Detection of retinal and optic disc neovascularization in patients with stage 4 diabetic retinopathy by multidirectional optical coherence tomography angiography / 中华眼底病杂志

ABSTRACT

Objective:To observe and analyze the detection rate of optical disc and retinal neovascularization in stage Ⅳ diabetic retinopathy by multidirectional OCT angiography (OCTA).Methods:A retrospective study. From September to October 2018, 50 eyes of 46 patients with diabetic retinopathy of stage Ⅳ diagnosed in Tangshan Ophthalmological Hospital were included in the study. Among them, there were 18 males (19 eyes) and 28 females (31 eyes). The age ranged from 31 to 78 years, with an average age of 56.64±10.64 years. All patients underwent medical optometry, mydriasis fundus examination and FFA examination. All patients met the diagnostic criteria of stage Ⅳ diabetic retinopathy. All patients underwent multidirectional OCTA examination on the same day after mydriasis fundus examination and FFA examination. Angiography 6 mm × 6 mm scanning mode was selected for OCTA examination. The retinal areas of macular area, optic disc, superior nasal disc, superior optic disc, superior macular area, superior temporal macular area, temporal macular area, inferior nasal disc, inferior optic disc, inferior macular area and inferior temporal macular area were scanned respectively. All images were taken by the same physician and read by two physicians independently. Cases with inconsistent opinions between the two physicians were not included in this study. The optical disc and retinal neovascularization in patients with stage Ⅳ diabetic retinopathy were observed on FFA and multidirectional OCTA images.Results:In 50 eyes, the positive number of screening optic disc neovascularization using FFA was 8 eyes, OCTA was 15 eyes (100%). In the 42 eyes without optic disc neovascularization detected by FFA, OCTA detected 7 eyes, all located on the optic disc surface. Four of the eyes were located in the optic cup, linear and branching, with an area of less than 1/4 optic disc. In 50 eyes, the positive number of screening retinal neovascularization using FFA was 50 eyes, the positive number of OCTA was 43 eyes. In 43 eyes with detected by OCTA, retinal neovascularization buds were detected in 3 eyes, but not in FFA. The retinal neovascularization not detected by OCTA was located in the mid-peripheral part of the retina, which is beyond the inspection range of multi-directional OCTA.Conclusion:The positive rate of optic disc neovascularization and retinal neovascularization in stage Ⅳ DR by multidirectional OCTA is 100.0% and 86.0%, respectively.