Agreement between OCT Leakage and Fluorescein Angiography to Identify Sites of Alteration of the Blood–Retinal Barrier in Diabetes

Abstract

To compare the location of the sites of lower reflectivity, as determined by OCT leakage using spectral domain (SD)-OCT, with sites of fluorescein leakage identified by fluorescein angiography (FA) in eyes with diabetic retinopathy. Prospective consecutive case series. Fifty-two eyes from 28 patients with type 2 diabetes and presence of nonproliferative diabetic retinopathy. All patients were imaged with FA and SD-OCT (Angioplex, Carl Zeiss Meditec, Inc). All FA images were analyzed by 2 experienced graders, and the area surrounding well-defined sites of leakage was outlined by the graders. The SD-OCT scans were processed using OCT leakage proprietary software and semiautomated segmentation. Both procedures were performed without access to the clinical data. Agreement of OCT leakage with FA findings. In eyes that were classified as having well-defined sites of leakage on FA, OCT leakage showed a sensitivity of 95.9% and a specificity of 75.4% regarding agreement between these sites of alteration of the blood-retinal barrier. The areas of abnormal extracellular fluid increase were larger than the areas of fluorescein leakage and included the well-defined leakage sites identified by FA. On OCT leakage, localized increases in extracellular space were identified, mainly in the inner nuclear, outer plexiform, or outer nuclear layers, even in eyes without leakage on FA. Using SD-OCT, OCT leakage was found to better identify abnormal retinal fluid than did FA and showed good sensitivity and specificity in comparison with FA for identification of sites of alterations of the blood-retinal barrier.