Abstract
Objective: To compare typical findings of diabetic retinopathy in optical coherence tomography angiography (OCTA) and fluorescein angiography (FA). Subjects/Methods: 42 patients were enrolled in this study. We performed FA and obtained en face 3 × 3 mm OCTA images of the macular region. The count of microaneurysms (MAs) and the size of the foveal avascular zone (FAZ) were compared. The assessability of the imaging modalities was graded in each eye. Results: 53 eyes of 42 patients with a mean age of 61 years were included. 36/53 eyes revealed nonproliferative diabetic retinopathy, 17/53 eyes had proliferative diabetic retinopathy. The mean size of the FAZ was 0.39 mm2 in FA and 0.42 mm2 in OCTA. The mean MA count was 14 in FA and 13 in OCTA. The assessability was favorable to OCTA in 38–41/53 eyes regarding the FAZ and favorable to FA in 45–49/53 eyes regarding MAs. Conclusion: We found a good agreement for the size of the FAZ and a weak agreement regarding the count of MAs in both imaging modalities. The readers favored OCTA for the assessment of the FAZ and FA for the assessment of MAs. Complementary use of FA and OCTA ensures the best diagnostic approach in patients with diabetic retinopathy.
References
1.
Klein
R
, Klein
BE
, Moss
SE
. The Wisconsin Epidemiologic Study of Diabetic Retinopathy. XVI. The relationship of C-peptide to the incidence and progression of diabetic retinopathy
. Diabetes
. 1995
Jul
;44
(7
):796
–801
.
[PubMed]
0012-17972.
Ishibazawa
A
, Nagaoka
T
, Takahashi
A
, Omae
T
, Tani
T
, Sogawa
K
, et al Optical coherence tomography angiography in diabetic retinopathy: a prospective pilot study
. Am J Ophthalmol
. 2015
Jul
;160
(1
):35
–44.e1
.
[PubMed]
0002-93943.
Mansour
AM
, Schachat
A
, Bodiford
G
, Haymond
R
. Foveal avascular zone in diabetes mellitus
. Retina
. 1993
;13
(2
):125
–8
.
[PubMed]
0275-004X4.
Freiberg
FJ
, Pfau
M
, Wons
J
, Wirth
MA
, Becker
MD
, Michels
S
. Optical coherence tomography angiography of the foveal avascular zone in diabetic retinopathy
. Graefes Arch Clin Exp Ophthalmol
. 2016
Jun
;254
(6
):1051
–8
.
[PubMed]
0721-832X5.
Wiley
F
, Ferris
F
. Nonproliferative diabetic retinopathy and diabetic macular edma. In: Ryan
S
, Sadda
S
, Hinton
D
, editors. Retina
. London, UK
: Elsevier Saunders
; 2013
. pp. 940
–68
. 6.
Gass
JD
. A fluorescein angiographic study of macular dysfunction secondary to retinal vascular disease. IV. Diabetic retinal angiopathy
. Arch Ophthalmol
. 1968
Nov
;80
(5
):583
–91
.
[PubMed]
0003-99507.
Kwiterovich
KA
, Maguire
MG
, Murphy
RP
, Schachat
AP
, Bressler
NM
, Bressler
SB
, et al Frequency of adverse systemic reactions after fluorescein angiography. Results of a prospective study
. Ophthalmology
. 1991
Jul
;98
(7
):1139
–42
.
[PubMed]
0161-64208.
Spaide
RF
, Klancnik
JM
Jr, Cooney
MJ
. Retinal vascular layers imaged by fluorescein angiography and optical coherence tomography angiography
. JAMA Ophthalmol
. 2015
Jan
;133
(1
):45
–50
.
[PubMed]
2168-61659.
Enders
C
, Lang
GE
, Dreyhaupt
J
, Loidl
M
, Lang
GK
, Werner
JU
. Quantity and quality of image artifacts in optical coherence tomography angiography. PLoS ONE 14(1)1:e021050510.
Chow
, David R.
, (editor.) & Oliveira, Paulo Ricardo Chaves de, (editor.) 2017
, OCT angiography, New York, NY Thieme Medical Publishers, Inc11.
Zhang
A
, Zhang
Q
, Chen
CL
, Wang
RK
. Methods and algorithms for optical coherence tomography-based angiography: a review and comparison
. J Biomed Opt
. 2015
Oct
;20
(10
):100901
.
[PubMed]
1083-366812.
Ho
J
, Dans
K
, You
Q
, Nudleman
EN
, Freeman
WR
. Comparison of 3 mm x 3 mm versus 6 mm x 6 mm optical coherence tomography angiography scan sizes in the evaluation of non-proliferative diabetic retinopathy
. Retina
. 2017
Nov
.
[PubMed]
0275-004X13.
Bunce
C
. Correlation, agreement, and Bland-Altman analysis: statistical analysis of method comparison studies
. Am J Ophthalmol
. 2009
Jul
;148
(1
):4
–6
.
[PubMed]
0002-939414.
McAlinden
C
, Khadka
J
, Pesudovs
K
. Statistical methods for conducting agreement (comparison of clinical tests) and precision (repeatability or reproducibility) studies in optometry and ophthalmology
. Ophthalmic Physiol Opt
. 2011
Jul
;31
(4
):330
–8
.
[PubMed]
0275-540815.
Wilkinson
CP
, Ferris
FL
3rd, Klein
RE
, Lee
PP
, Agardh
CD
, Davis
M
, et al; Global Diabetic Retinopathy Project Group
. Proposed international clinical diabetic retinopathy and diabetic macular edema disease severity scales
. Ophthalmology
. 2003
Sep
;110
(9
):1677
–82
.
[PubMed]
0161-642016.
Sim
DA
, Keane
PA
, Zarranz-Ventura
J
, Fung
S
, Powner
MB
, Platteau
E
, et al The effects of macular ischemia on visual acuity in diabetic retinopathy
. Invest Ophthalmol Vis Sci
. 2013
Mar
;54
(3
):2353
–60
.
[PubMed]
0146-040417.
Cao
D
, Yang
D
, Huang
Z
, Zeng
Y
, Wang
J
, Hu
Y
, et al Optical coherence tomography angiography discerns preclinical diabetic retinopathy in eyes of patients with type 2 diabetes without clinical diabetic retinopathy
. Acta Diabetol
. 2018
May
;55
(5
):469
–77
.
[PubMed]
0940-542918.
Mastropasqua
R
, Toto
L
, Mastropasqua
A
, Aloia
R
, De Nicola
C
, Mattei
PA
, et al Foveal avascular zone area and parafoveal vessel density measurements in different stages of diabetic retinopathy by optical coherence tomography angiography
. Int J Ophthalmol
. 2017
Oct
;10
(10
):1545
–51
.
[PubMed]
2222-395919.
Henke
S
, Papapostolou
I
, Heimes
B
, Lommatzsch
A
, Pauleikhoff
D
, Spital
G
. OCT-Angiography in diabetic maculopathy : comparison between microaneurysms and the foveal avascular zone with flourescein angiography
. Ophthalmologe
. 2017
Dec
.
[PubMed]
0941-293X20.
Lee
J
, Moon
BG
, Cho
AR
, Yoon
YH
. Optical coherence tomography angiography of DME and its associationwith anti-VEGF treatment response
. Ophthalmology
. 2016
Nov
;123
(11
):2368
–75
.
[PubMed]
0161-642021.
Hasegawa
N
, Nozaki
M
, Takase
N
, Yoshida
M
, Ogura
Y
. New insights into microaneurysms in the deep capillary plexus detected by optical coherence tomography angiography in diabetic macular edema
. Invest Ophthalmol Vis Sci
. 2016
Jul
;57
(9
):OCT348
–55
.
[PubMed]
0146-040422.
Ehlers
JP
, Wang
K
, Vasanji
A
, Hu
M
, Srivastava
SK
. Automated quantitative characterisation of retinal vascular leakage and microaneurysms in ultra-widefield fluorescein angiography
. Br J Ophthalmol
. 2017
Jun
;101
(6
):696
–9
.
[PubMed]
0007-116123.
ETDRS Research Group
. Grading diabetic retinopathy from stereoscopic color fundus photographs—an extension of the modified Airlie House classification. ETDRS report number 10. Ophthalmology. 191 May;98(5 Suppl):786-80624.
Miwa
Y
, Murakami
T
, Suzuma
K
, Uji
A
, Yoshitake
S
, Fujimoto
M
, et al Relationship between Functional and Structural Changes in Diabetic Vessels in Optical Coherence Tomography Angiography
. Sci Rep
. 2016
Jun
;6
(1
):29064
.
[PubMed]
2045-2322© 2019 S. Karger AG, Basel
2019
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.
