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Optical Coherence Tomography Angiography in Diabetic Retinopathy: A Major Review Publisher Pubmed



Nouri H1, 2 ; Abtahi SH1, 3 ; Mazloumi M4 ; Samadikhadem S5 ; Arevalo JF6 ; Ahmadieh H1
Authors
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Authors Affiliations
  1. 1. Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  2. 2. School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  3. 3. Department of Ophthalmology, Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  4. 4. Eye Research Center, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
  5. 5. Department of Ophthalmology, Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  6. 6. Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, United States

Source: Survey of Ophthalmology Published:2024


Abstract

Diabetic retinopathy (DR) is characterized by retinal vasculopathy and is a leading cause of visual impairment. Optical coherence tomography angiography (OCTA) is an innovative imaging technology that can detect various pathologies and quantifiable changes in retinal microvasculature. We briefly describe its functional principles and advantages over fluorescein angiography and perform a comprehensive review on its clinical applications in the screening or management of people with prediabetes, diabetes without clinical retinopathy (NDR), nonproliferative DR (NPDR), proliferative DR (PDR), and diabetic macular edema (DME). OCTA reveals early microvascular alterations in prediabetic and NDR eyes, which may coexist with sub-clinical neuroretinal dysfunction. Its applications in NPDR include measuring ischemia, detecting retinal neovascularization, and timing of early treatment through predicting the risk of retinopathy worsening or development of DME. In PDR, OCTA helps characterize the flow within neovascular complexes and evaluate their progression or regression in response to treatment. In eyes with DME, OCTA perfusion parameters may be of predictive value regarding the visual and anatomical gains associated with treatment. We further discussed the limitations of OCTA and the benefits of its incorporation into an updated DR severity scale. © 2024 Elsevier Inc.
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