Wide-field OCTA Quantified Peripheral Nonperfusion Areas Predict the Risk of Subclinical Neovascularization

Area of Science:

• Ophthalmology
• Medical Imaging
• Diabetic Retinopathy Research

Background:

• Diabetic retinopathy (DR) is a leading cause of vision loss.
• Early detection of complications like retinal neovascularization (RNV) is crucial for timely intervention.
• Nonproliferative diabetic retinopathy (NPDR) can harbor subclinical RNV.

Purpose of the Study:

• To evaluate single-shot widefield swept-source OCT angiography (SS-OCTA) for detecting subclinical RNV in NPDR.
• To quantify nonperfusion areas (NPAs) in eyes with NPDR.
• To explore the relationship between NPAs and subclinical RNV.

Main Methods:

• SS-OCTA was performed on 37 eyes with moderate to severe NPDR.
• Subclinical RNV was identified by expert graders using OCTA features.
• Nonperfusion area (NPA) index was calculated for different retinal regions.

Main Results:

• Subclinical RNV was detected in 37.8% of eyes.
• Eyes with RNV showed significantly higher mid-peripheral and total NPA indices.
• The total NPA index demonstrated good diagnostic accuracy for subclinical RNV detection (AUC: 0.761).

Conclusions:

• Widefield SS-OCTA is capable of detecting subclinical RNV in NPDR.
• Elevated mid-peripheral NPA indices are associated with the presence of subclinical RNV.
• NPA index may serve as a valuable biomarker for identifying eyes at risk of RNV.