scholarly journals Correlations between visual acuity and macular microvasculature quantified with optical coherence tomography angiography in diabetic macular oedema

Eye ◽  
2019 ◽  
Vol 34 (3) ◽  
pp. 544-552 ◽  
Author(s):  
Chia-Chieh Hsiao ◽  
Chung-May Yang ◽  
Chang-Hao Yang ◽  
Tzyy-Chang Ho ◽  
Tso-Ting Lai ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Macular Oedema ◽  
Optical Coherence Tomography Angiography ◽  
Diabetic Macular Oedema ◽  
Optical Coherence

Optical coherence tomography angiography in pseudophakic cystoid macular oedema compared to diabetic macular oedema: qualitative and quantitative evaluation of retinal vasculature

2018 ◽  
Vol 102 (12) ◽  
pp. 1684-1690 ◽  
Author(s):  
Riccardo Sacconi ◽  
Eleonora Corbelli ◽  
Adriano Carnevali ◽  
Stefano Mercuri ◽  
Alessandro Rabiolo ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Macular Oedema ◽  
Optical Coherence Tomography Angiography ◽  
Diabetic Macular Oedema ◽  
Foveal Avascular Zone ◽  
Cystoid Macular Oedema ◽  
Control Group ◽  
Retinal Vasculature ◽  
Ophthalmological Examination ◽  
Optical Coherence

AimsTo describe optical coherence tomography angiography (OCT-A) abnormalities of patients with pseudophakic cystoid macular oedema (PCMO) before and after pharmacological resolution, compared with diabetic macular oedema (DMO) and normal eyes.MethodsIn this retrospective, observational study, 44 eyes (30 patients) were included: 15 eyes (15 patients) affected by PCMO; 14 healthy fellow eyes used as negative control group; 15 eyes (15 age-matched and sex-matched patients) with DMO used as positive control group. All patients underwent a complete ophthalmological examination at baseline, including OCT-A scans of the macula through AngioPlex CIRRUS-5000 (Carl Zeiss Meditec, Dublin, USA). Patients with PCMO and DMO were re-evaluated after the pharmacological resolution of cystoid macular oedema (CMO).ResultsDisruption of parafoveal capillary arcade and cystoid spaces in deep capillary plexus (DCP) were frequent in patients with PCMO and DMO (73% and 100%, 87% and 100%). Capillary abnormalities and non-perfusion greyish areas in DCP were more frequent in DMO (P<0.001 and P=0.014). Patients with PCMO showed a larger foveal avascular zone area in DCP at baseline (P<0.001), which significantly reduced after treatment (P=0.001). Vessel density of full-thickness retina and DCP was reduced in patients with PCMO (P=0.022 and P=0.001), and no changes were observed after treatment. Interestingly, DCP appeared less represented in patients with DMO than PCMO subjects (P=0.001).ConclusionsPatients with PCMO have an impairment of mainly DCP, partially reversible after treatment. Furthermore, we disclosed that different alterations of the retinal vasculature characterise CMO derived from two different diseases, namely PCMO and DMO, and this could be due to their distinct pathophysiology.

Morphological and topographical appearance of microaneurysms on optical coherence tomography angiography

2018 ◽  
Vol 103 (5) ◽  
pp. 630-635 ◽  
Author(s):  
Vivian Schreur ◽  
Artin Domanian ◽  
Bart Liefers ◽  
Freerk G Venhuizen ◽  
B Jeroen Klevering ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Macular Oedema ◽  
Optical Coherence Tomography Angiography ◽  
Diabetic Macular Oedema ◽  
Optical Coherence ◽  
Retinal Area ◽  
Fundus Fluorescein Angiography ◽  
Morphological Appearance ◽  
Capillary Plexus ◽  
Retinal Microaneurysms

AimsTo investigate retinal microaneurysms in patients with diabetic macular oedema (DME) by optical coherence tomography angiography (OCTA) according to their location and morphology in relationship to their clinical properties, leakage on fundus fluorescein angiography (FFA) and retinal thickening on structural OCT.MethodsOCTA and FFA images of 31 eyes of 24 subjects were graded for the presence of microaneurysms. The topographical and morphological appearance of microaneurysms on OCTA was evaluated and classified. For each microaneurysm, the presence of focal leakage on FFA and associated retinal thickening on OCT was determined.ResultsOf all microaneurysms flagged on FFA, 295 out of 513 (58%) were also visible on OCTA. Microaneurysms with focal leakage and located in a thickened retinal area were more likely to be detected on OCTA than not leaking microaneurysms in non-thickened retinal areas (p=0.001). Most microaneurysms on OCTA were seen in the intermediate (23%) and deep capillary plexus (22%). Of all microaneurysms visualised on OCTA, saccular microaneurysms were detected most often (31%), as opposed to pedunculated microaneurysms (9%). Irregular, fusiform and mixed fusiform/saccular-shaped microaneurysms had the highest likeliness to leak and to be located in thickened retinal areas (p<0.001, p<0.001 and p=0.001).ConclusionsRetinal microaneurysms in DME could be classified topographically and morphologically by OCTA. OCTA detected less microaneurysms than FFA, and this appeared to be dependent on leakage activity and retinal thickening. Morphological appearance of microaneurysms (irregular, fusiform and mixed saccular/fusiform) was associated with increased leakage activity and retinal thickening.

scholarly journals Optical Coherence Tomography Angiography in Diabetic Patients: A Systematic Review

Biomedicines ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 88
Author(s):  
Ana Boned-Murillo ◽  
Henar Albertos-Arranz ◽  
María Dolores Diaz-Barreda ◽  
Elvira Orduna-Hospital ◽  
Ana Sánchez-Cano ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Optical Coherence Tomography ◽  
Diabetic Retinopathy ◽  
Macular Oedema ◽  
Literature Search ◽  
Optical Coherence Tomography Angiography ◽  
Diabetic Macular Oedema ◽  
Oct Angiography ◽  
Diabetic Patients ◽  
Optical Coherence

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.

Simulating vascular leakage on optical coherence tomography angiography using an overlay technique with corresponding thickness maps

2019 ◽  
Vol 104 (4) ◽  
pp. 514-517
Author(s):  
Talisa E de Carlo ◽  
Sarwar Zahid ◽  
Kelley J Bohm ◽  
R V Paul Chan ◽  
Jennifer I Lim ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Positive Predictive Value ◽  
Macular Oedema ◽  
Predictive Value ◽  
Optical Coherence Tomography Angiography ◽  
Diabetic Macular Oedema ◽  
Diabetic Patients ◽  
Optical Coherence ◽  
Retinal Pathology ◽  
Overlay Technique

BackgroundTo demonstrate a technique for using optical coherence tomography angiography (OCTA) to simulate leakage in eyes with diabetic macular oedema and determine the sensitivity and positive predictive value of detecting leaking microvasculature on OCTA using fluorescein angiography (FA) as the comparative norm.Methods6×6 mm OCT angiograms were overlaid with the corresponding OCT thickness maps. Microvascular abnormalities on the OCT angiogram underlying areas of thickening on the OCT thickness map were assumed to be leaking. Two independent readers blindly read the OCTA overlay images then the FA images cropped to the same approximate region to delineate areas of leaking microvasculature. The results were compared to determine the sensitivity and positive predictive value of OCTA for detection of leaking vessels.Results28 eyes of 19 diabetic patients were included. Each eye demonstrated an average of seven leaking microvascular abnormalities on the OCTA images and 22 leaking abnormalities on the FA images. Sensitivity of leaking microvasculature detection by OCTA was 26.1% and positive predictive value was 68.4%. The correlation coefficient of the two readers’ detection of leaking microvasculature was 0.605 for OCTA reads compared with 0.916 for FA.ConclusionOCTA as a whole can be used to simulate leakage, but currently, sensitivity of the technique is low. Further understanding of the OCTA technology may yield novel means of detecting retinal pathology.

Gender-related differences in patients treated with intravitreal anti-vascular endothelial growth factor medication for diabetic macular oedema

2020 ◽  
Vol 30 (6) ◽  
pp. 1410-1417 ◽  
Author(s):  
Johannes Schiefelbein ◽  
Michael Müller ◽  
Christoph Kern ◽  
Tina Herold ◽  
Raffael Liegl ◽  
...  
Keyword(s):  
Vascular Endothelial Growth Factor ◽  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Growth Factor ◽  
Macular Oedema ◽  
Retinal Thickness ◽  
Diabetic Macular Oedema ◽  
Vascular Endothelial ◽  
Optical Coherence ◽  
Endothelial Growth Factor

Background: Diabetes prevalence is constantly rising, involving the eyes with damage including development of diabetic macular oedema. Since 2012, intravitreal anti-vascular endothelial growth factor medication is available for diabetic macular oedema treatment. Endocrinological studies have shown that fewer women are affected by diabetes. However, when affected, they exhibit more severe diabetic complications than men. We have investigated gender-related differences in diabetic macular oedema and outcome in an ophthalmological tertiary referral hospital. Methods: We included 88 patients (54 males and 34 females) with 112 eyes (68 male and 44 female) having clinically significant diabetic macular oedema, treated with anti-vascular endothelial growth factor medication. A 1 year follow-up was performed in all patients (visual acuity and optical coherence tomography). Previous retinal surgery was an exclusion criterion, as were other retinal pathologies. Results: The mean visual acuity and mean central retinal thickness at baseline were 0.53 logMAR (male 0.49 and female 0.595) and 469 μm (male 452 μm and female: 494 μm), respectively. After 360 days, mean visual acuity changed by −0.07 (±0.36) logMAR (male −0.11 and female +0.01) and mean central retinal thickness changed by −119 μm (male −113 μm and female −127 μm). For visual acuity, a significant difference was noted at baseline ( p = 0.02) and at 1 year ( p < 0.001). Males received 5.6 injections and females received 5.68 injections in 1 year. Conclusion: Our study showed that female patients with diabetic macular oedema were diagnosed with and treated for diabetic macular oedema at a stage when visual acuity and optical coherence tomography were worse than those in their male counterparts. This gender difference could not be reduced, despite similar numbers of injections. Female diabetic patients should therefore be assessed early for ophthalmological pathologies.

scholarly journals Optic coherence tomography angiography follow-up in a case of Purtscher-like retinopathy due to atypical hemolytic uremic syndrome

2019 ◽  
Vol 30 (3) ◽  
pp. NP14-NP17 ◽  
Author(s):  
Juan Francisco Santamaría Álvarez ◽  
Anna Serret Camps ◽  
Javier Aguayo Alvarez ◽  
Olga García García
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Hemolytic Uremic Syndrome ◽  
Optical Coherence Tomography Angiography ◽  
Atypical Hemolytic Uremic Syndrome ◽  
Optical Coherence ◽  
Corrected Visual Acuity ◽  
Capillary Plexus ◽  
Uremic Syndrome ◽  
Best Corrected Visual Acuity

Purpose: To report a case of Purtscher-like retinopathy due to atypical hemolytic uremic syndrome and the changes seen in the optical coherence tomography angiography before and after treatment with eculizumab. Case description: A 22-year-old man with an unremarkable medical history presented with acute, bilateral blurred vision and headache of 1-week duration. Best corrected visual acuity of 20/50 and 20/40, respectively, in the patient’s right eye and left eye. Funduscopy revealed multiple cotton-wool spots associated with intrarretinal fluid. Swept source optical coherence tomography revealed multifocal retinal detachments with increased choroidal thickness. Optical coherence tomography angiography showed areas of ischemia in both capillary plexus. Due to concurrent symptoms and laboratory analysis, he was diagnosed with atypical hemolytic uremic syndrome and secondary Purtscher-like retinopathy; therefore, treatment with eculizumab was initiated. After 2 months revascularization of the previous ischemic areas was seen in the optical coherence tomography angiography that were correlated with best corrected visual acuity improvement. Conclusion: Our findings suggest that evaluation of the macular capillary plexus revascularization by optical coherence tomography angiography during the disease could help to predict an improvement of best corrected visual acuity in these patients and the measurement of choroidal thickness could give us information about the resolution of the pathologic process.

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