TY - JOUR
T1 - Retinal Nonperfusion in Proliferative Diabetic Retinopathy Before and After Panretinal Photocoagulation Assessed by Widefield OCT Angiography
AU - Russell, Jonathan F.
AU - Al-khersan, Hasenin
AU - Shi, Yingying
AU - Scott, Nathan L.
AU - Hinkle, John W.
AU - Fan, Kenneth C.
AU - Lyu, Cancan
AU - Feuer, William J.
AU - Gregori, Giovanni
AU - Rosenfeld, Philip J.
N1 - Funding Information:
Funding/Support: Supported by grants from Carl Zeiss Meditec , the Salah Foundation, Research to Prevent Blindness , and a 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.
Funding Information:
All authors have completed and submitted the ICMJE form for Disclosure of Potential Conflicts of Interest and none were reported. Funding/Support: Supported by grants from Carl Zeiss Meditec, the Salah Foundation, Research to Prevent Blindness, and a 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: G.G. and P.J.R. have received research support from Carl Zeiss Meditec. G.G. and the University of Miami hold a patent licensed to Carl Zeiss Meditec. P.J.R. has received additional research support from Stealth BioTherapeutics and Boehringer Ingelheim; and is a consultant for Apellis, Boehringer Ingelheim, Carl Zeiss Meditec, Chengdu Kanghong Biotech, Ocudyne, Ocunexus Therapeutics, and Unity Biotechnology; and holds equity in Apellis, Verana Health, and Ocudyne. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
Publisher Copyright:
© 2020 Elsevier Inc.
PY - 2020/5
Y1 - 2020/5
N2 - Purpose: Widefield swept source optical coherence tomography angiography (WF SS-OCTA) imaging was compared with ultra-widefield (UWF) fluorescein angiography (FA) imaging to better understand changes in retinal nonperfusion before and after panretinal photocoagulation (PRP) in treatment-naïve eyes with proliferative diabetic retinopathy (PDR). Design: Prospective, observational, consecutive case series. Methods: Participants with treatment-naïve PDR were imaged using the SS-OCTA 12- × 12-mm scan pattern at baseline and at 1 week, 1 month, and 3 months after PRP. UWF FA was obtained at baseline and 3 months after PRP. Selected eyes were imaged using 5 SS-OCTA 12- × 12-mm scans to create a posterior pole montage, and 5 eyes also underwent SS-OCTA imaging at 6 months and 1 year. Areas of retinal nonperfusion (RNP) were drawn independently by 2 masked graders, and analysis of variance (ANOVA) tests were used to compare areas of RNP over time. Main outcome measurements consisted of areas and boundaries of RNP visualized using WF SS-OCTA and UWF FA. Results: From January 2018 through January 2019, WF SS-OCTA was performed on 20 eyes with treatment-naïve PDR from 15 patients. Areas of RNP identified on UWF FA images co-localized with RNP areas visualized on WF SS-OCTA images. There were no statistically significant changes in RNP area on WF SS-OCTA images through 3 months after PRP. Even eyes that were severely ischemic at baseline had no significant changes in RNP area 1 year after PRP. Conclusions: RNP in PDR can be identified at baseline and imaged serially after PRP using WF SS-OCTA. Retinal perfusion in PDR does not change significantly after PRP. The ability of WF SS-OCTA to longitudinally evaluate RNP areas provides additional justification for adopting WF SS-OCTA as the sole imaging modality for clinical management of PDR.
AB - Purpose: Widefield swept source optical coherence tomography angiography (WF SS-OCTA) imaging was compared with ultra-widefield (UWF) fluorescein angiography (FA) imaging to better understand changes in retinal nonperfusion before and after panretinal photocoagulation (PRP) in treatment-naïve eyes with proliferative diabetic retinopathy (PDR). Design: Prospective, observational, consecutive case series. Methods: Participants with treatment-naïve PDR were imaged using the SS-OCTA 12- × 12-mm scan pattern at baseline and at 1 week, 1 month, and 3 months after PRP. UWF FA was obtained at baseline and 3 months after PRP. Selected eyes were imaged using 5 SS-OCTA 12- × 12-mm scans to create a posterior pole montage, and 5 eyes also underwent SS-OCTA imaging at 6 months and 1 year. Areas of retinal nonperfusion (RNP) were drawn independently by 2 masked graders, and analysis of variance (ANOVA) tests were used to compare areas of RNP over time. Main outcome measurements consisted of areas and boundaries of RNP visualized using WF SS-OCTA and UWF FA. Results: From January 2018 through January 2019, WF SS-OCTA was performed on 20 eyes with treatment-naïve PDR from 15 patients. Areas of RNP identified on UWF FA images co-localized with RNP areas visualized on WF SS-OCTA images. There were no statistically significant changes in RNP area on WF SS-OCTA images through 3 months after PRP. Even eyes that were severely ischemic at baseline had no significant changes in RNP area 1 year after PRP. Conclusions: RNP in PDR can be identified at baseline and imaged serially after PRP using WF SS-OCTA. Retinal perfusion in PDR does not change significantly after PRP. The ability of WF SS-OCTA to longitudinally evaluate RNP areas provides additional justification for adopting WF SS-OCTA as the sole imaging modality for clinical management of PDR.
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U2 - 10.1016/j.ajo.2020.01.024
DO - 10.1016/j.ajo.2020.01.024
M3 - Article
C2 - 32006481
AN - SCOPUS:85081213848
VL - 213
SP - 177
EP - 185
JO - American Journal of Ophthalmology
JF - American Journal of Ophthalmology
SN - 0002-9394
ER -