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Microaneurysm Imaging Using Multiple En Face OCT Angiography Image Averaging: Morphology and Visualization.

Yoshihiro Kaizu¹, Shintaro Nakao¹, Iori Wada¹

¹Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

Ophthalmology. Retina

|November 23, 2019

Summary

Multiple image averaging significantly enhances optical coherence tomography angiography (OCTA) for detecting microaneurysms in diabetic retinopathy (DR). This technique is particularly effective for identifying focal bulge-type microaneurysms, improving diagnostic capabilities.

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Area of Science:

Ophthalmology
Medical Imaging
Diabetic Retinopathy Research

Background:

Diabetic retinopathy (DR) diagnosis relies on imaging techniques like fluorescein angiography (FA) and optical coherence tomography angiography (OCTA).
OCTA has limitations in detecting all microaneurysms identified by FA in DR patients.

Purpose of the Study:

To investigate if multiple image averaging can improve the detection of microaneurysms using OCTA in patients with diabetic retinopathy.
To assess the correlation between microaneurysm characteristics and the required image averaging for OCTA detection.

Main Methods:

A prospective, cross-sectional observational study involving 31 patients (62 eyes) with DR.
OCTA imaging (Canon HS-100) was performed 10 consecutive times, with comparisons made between single, 3x, 5x, and 10x averaged images.
Microaneurysm detection was compared against single-scan OCTA images from a different device (RTVue XR Avanti).

Main Results:

Microaneurysm detection increased significantly with image averaging: 34.7% (single) to 73.7% (10x average).
Detection capability was not correlated with retinal thickness or FA leakiness.
Microaneurysm morphology, especially focal bulge types, showed a significant correlation with visibility after image averaging (P < 0.01).

Conclusions:

Multiple image averaging is a valuable technique to enhance microaneurysm detection using OCTA in diabetic retinopathy.
This method is especially beneficial for visualizing focal bulge-type microaneurysms, improving diagnostic accuracy in DR.