Abstract
PurposeTo compare quantitative changes in macular parameters in diabetic patients detected by two optical coherence tomography angiography (OCTA) instruments.Methods80 phakic eyes were classified as no diabetes, diabetes without diabetic retinopathy (DR), mild non-proliferative diabetic retinopathy (NPDR), and severe NPDR or proliferative DR (PDR). OCTA was performed using devices from two manufacturers (Zeiss and Heidelberg). Superficial and deeper vascular skeleton density (SVSD, DVSD), superficial and deeper vessel area density (SVAD, DVAD), choriocapillaris flow voids (CCFV), and choroidal flow voids (CFV) were calculated. Inter-device comparisons were performed using the size comparison index (SCI) and the discrepancy index (DI).ResultsThe two devices were inconsistent in SVSD, DVSD, DVAD, CCFV and CFV parameters (all P < 0.05). In addition, the SCI was positive for DVAD (all P < 0.001) and negative for SVSD, DVSD, CCFV and CFV in all groups (all P <0.001), except for DVSD in severe NPDR or PDR. The discrepancy index was not significantly different among groups for SVD, SPD, DVD, DPD and CFV (all P> 0.05). The mean DI of CCFV was statistically different between the four groups (P < 0.001).ConclusionsThe two instruments were largely inconsistent in the measurement of macular parameters relevant to DR. The choice of imaging device can impact OCTA analytics and should be taken into account when drawing conclusions about DR-related changes.
Highlights
Diabetes mellitus (DM) is a chronic metabolic disease that causes end-organ complications, including diabetic retinopathy (DR)
The two devices were inconsistent in superficial vascular skeleton density (SVSD), deep vessel skeleton density (DVSD), deep vessel area density (DVAD), choriocapillaris flow voids (CCFV) and choroidal flow voids (CFV) parameters
The size comparison index (SCI) was positive for DVAD and negative for SVSD, DVSD, CCFV and CFV in all groups, except for DVSD in severe non-proliferative diabetic retinopathy (NPDR) or proliferative DR (PDR)
Summary
Diabetes mellitus (DM) is a chronic metabolic disease that causes end-organ complications, including diabetic retinopathy (DR). DR is a microvascular disease that has profound effects on the retinal vasculature and is rapidly becoming more prevalent worldwide.[1] In the past, fluorescein angiography (FA) was the gold standard for studying DR.[2] due to the inconvenience and various potential risks of FA, optical coherence tomography (OCTA) is increasingly used in DR research. OCTA can produce a high-resolution blood flow image of all vessel layers within the retina in a rapid, non-invasive manner. OCTA can analyze choroidal blood flow by detecting flow voids.[3] Two widely used OCTA instruments on the market today, Heidelberg Engineering’s SPECTRALIS1 and Zeiss’s CIRRUSTM HD-OCT, utilize different algorithms for OCTA image acquisition. Heidelberg uses a full spectrum amplitude decorrelation algorithm while Zeiss uses optical microangiography.[4]
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