To detect vascular abnormalities in diabetic retinopathy using swept-source optical coherence tomography angiography (SS-OCTA) widefield images, and to compare the findings with color fundus photographs (CFPs) using Early Treatment Diabetic Retinopathy Study severity grading.
3 mm × 3 mm and 12 mm × 12 mm scans were acquired to cover 70° to 80° of the posterior pole using a 100-kHz SS-OCTA instrument. Two masked graders assessed the presence of vascular abnormalities on SS-OCTA and the Early Treatment Diabetic Retinopathy Study level on CFP. The grading results were then compared.
A total of 120 diabetic eyes (60 patients) were imaged with the SS-OCTA instrument. Cohort 1 (91 eyes; SS-OCTA grading only) showed microaneurysms in 91% (n = 83), intraretinal microvascular abnormalities in 79% (n = 72), and neovascularization in 21% (n = 19) of cases. Cohort 2 (52 eyes; CFP grading compared with SS-OCTA) showed microaneurysms on CFP in 90% (n = 47) and on SS-OCTA in 96% (n = 50) of cases. Agreement in intraretinal microvascular abnormality detection was fair (k = 0.2). Swept-source optical coherence tomography angiography detected 50% of intraretinal microvascular abnormality cases (n = 26), which were missed on CFP. Agreement in detecting neovascularization was moderate (k = 0.5).
Agreement in detection of diabetic retinopathy features on CFP and SS-OCTA varies depending on the vascular changes examined. Swept-source optical coherence tomography angiography shows a higher detection rate of intraretinal microvascular abnormalities (P = 0.039), compared with Early Treatment Diabetic Retinopathy Study grading.
Comparison of swept-source optical coherence tomography angiography widefield imaging in the detection of diabetic vascular abnormalities versus Early Treatment Diabetic Retinopathy Study–based color fundus photograph severity grading reveals a higher detection rate of intraretinal microvascular abnormalities on swept-source optical coherence tomography angiography.
Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Reprint requests: Sebastian Wolf, MD, PhD, Department of Ophthalmology, Inselspital, Bern University Hospital, Freiburgstrasse 8, Bern 3010, Switzerland; e-mail: firstname.lastname@example.org
Supported by a nonfinancial grant by Zeiss. Zeiss had no role in the design or conduct of this research, and the authors have no financial or proprietary interest in the materials presented herein.
None of the authors has any conflicting interests to disclose.