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Review
. 2021 Jan;35(1):149-161.
doi: 10.1038/s41433-020-01233-y. Epub 2020 Oct 24.

Optical coherence tomography angiography in diabetic retinopathy: an updated review

Zihan Sun  1 , Dawei Yang  1 , Ziqi Tang  1 , Danny S Ng  1   2 , Carol Y Cheung  3
Affiliations
Review

Optical coherence tomography angiography in diabetic retinopathy: an updated review

Zihan Sun et al. Eye (Lond). 2021 Jan.

Abstract
in English, Chinese

Diabetic retinopathy (DR) is a common microvascular complication of diabetes mellitus. Optical coherence tomography angiography (OCTA) has been developed to visualize the retinal microvasculature and choriocapillaris based on the motion contrast of circulating blood cells. Depth-resolved ability and non-invasive nature of OCTA allow for repeated examinations and visualization of microvasculature at the retinal capillary plexuses and choriocapillaris. OCTA enables quantification of microvascular alterations in the retinal capillary network, in addition to the detection of classical features associated with DR, including microaneurysms, intraretinal microvascular abnormalities, and neovascularization. OCTA has a promising role as an objective tool for quantifying extent of microvascular damage and identify eyes with diabetic macular ischaemia contributed to visual loss. Furthermore, OCTA can identify preclinical microvascular abnormalities preceding the onset of clinically detectable DR. In this review, we focused on the applications of OCTA derived quantitative metrics that are relevant to early detection, staging and progression of DR. Advancement of OCTA technology in clinical research will ultimately lead to enhancement of individualised management of DR and prevention of visual impairment in patients with diabetes.

摘要: 糖尿病视网膜病变 (DR) 是糖尿病常见微血管并发症。相干光断层扫描血管成像技术 (OCTA) 可根据对比血管中循环红细胞的变化可视化视网膜微循环系统和脉络膜毛细血管。OCTA的深度分辨能力以及非侵入性的特点可对视网膜毛细血管丛和脉络膜毛细血管系统进行重复性检查以及实现可视化。OCTA不仅可以检测与DR相关的典型体征, 包括微动脉瘤, 视网膜内微血管异常和新生血管形成, 还可量化视网膜毛细血管网中微血管的细微变化。OCTA作为量化微血管损伤程度以及发现由于糖尿病黄斑缺血而导致的视力丧失的客观检查工具, 具有广阔的临床应用前景。此外, OCTA可识别DR临床前期的微血管异常。本篇综述中重点讨论了基于OCTA衍生定量指标的应用, 这些指标与DR的早期检测、分期以及进展密切相关。OCTA技术在临床研究中, 对糖尿病患者DR并发症的个体化管理和视力障碍的预防方面将起到重要作用。.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1. Quantification of retinal microvasculature from OCT angiography (OCTA) images.
After applying different imaging processing steps including denoising, binarization, skeletonization, region growing and smoothing, a series of OCTA metrics including foveal avascular zone (FAZ) area, FAZ circularity, vessel density, inter-capillary area and fractal dimension were automatically calculated by a customized MATLAB (MathWorks, Natick, MA) programme.
Fig. 2
Fig. 2. Examples of shadowgraphic projection artefacts from superficial capillary plexus (SCP) on the deep capillary plexus (DCP) (indicated by yellow arrows).
These “false” blood flow signals interfere with the visualization of deeper capillary plexus and lead to incorrect interpretations.
See this image and copyright information in PMC

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