

“…(A) WF-OCTA (24 × 20 mm) in DR can be used to quantify the vascular morphology at the peripheral retina in patients with DR [27]. Alterations in angio-OCT parameters at the peripheral retina are noted in vascular density and the thickness of vascular capillary WF-OCTA (24 × 20 mm) in DR can be used to quantify the vascular morphology at the peripheral retina in patients with DR [27].…”

“…Alterations in angio-OCT parameters at the peripheral retina are noted in vascular density and the thickness of vascular capillary WF-OCTA (24 × 20 mm) in DR can be used to quantify the vascular morphology at the peripheral retina in patients with DR [27]. Alterations in angio-OCT parameters at the peripheral retina are noted in vascular density and the thickness of vascular capillary WF-OCTA (24 × 20 mm) in DR can be used to quantify the vascular morphology at the peripheral retina in patients with DR [27]. Alterations in angio-OCT parameters at the peripheral retina are noted in vascular density and the thickness of vascular capillary complexes and can serve as predictors of DR development/progression.…”

Advances in Structural and Functional Retinal Imaging and Biomarkers for Early Detection of Diabetic Retinopathy

“…This innovative system combines high-speed imaging with an extensive field of view, enabling comprehensive and efficient examination of retinal and choroidal structures [84,85]. An observational study demonstrated that the average vascular density (VD) of the superficial vascular complex (SVC) across all observed areas was significantly lower in DR eyes compared to normal controls [86]. However, only the most peripheral area (16-21 mm) exhibited a significant decrease in VD for the DM group relative to healthy individuals, with a good receiver operating characteristic (ROC) curve value (0.8353) to predict DR.…”