Widefield OCT angiography

Optical coherence tomography angiography (OCTA) is a volumetric, non-invasive, high-resolution vascular imaging modality capable of acquiring highly detailed visualizations of retinal microvasculature. It has become an important tool for diagnosis and prognosis in prevalent diseases and pathologies such as diabetic retinopathy, retinopathy of prematurity, and vein occlusions, as well as more rare conditions, including inherited retinal dystrophies. It is also useful for measuring treatment response and assessing which patients would benefit from treatment. Unlike dye-based angiography, OCTA eliminates risks such as anaphylaxis. It also often outperforms fundus photography in feature detection. However, conventional OCTA imaging has been limited by its small field of view, which restricts simultaneous visualization of the posterior pole and peripheral retina, causing single images to potentially miss widely spaced critical biomarkers and pathological features. Recent technological advances in widefield OCTA have addressed this limitation, extending the field of view to the mid-periphery and beyond. This breakthrough enhances the simultaneous detection of macular and peripheral retinal pathology and significantly broadens OCTA's diagnostic and research applications. This review explores the technical innovations enabling widefield OCTA and highlights its clinical utility across various conditions, emphasizing its growing importance as a powerful tool in ophthalmic practice and research.