Early Detection of Microvascular Changes in Patients with Diabetes Mellitus without and with Diabetic Retinopathy: Comparison between Different Swept-Source OCT-A Instruments
Optical coherence tomography angiography (OCT-A) has recently improved the ability to detect subclinical and early clinically visible microvascular changes occurring in patients with diabetes mellitus (DM). The aim of the present study is to evaluate and compare early quantitative changes of macular...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Journal of Diabetes Research |
| Online Access: | http://dx.doi.org/10.1155/2019/2547216 |
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| author | Stela Vujosevic Caterina Toma Edoardo Villani Valentina Gatti Marco Brambilla Andrea Muraca Maria Chantal Ponziani Gianluca Aimaretti Alessandro Nuzzo Paolo Nucci Stefano De Cilla’ |
| author_facet | Stela Vujosevic Caterina Toma Edoardo Villani Valentina Gatti Marco Brambilla Andrea Muraca Maria Chantal Ponziani Gianluca Aimaretti Alessandro Nuzzo Paolo Nucci Stefano De Cilla’ |
| author_sort | Stela Vujosevic |
| collection | DOAJ |
| description | Optical coherence tomography angiography (OCT-A) has recently improved the ability to detect subclinical and early clinically visible microvascular changes occurring in patients with diabetes mellitus (DM). The aim of the present study is to evaluate and compare early quantitative changes of macular perfusion parameters in patients with DM without DR and with mild nonproliferative DR (NPDR) evaluated by two different swept-source (SS) OCT-A instruments using two scan protocols (3×3 mm and 6×6 mm). One hundred eleven subjects/eyes were prospectively evaluated: 18 healthy controls (control group), 73 eyes with DM but no DR (no-DR group), and 20 eyes with mild NPDR (DR group). All quantitative analyses were performed using ImageJ and included vessel and perfusion density, area and circularity index of the FAZ, and vascular complexity parameters. The agreement between methods was assessed according to the method of Bland-Altman. A significant decrease in the majority of the considered parameters was found in the DR group versus the controls with both instruments. The results of Bland-Altman analysis showed the presence of a systemic bias between the two instruments with PLEX Elite providing higher values for the majority of the tested parameters when considering 6×6 mm angiocubes and a less definite difference in 3×3 mm angiocubes. In conclusion, this study documents early microvascular changes occurring in the macular region of patients at initial stages of DR, confirmed with both SS OCT-A instruments. The fact that early microvascular alterations could not be detected with one instrument does not necessarily mean that these alterations are not actually present, but this could be an intrinsic limitation of the device itself. Further, larger longitudinal studies are needed to better understand microvascular damage at very early stages of diabetic retinal disease and to define the strengths and weaknesses of different OCT-A devices. |
| format | Article |
| id | doaj-art-4bc6786de3ed469e846247c6dbe6e2fa |
| institution | Kabale University |
| issn | 2314-6745 2314-6753 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Diabetes Research |
| spelling | doaj-art-4bc6786de3ed469e846247c6dbe6e2fa2025-02-03T01:31:50ZengWileyJournal of Diabetes Research2314-67452314-67532019-01-01201910.1155/2019/25472162547216Early Detection of Microvascular Changes in Patients with Diabetes Mellitus without and with Diabetic Retinopathy: Comparison between Different Swept-Source OCT-A InstrumentsStela Vujosevic0Caterina Toma1Edoardo Villani2Valentina Gatti3Marco Brambilla4Andrea Muraca5Maria Chantal Ponziani6Gianluca Aimaretti7Alessandro Nuzzo8Paolo Nucci9Stefano De Cilla’10Eye Clinic, University Hospital “Maggiore della Carità”, Novara, ItalyEye Clinic, University Hospital “Maggiore della Carità”, Novara, ItalyDepartment of Clinical Sciences and Community Health, University of Milan, Milan, ItalyEye Clinic, University Hospital “Maggiore della Carità”, Novara, ItalyDepartment of Medical Physics, University Hospital “Maggiore della Carità”, Novara, ItalyEye Clinic, University Hospital “Maggiore della Carità”, Novara, ItalyDiabetology Unit, S.S. Trinità Hospital, Borgomanero, ItalyDepartment of Translational Medicine, Endocrinology, University Hospital “Maggiore della Carità”, Novara, ItalyDepartment of Translational Medicine, Endocrinology, University Hospital “Maggiore della Carità”, Novara, ItalyDepartment of Clinical Sciences and Community Health, University of Milan, Milan, ItalyEye Clinic, University Hospital “Maggiore della Carità”, Novara, ItalyOptical coherence tomography angiography (OCT-A) has recently improved the ability to detect subclinical and early clinically visible microvascular changes occurring in patients with diabetes mellitus (DM). The aim of the present study is to evaluate and compare early quantitative changes of macular perfusion parameters in patients with DM without DR and with mild nonproliferative DR (NPDR) evaluated by two different swept-source (SS) OCT-A instruments using two scan protocols (3×3 mm and 6×6 mm). One hundred eleven subjects/eyes were prospectively evaluated: 18 healthy controls (control group), 73 eyes with DM but no DR (no-DR group), and 20 eyes with mild NPDR (DR group). All quantitative analyses were performed using ImageJ and included vessel and perfusion density, area and circularity index of the FAZ, and vascular complexity parameters. The agreement between methods was assessed according to the method of Bland-Altman. A significant decrease in the majority of the considered parameters was found in the DR group versus the controls with both instruments. The results of Bland-Altman analysis showed the presence of a systemic bias between the two instruments with PLEX Elite providing higher values for the majority of the tested parameters when considering 6×6 mm angiocubes and a less definite difference in 3×3 mm angiocubes. In conclusion, this study documents early microvascular changes occurring in the macular region of patients at initial stages of DR, confirmed with both SS OCT-A instruments. The fact that early microvascular alterations could not be detected with one instrument does not necessarily mean that these alterations are not actually present, but this could be an intrinsic limitation of the device itself. Further, larger longitudinal studies are needed to better understand microvascular damage at very early stages of diabetic retinal disease and to define the strengths and weaknesses of different OCT-A devices.http://dx.doi.org/10.1155/2019/2547216 |
| spellingShingle | Stela Vujosevic Caterina Toma Edoardo Villani Valentina Gatti Marco Brambilla Andrea Muraca Maria Chantal Ponziani Gianluca Aimaretti Alessandro Nuzzo Paolo Nucci Stefano De Cilla’ Early Detection of Microvascular Changes in Patients with Diabetes Mellitus without and with Diabetic Retinopathy: Comparison between Different Swept-Source OCT-A Instruments Journal of Diabetes Research |
| title | Early Detection of Microvascular Changes in Patients with Diabetes Mellitus without and with Diabetic Retinopathy: Comparison between Different Swept-Source OCT-A Instruments |
| title_full | Early Detection of Microvascular Changes in Patients with Diabetes Mellitus without and with Diabetic Retinopathy: Comparison between Different Swept-Source OCT-A Instruments |
| title_fullStr | Early Detection of Microvascular Changes in Patients with Diabetes Mellitus without and with Diabetic Retinopathy: Comparison between Different Swept-Source OCT-A Instruments |
| title_full_unstemmed | Early Detection of Microvascular Changes in Patients with Diabetes Mellitus without and with Diabetic Retinopathy: Comparison between Different Swept-Source OCT-A Instruments |
| title_short | Early Detection of Microvascular Changes in Patients with Diabetes Mellitus without and with Diabetic Retinopathy: Comparison between Different Swept-Source OCT-A Instruments |
| title_sort | early detection of microvascular changes in patients with diabetes mellitus without and with diabetic retinopathy comparison between different swept source oct a instruments |
| url | http://dx.doi.org/10.1155/2019/2547216 |
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