THE FEASIBILITY OF ULTRA-WIDEFIELD SWEPT-SOURCE OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY TO GUIDE LASER...

This study aimed to evaluate the feasibility of ultra-widefield swept-source optical coherence tomography angiography (UWF SS-OCTA) in guiding laser photocoagulation for retinal vascular diseases.

A total of 285 eyes from 195 patients with retinal vein occlusion and diabetic retinopathy were retrospectively evaluated at the Medical Retina Department of Zhongshan Ophthalmic Center, Sun Yat-sen University, from July 24 to October 27, 2023. All patients underwent UWF SS-OCTA (VG200, Intalight Imaging, Ltd, Luoyang, China) examination with a single scan using the widefield AngioMosaic protocol. A subset of patients also underwent fluorescein fundus angiography and fundus photography based on clinical discretion. Retinal nonperfusion area, a key biomarker for guiding laser photocoagulation, along with other findings such as existing laser spots were analyzed to guide treatment.

The UWF SS-OCTA produced a 29 × 24-mm single-scan angiographic image and generated a 220° field-of-view montage. Images of the retinal superficial vascular complex could distinctly depict nonperfusion area, retinal neovascularization, and intraretinal microvascular abnormalities, while enhanced angio mode images of the choroidal capillary layer effectively demonstrated the location of existing laser spots. Using the UWF SS-OCTA findings, initial photocoagulation therapy was performed in 34.3% of patients with retinal vein occlusion and 15.8% of patients with diabetic retinopathy, and supplementary photocoagulation was applied in 13.9% of patients with retinal vein occlusion and 13.6% of patients with diabetic retinopathy.

UWF SS-OCTA images of the retinal superficial vascular complex and the choroidal capillary layer with the enhanced angio mode provide a noninvasive, efficient, and precise method for guiding retinal photocoagulation, representing a viable alternative to conventional invasive techniques.