Optical Coherence Tomography Angiography Findings in Proliferative Diabetic Retinopathy.

Area of Science:

• Ophthalmology
• Medical Imaging
• Diabetic Retinopathy Research

Background:

• Proliferative diabetic retinopathy (PDR) is characterized by the growth of new blood vessels (neovascularization, NV).
• Understanding the routes of NV proliferation is crucial for managing PDR.
• Traditional imaging methods like fluorescein angiography (FA) have limitations in visualizing NV details.

Purpose of the Study:

• To characterize preretinal neovascularizations (NV) and their branching routes in PDR using optical coherence tomography angiography (OCTA).
• To compare OCTA findings with those from fluorescein angiography (FA).

Main Methods:

• Spectral-domain OCTA and FA were performed on patients with PDR.
• Neovascularization of the disc (NVD) and elsewhere (NVE) were analyzed using OCTA flow images and B-scans.
• Two independent investigators compared OCTA and FA findings.

Main Results:

• Seventy-six NV with proliferation routes were analyzed in 42 eyes.
• The posterior hyaloid membrane (PHM) was the main proliferation route (72.4%).
• OCTA was superior or equivalent to FA in detecting NV in most cases (38/42 eyes), offering more detailed vessel information.

Conclusions:

• OCTA is a valuable, non-invasive tool for detecting and characterizing NV in PDR.
• OCTA provides better visualization of NV by avoiding dye leakage artifacts seen in FA.
• FA remains essential for comprehensive NV detection due to OCTA's smaller field of view.
• The PHM is identified as the primary route for diabetic NV proliferation.