Microaneurysm detection using high-speed megahertz optical coherence tomography angiography in advanced diabetic retinopathy.

Autor: Huber KL; Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria., Stino H; Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria., Schlegl T; Center for Medical Physics and Biomedical Engineering, Medical University Vienna, Vienna, Austria., Steiner I; Center for Medical Data Science, Institute of Medical Statistics, Medical University of Vienna, Vienna, Austria., Nagy G; Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria., Niederleithner M; Center for Medical Physics and Biomedical Engineering, Medical University Vienna, Vienna, Austria., Baumann B; Center for Medical Physics and Biomedical Engineering, Medical University Vienna, Vienna, Austria., Drexler W; Center for Medical Physics and Biomedical Engineering, Medical University Vienna, Vienna, Austria., Leitgeb RA; Center for Medical Physics and Biomedical Engineering, Medical University Vienna, Vienna, Austria., Schmidt-Erfurth U; Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria., Schmoll T; Center for Medical Physics and Biomedical Engineering, Medical University Vienna, Vienna, Austria.; Carl Zeiss Meditec, Inc., Dublin, California, USA., Pollreisz A; Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria.
Jazyk: angličtina
Zdroj: Acta ophthalmologica [Acta Ophthalmol] 2024 Aug; Vol. 102 (5), pp. e687-e695. Date of Electronic Publication: 2023 Dec 21.
DOI: 10.1111/aos.16619
Abstrakt: Purpose: To compare detection rates of microaneurysms (MAs) on high-speed megahertz optical coherence tomography angiography (MHz-OCTA), fluorescein angiography (FA) and colour fundus photography (CF) in patients with diabetic retinopathy (DR).
Methods: For this exploratory cross-sectional study, MHz-OCTA data were acquired with a swept-source OCT prototype (A-scan rate: 1.7 MHz), and FA and CF imaging was performed using Optos® California. MA count was manually evaluated on en face MHz-OCTA/FA/CF images within an extended ETDRS grid. Detectability of MAs visible on FA images was evaluated on corresponding MHz-OCTA and CF images. MA distribution and leakage were correlated with detectability on OCTA and CF imaging.
Results: 47 eyes with severe DR (n = 12) and proliferative DR (n = 35) were included. MHz-OCTA and CF imaging detected on average 56% and 36% of MAs, respectively. MHz-OCTA detection rate was significantly higher than CF (p < 0.01). The combination of MHz-OCTA and CF leads to an increased detection rate of 70%. There was no statistically significant association between leakage and MA detectability on OCTA (p = 0.13). For CF, the odds of detecting leaking MAs were significantly lower than non-leaking MAs (p = 0.012). Using MHz-OCTA, detection of MAs outside the ETDRS grid was less likely than MAs located within the ETDRS grid (outer ring, p < 0.01; inner ring, p = 0.028). No statistically significant difference between rings was observed for CF measurements.
Conclusions: More MAs were detected on MHz-OCTA than on CF imaging. Detection rate was lower for MAs located outside the macular region with MHz-OCTA and for leaking MAs with CF imaging. Combining both non-invasive modalities can improve MA detection.
(© 2023 The Authors. Acta Ophthalmologica published by John Wiley & Sons Ltd on behalf of Acta Ophthalmologica Scandinavica Foundation.)
Databáze: MEDLINE
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