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Diagnostics
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Optical Coherence Tomography Angiography: Value for Retinal Diseases Diagnostics
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Optical Coherence Tomography Angiography: Value for Retinal Diseases Diagnostics

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Biomedical Optics".

Deadline for manuscript submissions: closed (31 August 2022) | Viewed by 12924

Special Issue Editors

Dr. Sara Vaz-Pereira

E-Mail Website
Guest Editor
1. Centro Hospitalar Lisboa Norte - Hospital de Santa Maria, Lisbon, Portugal
2. Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
Interests: medical retina; retinal imaging; OCT; OCT-angiography
Dr. Gabriella De Salvo

E-Mail Website
Guest Editor
Southampton Eye Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK
Interests: age related macular degeneration; retinal vascular diseases; intraocular tumours; retinal imaging
Dr. Rosa Dolz-Marco

E-Mail Website
Guest Editor
Unit of Macula, Oftalvist Clinic, Valencia, Spain
Interests: retina; imaging; AMD; atrophy; neovascularization

Special Issue Information

Dear Colleagues, 

Retinal diseases are among the most prevalent and potentially blinding eye conditions. In the current times of multimodal imaging with an emphasis on early diagnosis and sensitive monitoring of disease, optical coherence tomography angiography (OCTA) is becoming widely used in many retinal pathologies. OCTA is noninvasive and can obviate the need for conventional angiography, while offering new and important information. Furthermore, the technology is advancing rapidly, with better resolution, field of view, and software, making it appropriate for both macular and panretinal diseases.

This Special Issue aims to collect articles focused on the value of OCTA in the diagnostic and evaluation of any retinal disease (e.g., age-related macular degeneration, diabetic retinopathy, retinal vein occlusion, inherited retinal dystrophies), while reflecting upon innovative research and emerging ideas.

With the generalization of the use of OCTA and the need to be familiar and experienced with this technology, we believe this collection will enrich the reader’s knowledge.

Dr. Sara Vaz-Pereira
Dr. Gabriella De Salvo
Dr. Rosa Dolz-Marco
Guest Editors

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Published Papers (6 papers)

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Research

9 pages, 6668 KiB  
Article
A Comparative Study of Choroidal Vascular and Structural Characteristics of Typical Polypoidal Choroidal Vasculopathy and Polypoidal Choroidal Neovascularization: OCTA-Based Evaluation of Intervortex Venous Anastomosis
by Figen Batıoğlu, Özge Yanık, Ferhad Özer, Sibel Demirel and Emin Özmert
Diagnostics 2023, 13(1), 138; https://doi.org/10.3390/diagnostics13010138 - 31 Dec 2022
Cited by 3 | Viewed by 1438
Abstract
Background: The aim of this study was to compare the choroidal characteristics of typical polypoidal choroidal vasculopathy (T-PCV) and polypoidal choroidal neovascularization (P-CNV) cases, and to investigate the presence of intervortex venous anastomoses in these PCV subtypes by using en face optical coherence [...] Read more.
Background: The aim of this study was to compare the choroidal characteristics of typical polypoidal choroidal vasculopathy (T-PCV) and polypoidal choroidal neovascularization (P-CNV) cases, and to investigate the presence of intervortex venous anastomoses in these PCV subtypes by using en face optical coherence tomography angiography (OCTA). Methods: A total of 35 eyes of 33 PCV cases were included. The PCV cases were divided into T-PCV and P-CNV groups. The choroidal vascularity index (CVI) was calculated. En face OCTA images were evaluated for the presence of intervortex venous anastomoses. The diameter of the largest anastomotic Haller vessel was measured. Results: T-PCV cases had significantly higher mean CVI values (73.9 ± 3.7 vs. 70.8 ± 4.5%) than P-CNV cases (p = 0.039). Intervortex venous anastomoses were observed in 85.7% of T-PCV eyes and in 91.7% of P-CNV eyes on en face OCTA (p = 1.000). In the cases with intervortex venous anastomosis, the mean diameter of the largest anastomotic vessel on en face OCTA was 341.2 ± 109.1 µm in the T-PCV and 280.4 ± 68.4 µm in the P-CNV group (p = 0.048). Conclusions: The higher CVI value in T-PCV may be an important feature concerning the pathogenesis and classification of PCV. Although there was no difference between the two subtypes in terms of intervortex anastomosis, more dilated anastomotic vessels were observed in the T-PCV. Full article
(This article belongs to the Special Issue Optical Coherence Tomography Angiography: Value for Retinal Diseases Diagnostics)
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11 pages, 730 KiB  
Article
OCT Angiography Features in Diabetes Mellitus Type 1 and 2
by Giovanni William Oliverio, Alessandro Meduri, Gabriella De Salvo, Luigi Trombetta and Pasquale Aragona
Diagnostics 2022, 12(12), 2942; https://doi.org/10.3390/diagnostics12122942 - 25 Nov 2022
Cited by 4 | Viewed by 2317
Abstract
Purpose: To study the foveal avascular zone (FAZ) and the vessel densities (VD) in diabetic patients using optical coherence tomography angiography (OCT-A) and inner retinal layer changes to compare patients affected by type 1 diabetes (DM1) and type 2 diabetes (DM2). Methods [...] Read more.
Purpose: To study the foveal avascular zone (FAZ) and the vessel densities (VD) in diabetic patients using optical coherence tomography angiography (OCT-A) and inner retinal layer changes to compare patients affected by type 1 diabetes (DM1) and type 2 diabetes (DM2). Methods: Cross-sectional observational study involving 150 eyes of 150 patients with DM1, and 155 eyes of 155 patients with DM2 with diabetic retinopathy (DR). Retinal nerve fiber layer (RNFL) and Ganglion cell layer (GCL) were evaluated. OCT-A studied both FAZ and VD at the level of the superficial capillary plexus (SCP) and the deep capillary plexus (DCP). Results: A statistically significant difference in FAZ area and foveal VD measured at the SCP (p < 0.001) was noted between DM1 and DM2 groups when comparing patients with mild and moderate non-proliferative diabetic retinopathy (NPDR), while no differences were found in the severe NPDR and proliferative diabetic retinopathy (PDR) subgroups. Duration of diabetes and stage of DR were directly correlated with enlargement of FAZ area and inversely correlated with foveal VD measured at SCP. RNFL and GCL were not different between DM1 and DM2 groups. Conclusion: Changes in OCT-A parameters detected in FAZ area and VD of diabetic patients with different stages of DR may help to predict the risk for progression of the disease. Full article
(This article belongs to the Special Issue Optical Coherence Tomography Angiography: Value for Retinal Diseases Diagnostics)
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10 pages, 1159 KiB  
Article
The Architecture of Macular Neovascularizations Predicts Treatment Responses to Anti-VEGF Therapy in Neovascular AMD
by Henrik Faatz, Kai Rothaus, Martin Ziegler, Marius Book, Georg Spital, Clemens Lange and Albrecht Lommatzsch
Diagnostics 2022, 12(11), 2807; https://doi.org/10.3390/diagnostics12112807 - 15 Nov 2022
Cited by 6 | Viewed by 1615
Abstract
Introduction: Anti-VEGF therapy is an effective option for improving and stabilizing the vision in neovascular age-related macular degeneration (nAMD). However, the response to treatment is markedly heterogeneous. The aim of this study was therefore to analyze the vascular characteristics of type 1,2, and [...] Read more.
Introduction: Anti-VEGF therapy is an effective option for improving and stabilizing the vision in neovascular age-related macular degeneration (nAMD). However, the response to treatment is markedly heterogeneous. The aim of this study was therefore to analyze the vascular characteristics of type 1,2, and 3 macular neovascularizations (MNV) in order to identify biomarkers that predict treatment response, especially with regard to changes in intraretinal and subretinal fluid. Materials and Methods: Overall, 90 treatment-naive eyes with nAMD confirmed by optic coherence tomography (OCT), fluorescein angiography, and OCT angiography (OCTA) were included in this retrospective study. The MNV detected by OCTA were subjected to quantitative vascular analysis by binarization and skeletonization of the vessel using ImageJ. We determined their area, total vascular length (sumL), fractal dimension (FD), flow density, number of vascular nodes (numN), and average vascular diameter (avgW). The results were correlated with the treatment response to the initial three injections of anti-VEGF and the changes in intraretinal (IRF) and subretinal fluid (SRF) and the occurrence of pigment epithelial detachements (PED). Results: All patients found to have no subretinal or intraretinal fluid following the initial three injections of anti-VEGF showed a significantly smaller MNV area (p < 0.001), a lower sumL (p < 0.0005), and lesser FD (p < 0.005) before treatment than those who still exhibited signs of activity. These parameters also showed a significant influence in the separate analysis of persistent SRF (p < 0.005) and a persistent PED (p < 0.05), whereas we could not detect any influence on changes in IRF. The vascular parameters avgW, numN, and flow density showed no significant influence on SRF/IRF or PED changes. Conclusions: The size, the total vessel length, and the fractal dimension of MNV at baseline are predictors for the treatment response to anti-VEGF therapy. Therefore, particularly regarding the development of new classes of drugs, these parameters could yield new insights into treatment response. Full article
(This article belongs to the Special Issue Optical Coherence Tomography Angiography: Value for Retinal Diseases Diagnostics)
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12 pages, 297 KiB  
Article
Long-Term Functional Hyperemia after Uncomplicated Phacoemulsification: Benefits beyond Restoring Vision
by Ana Ćurić, Mirjana Bjeloš, Mladen Bušić, Biljana Kuzmanović Elabjer, Benedict Rak and Nenad Vukojević
Diagnostics 2022, 12(10), 2449; https://doi.org/10.3390/diagnostics12102449 - 10 Oct 2022
Cited by 1 | Viewed by 1508
Abstract
The purpose of the study was to investigate the long-term effects of uncomplicated phacoemulsification on macular perfusion using optical coherence tomography angiography (OCTA) in healthy aging subjects. OCTA was performed before phacoemulsification and 1 week, 1 month, 3 months, and 6 months after. [...] Read more.
The purpose of the study was to investigate the long-term effects of uncomplicated phacoemulsification on macular perfusion using optical coherence tomography angiography (OCTA) in healthy aging subjects. OCTA was performed before phacoemulsification and 1 week, 1 month, 3 months, and 6 months after. Superficial vascular complex (formed of nerve fiber layer vascular plexus and superficial vascular plexus), deep vascular complex (formed of intermediate capillary plexus and deep capillary plexus), as well as choriocapillaris (CC) and large choroidal blood vessels were recorded. Significant changes of vascular parameters in 95 eyes of 95 patients reached plateau 1 week after surgery and remained stable up to 6 months, occurring in all retinal layers but not in choroid and CC. Statistically significant increases in retinal vessels area, vessels percentage area, total number of junctions, junctions density, and total and average vessels length were found, followed by the total number of end points and mean lacunarity decline, proving an increase in blood supply. The study confirmed that uncomplicated phacoemulsification leads to a long-term increase in macular retinal perfusion. The results might ease the decision regarding timing for cataract surgery as long-term perfusion benefits can be achieved. Furthermore, study results provide a normative database of retinal and choroidal vasculature in healthy aging patients. Full article
(This article belongs to the Special Issue Optical Coherence Tomography Angiography: Value for Retinal Diseases Diagnostics)
13 pages, 3099 KiB  
Article
Choroidal Vascular Impairment in Intermediate Age-Related Macular Degeneration
by Rita Flores, Ângela Carneiro, Guilherme Neri, Ana C. Fradinho, Bruno Quenderra, Maria João Barata, Sandra Tenreiro and Miguel C. Seabra
Diagnostics 2022, 12(5), 1290; https://doi.org/10.3390/diagnostics12051290 - 22 May 2022
Cited by 4 | Viewed by 2340
Abstract
Age-related macular degeneration (AMD) is a multifactorial disease, whose complete pathogenesis is still unclear. Local hemodynamics may play a crucial role in its manifestation and progression. To evaluate choroidal and retinal vascular parameters, a total of 134 eyes were analyzed, 100 with intermediate [...] Read more.
Age-related macular degeneration (AMD) is a multifactorial disease, whose complete pathogenesis is still unclear. Local hemodynamics may play a crucial role in its manifestation and progression. To evaluate choroidal and retinal vascular parameters, a total of 134 eyes were analyzed, 100 with intermediate AMD and 34 age matched healthy controls. 131 eyes of 104 patients were eligible for complete image assessment and 3 eyes were excluded for insufficient image quality: Group 1: intermediate AMD (n = 97) and Group 2: healthy controls (n = 34). Spectral domain optic coherence tomography (SD-OCT) with enhanced depth imaging (EDI) and optic coherence tomography angiography (OCT-A) were acquired using Spectralis (Heidelberg Engineering). Choroid and retinal capillary plexus were evaluated and image binarization was used to obtain quantitative data. Mean age was 77.67 years old (YO) and 67.2% were women. Total subfoveal choroidal area and luminal area were significantly reduced in Group 1 compared with Group 2 (0.88 mm2 and 0.40 mm2 vs. 1.24 mm2 and 0.55 mm2, respectively) (p < 0.05). Regarding choriocapillary flow density, AMD eyes recorded reduced values (34.83%) compared with controls (36.25%) (p < 0.05). Chorioretinal vasculature is impaired in intermediate AMD patients and vascular parameters could be attractive new prognostic biomarkers. Future therapeutic approaches may target this vascular dysfunction and delay disease progression. Full article
(This article belongs to the Special Issue Optical Coherence Tomography Angiography: Value for Retinal Diseases Diagnostics)
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13 pages, 1887 KiB  
Article
Correlation of Optical Coherence Tomography Angiography Characteristics with Visual Function to Define Vision-Threatening Diabetic Macular Ischemia
by Wei-Shan Tsai, Sridevi Thottarath, Sarega Gurudas, Piyali Sen, Elizabeth Pearce, Andrea Giani, Victor Chong, Chui Ming Gemmy Cheung and Sobha Sivaprasad
Diagnostics 2022, 12(5), 1050; https://doi.org/10.3390/diagnostics12051050 - 22 Apr 2022
Cited by 5 | Viewed by 2916
Abstract
The thresholds of macular microvasculature parameters associated with mild visual impairment in diabetic macular ischemia (DMI) patients are unclear. Therefore, this prospective observational study is aimed at demonstrating the optical coherence tomography angiography parameters that best correlate with mild visual impairment (<70 Early [...] Read more.
The thresholds of macular microvasculature parameters associated with mild visual impairment in diabetic macular ischemia (DMI) patients are unclear. Therefore, this prospective observational study is aimed at demonstrating the optical coherence tomography angiography parameters that best correlate with mild visual impairment (<70 Early Treatment Diabetic Retinopathy Study (ETDRS) letters, Snellen equivalent 20/40) in DMI. The study was completed at the Moorfields Eye Hospital from December 2019 to August 2021. A total of 123 eyes of 87 patients with stable-treated proliferative diabetic retinopathy following panretinal photocoagulation were recruited. DMI was defined as an irregular foveal avascular zone (FAZ) area ≥ 0.5 mm2 or a smaller FAZ area with parafoveal capillary dropout in at least one quadrant. The analysis showed that the whole image deep vascular complex vessel density (DVC VD) in the 3 × 3 mm area had the best discriminatory ability to identify participants with mild visual impairment at 41.9% (area under the curve = 0.77, sensitivity 94%, specificity 54%, likelihood ratio [LR] = 2.04), and the FAZ area had the greatest post-test LR = 4.21 at 0.64 mm2. The 3 × 3 mm whole image DVC VD and FAZ area cutoffs are useful for screening vision-threatening DMI, but DVC VD has low specificity. Full article
(This article belongs to the Special Issue Optical Coherence Tomography Angiography: Value for Retinal Diseases Diagnostics)
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