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Perfused and Nonperfused Microaneurysms Identified and Characterized by Structural and Angiographic OCT.

Min Gao1, Tristan T Hormel1, Yukun Guo1,2

  • 1Casey Eye Institute, Oregon Health & Science University, Portland, Oregon.

Arxiv
|October 24, 2023
PubMed
Summary

Fully perfused microaneurysms (MAs) detected with OCT/OCTA are more likely to correlate with diabetic macular edema (DME). This finding helps understand MA contribution to DME in diabetic retinopathy.

Keywords:
OCTOCT angiographyPerfused and nonperfused microaneurysms

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Area of Science:

  • Ophthalmology
  • Medical Imaging
  • Diabetic Retinopathy Research

Background:

  • Diabetic retinopathy (DR) is a leading cause of vision loss.
  • Microaneurysms (MAs) are early indicators of DR, but their association with macular edema is not fully understood.
  • Optical Coherence Tomography Angiography (OCTA) allows for detailed visualization of vascular changes in the retina.

Approach:

  • A retrospective cross-sectional study analyzed OCT and OCTA scans from 99 participants with DR.
  • Microaneurysms were identified and classified based on the presence and extent of blood flow signal (perfused vs. nonperfused).
  • The association between MA perfusion status and the presence of retinal fluid (diabetic macular edema) was quantitatively assessed.

Key Points:

  • OCT/OCTA identified 308 MAs, classified as fully perfused, partially perfused, or nonperfused.
  • Fully perfused MAs were significantly more likely to be associated with local retinal fluid compared to other types.
  • The volume of associated retinal fluid was larger for fully perfused MAs.
  • OCT/OCTA demonstrated high sensitivity in detecting MAs compared to fundus photography and fluorescein angiography.

Conclusions:

  • OCT-identified microaneurysms with detectable blood flow on OCTA are more strongly associated with diabetic macular edema.
  • This classification of MAs based on perfusion status may improve understanding and management of DME in diabetic patients.
  • OCTA provides valuable insights into the functional characteristics of MAs in DR.