Retinal Neovascularization Secondary to Proliferative Diabetic Retinopathy Characterized by Spectral Domain Optical Coherence Tomography

Abstract

Purpose To characterize diabetic retinal neovascularization and accompanying retinal and vitreal morphological changes using high-resolution spectral domain optical coherence tomography (SD-OCT). Methods A cross-sectional retrospective analysis was performed on 16 eyes of 14 nonconsecutive subjects with proliferative diabetic retinopathy that were seen between August 2011 and December 2011 at the New England Eye Center, Boston, Massachusetts. Patients who had neovascularization of the disc (NVD), neovascularization elsewhere (NVE) and intraretinal microvascular abnormalities (IRMAs) were scanned using OCT scans directly over the region of the abnormal vessels. Results Characteristic changes of the retinal vasculature, retina and vitreous were seen in the 16 eyes with neovascularization. This study describes OCT characteristics of: 1) NVD; 2) NVE; 3) IRMA; 4) NV causing traction without retinal detachment; 5) NV causing traction with retinal detachment. The morphologic appearance of vitreous traction was found to be consistent with previous histological reports. Conclusions It is possible to image diabetic NV using SD-OCT and to visualize the spectrum of retinal, retinal vascular and vitreal changes seen through these areas of abnormal retinal vasculature.

Proliferative Diabetic Retinopathy

“…Nevertheless, a better clinical understanding of the retinal morphology has been provided by recent Spectral Domain OCT (SD-OCT), which can correlate at the same time with FA examination. In a recent paper, the SD-OCT appearance of NVD and NVE has been described [ 9 ]. NVD on SD-OCT appears as a hyperrefl ective line protruding from the optic disk in case of vitreous detachment or sitting over it in case of posterior hyaloid adherence.…”

“…Nevertheless, in some cases it could be diffi cult to differentiate NVs from intraretinal microvascular abnormalities (IRMAs). On dilated fundus examination, IRMAs are usually visible in the deeper retina, near to cotton wool spots, and rarely around the disk, often associated to other vascular signs, including venous loops [ 9 ]. In case of unusual presentation, NVs could be clearly differentiated from IRMAs using FA examination.…”

Characteristics of Retinal Neovascularization in Proliferative Diabetic Retinopathy Imaged by Optical Coherence Tomography Angiography

“…5 Several groups have reported features of neovascularization at the disc (NVD) and neovascularization elsewhere (NVE), as well as the associated changes at the vitreoretinal interface, using cross-sectional OCT images. [6][7][8][9][10] However, B-scan OCT images cannot directly visualize newly formed vessels; thus, concise morphologic evaluation of NVD and NVE remains restricted.…”

Pyogenic Granuloma of the Retina: A Case Series

“…These new vessels occur at the vitreoretinal interface and penetrate the inner limiting membrane into the vitreous. These vessels are typically fenestrated, brittle, and leaky, which can result in vitreous hemorrhage [1-4]. Retinal vein occlusion is usually a complication of systemic hypertension or hypercoagulability, as retinal blood supply is compromised from thrombosis or obstruction of a retinal vein branch from an overlapping rigid, sclerosed arteriole, leading to disorganized neovascularization.…”

“…These etiologies include proliferative diabetic retinopathy and central retinal vein occlusion, both of which are associated with other complications, including vitreous hemorrhage and traction retinal detachment [1]. Other common etiologies of retinal neovascularization include sickle cell disease and retinopathy of prematurity [2].…”