Optical Coherence Tomography Angiography Contributions in Classification of Nonproliferative Diabetic Retinopathy

Armin Kasumovic; Ines Matoc; Nesina Avdagic; Tarik Halimic; Bahrija Voloder; Lejla Muhamedagic; Seldjana Catovic Delic; Irena Sesar

doi:10.5455/aim.2020.28.103-107

Optical Coherence Tomography Angiography Contributions in Classification of Nonproliferative Diabetic Retinopathy

Acta Inform Med. 2020 Jun;28(2):103-107. doi: 10.5455/aim.2020.28.103-107.

Authors

Armin Kasumovic¹, Ines Matoc¹, Nesina Avdagic², Tarik Halimic¹, Bahrija Voloder¹, Lejla Muhamedagic¹, Seldjana Catovic Delic³, Irena Sesar⁴

Affiliations

¹ Eye Polyclinic "Sefic", Sarajevo, Bosnia and Herzegovina.
² Department of Human Physiology, Faculty of Medicine, University of Sarajevo, Bosnia and Herzegovina.
³ Cantonal Public Institution Health Center of Sarajevo, Bosnia and Herzegovina.
⁴ University Clinical Hospital Mostar, Bosnia and Herzegovina.

Abstract

Introduction: To show the importance of optical coherence tomography (OCT) angiography imaging of superficial and deep capillary network in patients with non-proliferative diabetic retinopathy (NPDR), and to show the correlation between blood glucose level and changes in the foveal microvasculature.

Methods: A cross-sectional study was performed on eyes with NPDR and healthy subjects using a highspeed 840-nm-wavelength spectral-domain optical coherence tomography instrument (RTVue XR Avanti; Optovue, Inc, Fremont, California, USA). Blood flow was detected using the split-spectrum amplitude-decorrelation angiography algorithm. A fully automated microstructural analysis of the foveal avascular zone (FAZ) and avascular surfaces was performed. Quantitative values from diabetic patients were compared with those of healthy subjects. Data about blood status in diabetic patients and healthy subjects were taken from patients' medical history.

Results: Size of both, FAZ and vascular dropout are significantly different between healthy patients and patients with NPDR. OCT angiography detected enlargement and distortion of the foveal avascular zone, retinal capillary dropout, and a higher number of vascular loops and microaneurysms. Sizes of FAZ and vascular dropout increase with the duration of disease. Central macular thickness (CMT) is not significantly different between healthy patients and patients with NPDR. A study has proven a positive correlation between the size of FAZ and the size of vascular dropout in superficial vascular plexus in patients that have DM over 10 years.

Conclusion: A qualitative and quantitative OCT angiography approach to retinal vascular status can offer objective data on monitoring patients with non-proliferative diabetic retinopathy as well as indicate the progression of the disease.

Keywords: Optical Coherence Tomography Angiography; diabetes; diabetic retinopathy; foveal avascular zone; non-proliferative diabetic retinopathy; vascular drop-out.