Optical coherence tomography angiography measured area of retinal neovascularization is predictive of treatment response and progression of disease in patients with proliferative diabetic retinopathy

International Journal of Retina and Vitreous

Thomas Lee Torp¹  Anna Stage Vergmann²  Jakob Grauslund³  Ryo Kawasaki⁴  Tunde Peto⁵  Tien Wong⁶  Kristian Tølbøl Sørensen⁷ 

[1]Department of Ophthalmology, Odense University Hospital, Kloevervaenget 5, indgang 132, 5000, Odense C, Denmark

[2]Research Unit of Ophthalmology, Department of Clinical Research, Faculty of Health Science, University of Southern Denmark, Odense, Denmark

[3]Department of Ophthalmology, Odense University Hospital, Kloevervaenget 5, indgang 132, 5000, Odense C, Denmark

[4]Research Unit of Ophthalmology, Department of Clinical Research, Faculty of Health Science, University of Southern Denmark, Odense, Denmark

[5]OPEN, Open Patient Data Explorative Network, Odense University Hospital, Odense, Denmark

[6]Department of Ophthalmology, Odense University Hospital, Kloevervaenget 5, indgang 132, 5000, Odense C, Denmark

[7]Research Unit of Ophthalmology, Department of Clinical Research, Faculty of Health Science, University of Southern Denmark, Odense, Denmark

[8]Steno Diabetes Center Odense, Odense, Denmark

[9]Research Unit of Ophthalmology, Department of Clinical Research, Faculty of Health Science, University of Southern Denmark, Odense, Denmark

[10]Department of Vision Informatics, Osaka University School of Medicine, Osaka, Japan

[11]Research Unit of Ophthalmology, Department of Clinical Research, Faculty of Health Science, University of Southern Denmark, Odense, Denmark

[12]School of Medicine, Dentistry and Biomedical Sciences, Queen’s University, Belfast, Northern Ireland, UK

[13]Singapore National Eye Centre, Singapore, Singapore

[14]Office of Clinical Sciences, Duke-NUS Medical School, National University of Singapore, Singapore, Singapore

[15]Visual Computing Lab, The Alexandra Institute, Aarhus, Denmark

关键词: Optical coherence tomography angiography;    Proliferative diabetic retinopathy;    Fluorescein angiography;    Diabetic retinopathy;   

DOI  :  10.1186/s40942-020-00249-6

来源: Springer

【 摘 要 】

BackgroundThe purpose of this study was to evaluate the area of retinal neovascularization in patients with treatment-naïve proliferative diabetic retinopathy (PDR) as measured by optical coherence tomography angiography (OCT-A) as a marker of subsequent treatment response after panretinal photocoagulation (PRP), and to examine if this area correlated with area of retinal neovascularization as measured by fluorescein angiography (FA).MethodsEn face OCT-A scans (4.5 × 4.5 mm) of neovascularizations were obtained at baseline (BL) before PRP and at month (M) 3 and M6 after treatment. Progression of PDR were defined as lesion growth (assessed by ophthalmoscopy and wide-field fundus photo) or increasing leakage by Optos ultra-widefield FA, and patients were divided into two groups; progression or non-progression. Mann–Whitney U test and Wilcoxon signed-rank test were used to analyse differences between groups and between time points. Areas of retinal neovascularizations (OCT-A and FA) were calculated by algorithms developed in Python (version 3.6.8, The Python Software Foundation, USA).ResultsOf 21 eyes included, 14 had progression of disease. Median OCT-A area did not differ between the two groups (progression vs. non-progression) at BL (76.40 ± 162.03 vs. 72.62 ± 94.15, p = 0.43) but were statistically significantly larger in the progression group at M6 (276.69 ± 168.78 vs. 61.30 ± 70.90, p = 0.025). Median FA area did not differ in the progression vs. the non-progression group at BL (111.42 ± 143.08 vs. 60.80 ± 54.83, p = 0.05) or at M6 (200.12 ± 91.81 vs. 123.86 ± 162.16, p = 0.62). Intraclass correlation between area by OCT-A and FA was −5.99 (95% CI: −35.28–0.993), p = 0.71.ConclusionsIn this study of patients with treatment-naïve PDR, we showed that increasing area of retinal neovascularizations measured by OCT-A at M6 indicated progression of disease after PRP treatment. Our results suggest that area by OCT-A reflects disease activity and that it can be used as an indicator to monitor the progression of PDR over time, and to evaluate treatment response six months after PRP.Trial registrationhttps://clinicaltrials.gov (identifier: NCT03113006). Registered April 13, 2017.

【 授权许可】

CC BY