TY - JOUR
T1 - Distribution of Diabetic Neovascularization on Ultra-Widefield Fluorescein Angiography and on Simulated Widefield OCT Angiography
AU - Russell, Jonathan F.
AU - Flynn, Harry W.
AU - Sridhar, Jayanth
AU - Townsend, Justin H.
AU - Shi, Yingying
AU - Fan, Kenneth C.
AU - Scott, Nathan L.
AU - Hinkle, John W.
AU - Lyu, Cancan
AU - Gregori, Giovanni
AU - Russell, Stephen R.
AU - Rosenfeld, Philip J.
N1 - Funding Information:
All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported. Funding/Support: Research was supported by grants from Carl Zeiss Meditec (Dublin, California) and the Salah Foundation , an unrestricted grant from Research to Prevent Blindness, Inc. (New York, New York), and National Eye Institute Center Core grant P30EY014801 to the Department of Ophthalmology, University of Miami Miller School of Medicine. The funding organizations had no role in the design or conduct of this research. Financial Disclosures: Dr. Sridhar is a consultant for Alcon Laboratories, Alimera Science, and Allergan. Dr. S.R. Russell received research support from Spark Therapeutics and ProQR ; and is a consultant for Novartis; and is a cofounder of and holds equity in IDx Technologies. Dr. Gregori and Dr. Rosenfeld have received research support from Carl Zeiss Meditec, Inc . Dr. Gregori and the University of Miami co-own a patent assigned to Carl Zeiss Meditec, Inc. Dr. Rosenfeld has received research support from Stealth and Boehringer Ingelheim ; and is a consultant for Boehringer Ingelheim, Carl Zeiss Meditec, Chengdu Kanghong Biotech, Healios K.K., Hemera Biosciences, F. Hoffmann-La Roche Ltd., Isarna Pharmaceuticals, and Unity Biotechnology; and holds equity in Apellis, Verana Health, and Ocudyne. The other authors have no disclosures.
Funding Information:
All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported. Funding/Support: Research was supported by grants from Carl Zeiss Meditec (Dublin, California) and the Salah Foundation, an unrestricted grant from Research to Prevent Blindness, Inc. (New York, New York), and National Eye Institute Center Core grant P30EY014801 to the Department of Ophthalmology, University of Miami Miller School of Medicine. The funding organizations had no role in the design or conduct of this research. Financial Disclosures: Dr. Sridhar is a consultant for Alcon Laboratories, Alimera Science, and Allergan. Dr. S.R. Russell received research support from Spark Therapeutics and ProQR; and is a consultant for Novartis; and is a cofounder of and holds equity in IDx Technologies. Dr. Gregori and Dr. Rosenfeld have received research support from Carl Zeiss Meditec, Inc. Dr. Gregori and the University of Miami co-own a patent assigned to Carl Zeiss Meditec, Inc. Dr. Rosenfeld has received research support from Stealth and Boehringer Ingelheim; and is a consultant for Boehringer Ingelheim, Carl Zeiss Meditec, Chengdu Kanghong Biotech, Healios K.K. Hemera Biosciences, F. Hoffmann-La Roche Ltd. Isarna Pharmaceuticals, and Unity Biotechnology; and holds equity in Apellis, Verana Health, and Ocudyne. The other authors have no disclosures.
PY - 2019/11
Y1 - 2019/11
N2 - Purpose: Areas of neovascularization (NV) in proliferative diabetic retinopathy (PDR) on ultra-widefield (UWF) fluorescein angiography (FA) were identified and compared with a simulated widefield (WF) swept-source OCT angiography (SS-OCTA) field of view to determine whether the WF SS-OCTA field of view was sufficient for detection of NV in PDR. Design: Retrospective, consecutive case series. Methods: All patients with PDR and UWF FA imaging at the Bascom Palmer Eye Institute over a period of 5.5 years were identified. UWF FA images were reviewed and sites of NV were identified either as NV of the disc or NV elsewhere. Sites of NV elsewhere were classified by disc-centered retinal quadrants. A simulated WF SS-OCTA montage field of view was overlaid on the UWF FA images to determine whether sites of NV would have been identified by this simulated WF SS-OCTA field of view. Results: A total of 651 eyes with PDR from 433 patients had at least 1 UWF FA with NV. Of the 651 eyes, 50% were treatment-naïve, 9.8% had NV of the disc only, 41.8% had NV elsewhere only, and 48.4% had both NV of the disc and NV elsewhere. NV elsewhere was most prevalent in the superotemporal quadrant and the least prevalent in the nasal quadrants. When the simulated WF SS-OCTA field of view was overlaid on the UWF FA, 98.3% of all eyes, 99.4% of treatment-naive eyes, and 97.2% of previously treated eyes had NV within the WF SS-OCTA field of view. In those eyes with a repeat UWF FA within 6 to 18 months of the first FA, the distribution of NV did not change in either the treatment-naive or previously treated eyes. Conclusions: NV elsewhere in PDR was most prevalent superotemporally, and 99.4% of treatment-naïve eyes had NV within the simulated WF SS-OCTA field of view. Combined with previous research using WF SS-OCTA to identify NV in PDR, these findings suggest that WF SS-OCTA may be the only imaging modality needed for the diagnosis and longitudinal management of PDR.
AB - Purpose: Areas of neovascularization (NV) in proliferative diabetic retinopathy (PDR) on ultra-widefield (UWF) fluorescein angiography (FA) were identified and compared with a simulated widefield (WF) swept-source OCT angiography (SS-OCTA) field of view to determine whether the WF SS-OCTA field of view was sufficient for detection of NV in PDR. Design: Retrospective, consecutive case series. Methods: All patients with PDR and UWF FA imaging at the Bascom Palmer Eye Institute over a period of 5.5 years were identified. UWF FA images were reviewed and sites of NV were identified either as NV of the disc or NV elsewhere. Sites of NV elsewhere were classified by disc-centered retinal quadrants. A simulated WF SS-OCTA montage field of view was overlaid on the UWF FA images to determine whether sites of NV would have been identified by this simulated WF SS-OCTA field of view. Results: A total of 651 eyes with PDR from 433 patients had at least 1 UWF FA with NV. Of the 651 eyes, 50% were treatment-naïve, 9.8% had NV of the disc only, 41.8% had NV elsewhere only, and 48.4% had both NV of the disc and NV elsewhere. NV elsewhere was most prevalent in the superotemporal quadrant and the least prevalent in the nasal quadrants. When the simulated WF SS-OCTA field of view was overlaid on the UWF FA, 98.3% of all eyes, 99.4% of treatment-naive eyes, and 97.2% of previously treated eyes had NV within the WF SS-OCTA field of view. In those eyes with a repeat UWF FA within 6 to 18 months of the first FA, the distribution of NV did not change in either the treatment-naive or previously treated eyes. Conclusions: NV elsewhere in PDR was most prevalent superotemporally, and 99.4% of treatment-naïve eyes had NV within the simulated WF SS-OCTA field of view. Combined with previous research using WF SS-OCTA to identify NV in PDR, these findings suggest that WF SS-OCTA may be the only imaging modality needed for the diagnosis and longitudinal management of PDR.
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U2 - 10.1016/j.ajo.2019.05.031
DO - 10.1016/j.ajo.2019.05.031
M3 - Article
C2 - 31194952
AN - SCOPUS:85069632679
VL - 207
SP - 110
EP - 120
JO - American Journal of Ophthalmology
JF - American Journal of Ophthalmology
SN - 0002-9394
ER -