Microaneurysms visualisation using five different optical coherence tomography angiography devices compared to...

Area of Science:

• Ophthalmology
• Medical Imaging
• Diabetic Retinopathy Research

Background:

• Diabetic retinopathy (DR) is a leading cause of vision loss.
• Retinal microaneurysms (MAs) are early indicators of DR.
• Accurate MA detection is crucial for DR management.

Purpose of the Study:

• Compare the diagnostic performance of fluorescein angiography (FA) and five optical coherence tomography angiography (OCTA) devices.
• Evaluate the reproducibility of OCTA devices in detecting microaneurysms in diabetic retinopathy.
• Assess the sensitivity and specificity of different OCTA devices for MA detection.

Main Methods:

• Retinal imaging of 15 patients with DR using FA and five OCTA devices (Spectralis OCTA, PlexElite, RTVue XR Avanti, AngioPlex, DRI OCT Triton).
• Standardized 3x3 volume scan pattern applied to all OCTA devices.
• Microaneurysms (MAs) evaluated in both superficial (SCP) and deep (DCP) capillary plexuses.

Main Results:

• FA detected significantly more MAs than any OCTA device.
• Spectralis OCTA identified more MAs than other OCTA devices, particularly in the DCP.
• DRI OCT Triton demonstrated the highest specificity (78.5%) and positive predictive value (83.3%) for MA detection.

Conclusions:

• Fluorescein angiography (FA) remains the gold standard for visualizing retinal microaneurysms (MAs).
• Spectralis OCTA showed higher MA detection rates, attributed to more B-scans and repeated scans.
• Significant variability among OCTA devices necessitates careful consideration in clinical trials and practice.