Early Sign of Retinal Neovascularization Evolution in Diabetic Retinopathy: A Longitudinal OCT Angiography Study

Area of Science:

• Ophthalmology
• Medical Imaging
• Diabetic Retinopathy Research

Background:

• Diabetic retinopathy (DR) is a leading cause of vision loss.
• Early detection of retinal neovascularization (RNV) is crucial for preventing vision impairment.
• Current imaging methods may not detect subtle, early structural changes preceding overt RNV.

Purpose of the Study:

• To evaluate if combined en face OCT and OCT angiography (OCTA) can detect subtle structural changes indicative of early retinal neovascularization (RNV) in diabetic retinopathy (DR).
• To assess the capability of OCT and OCTA in identifying early RNV stages before they are clinically apparent.

Main Methods:

• A retrospective, longitudinal study involving patients with DR and at least two visits.
• Wide-field OCTA scans were acquired, generating en face OCT, en face OCTA, and cross-sectional OCTA images.
• Eyes were analyzed for RNV sprouts and fronds, with longitudinal follow-up to track progression.

Main Results:

• The combination of OCT and OCTA identified RNV in 20 of 71 eyes, with most cases graded as proliferative or severe nonproliferative DR.
• 38 RNV sprouts and 26 RNV fronds were identified at baseline.
• Fifty percent of eyes showed progression, with RNV sprouts evolving into fronds over a mean interval of 7.0 months.

Conclusions:

• Combined en face OCT and cross-sectional OCTA can identify an earlier form of RNV.
• These imaging techniques detect RNV at a stage preceding its recognition on en face OCTA alone.
• This approach may enable earlier detection and intervention for RNV in diabetic retinopathy.