Optical coherence tomography angiography in diabetic retinopathy

Area of Science:

• Ophthalmology
• Medical Imaging
• Diabetology

Background:

• Diabetic retinopathy (DR) assessment and treatment present ongoing challenges.
• Optical coherence tomography angiography (OCTA) is a non-invasive 3D imaging technique visualizing retinal capillaries.
• OCTA aids in detecting early microvascular changes and quantifying DR extent.

Purpose of the Study:

• To review current and emerging OCTA metrics for assessing diabetic retinopathy (DR) in clinical trials.
• To highlight the importance of full-retinal slab and wide-field OCTA imaging for comprehensive DR evaluation.
• To emphasize the need for automated analysis and quality control in OCTA for DR studies.

Main Methods:

• Review of existing literature on OCTA applications in diabetic retinopathy.
• Identification of key OCTA metrics for DR assessment (e.g., FAZ, vessel density, neovascularization).
• Discussion of imaging strategies including full-retinal slab and wide-field OCTA, and automated analysis.

Main Results:

• OCTA provides quantitative metrics like foveal avascular zone (FAZ) area and vessel density for DR assessment.
• Full-retinal slab OCTA minimizes segmentation errors and confounding factors.
• Wide-field OCTA is important for evaluating peripheral retinal vasculature and DR progression.

Conclusions:

• OCTA is a valuable tool for assessing DR pathology and complications, offering quantitative insights.
• Standardized OCTA metrics, advanced imaging fields, and automated analysis are essential for reliable clinical trials.
• Addressing image quality and incorporating re-imaging protocols are critical for robust OCTA data in DR research.