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Widefield optical coherence tomography angiography in diabetic retinopathy

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Abstract

Aims

To evaluate superficial capillary plexus (SCP), deep capillary plexus (DCP) and choriocapillaris (CC) perfusion in macular and near/mid periphery regions in diabetic patients using widefield swept-source optical coherence tomography angiography (WSS-OCTA).

Methods

Ninety-four diabetic patients (94 eyes) classified as diabetics without diabetic retinopathy (no DR) (25 eyes), mild DR (23 eyes), moderate/severe DR (26 eyes), proliferative DR (20 eyes) and a control group of 25 healthy subjects (25 eyes) were imaged with the WSS-OCTA system (PLEX Elite 9000, Carl Zeiss Meditec Inc., Dublin, CA, USA). Quantitative analysis was performed in the macular and peripheral regions. The main outcome measures were perfusion density (PD) and vessel length density of SCP, DCP and CC.

Results

Peripheral retina (all sectors) showed lower SCP and DCP PD compared to the macular region (p  < 0.001). In diabetics without DR and DR in different stages, SCP and DCP PD significantly decreased at advancing stages of DR (p  < 0.001). At DCP level, central PD was significantly directly related to peripheral PD (superior, R = 0.682 and 0.479; temporal, R  = 0.918 and 0.554; inferior, R  = 0.711). A good sensitivity and an excellent specificity were found in terms of prediction of disease worsening, especially for central and temporal sectors in all plexuses and for all sectors both central and peripheral of DCP.

Conclusions

The widefield OCTA is useful for the study of central and peripheral retina in diabetic patients with or without diabetic retinopathy, assessing good correlation between central and peripheral retina.

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Author notes

  1. Rodolfo Mastropasqua and Rossella D’Aloisio authors have contributed equally to this work and should be considered as co-first authors.

Authors and Affiliations

  1. Vitreoretinal Unit, Bristol Eye Hospital, University of Bristol, Bristol, UK

    Rodolfo Mastropasqua

  2. Eye Clinic, Polytechnic University of Marche, 60126, Ancona, Italy

    Rodolfo Mastropasqua

  3. Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D’Annunzio Chieti-Pescara, Via dei Vestini 31, 66100, Chieti, Italy

    Rossella D’Aloisio, Luca Di Antonio, Emanuele Erroi, Federica Evangelista, Giada D’Onofrio & Lisa Toto

  4. Department of Ophthalmology, University Vita Salute, IRCCS Ospedale San Raffaele, 20132, Milan, Italy

    Enrico Borrelli

  5. Laboratory of Biostatistics, Department of Medical, Oral and Biotechnological Sciences, University “G. d’Annunzio” Chieti-Pescara, 66100, Chieti, Italy

    Marta Di Nicola

  6. Department of Medicine and Science of Ageing, School of Hygiene and Preventive Medicine, University G. d’Annunzio Chieti-Pescara, 66100, Chieti, Italy

    Giuseppe Di Martino

Authors
  1. Rodolfo Mastropasqua
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  2. Rossella D’Aloisio
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Correspondence to Rossella D’Aloisio.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee (Ophthalmology Clinic, Department of Medicine and Science of Ageing) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Mastropasqua, R., D’Aloisio, R., Di Antonio, L. et al. Widefield optical coherence tomography angiography in diabetic retinopathy. Acta Diabetol 56, 1293–1303 (2019). https://doi.org/10.1007/s00592-019-01410-w

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  • DOI: https://doi.org/10.1007/s00592-019-01410-w

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