Abstract
Purpose
Xephilio OCT-S1 can capture single-acquisition 23 × 20-mm wide-field swept-source optical coherence tomography angiography (SS-OCTA) images and high-resolution images using artificial intelligence. We aimed to evaluate the ability of wide-field SS-OCTA in the detection of retinal neovascularizations (NVs) in eyes with proliferative diabetic retinopathy (PDR).
Methods
This retrospective study included 64 eyes of 36 patients (age, 57 ± 10 years; 10 female, 26 male) with PDR. All patients underwent a comprehensive ophthalmological examination, including fluorescein angiography (FA), as well as fovea- and disc-centered 23 × 20-mm OCTA imaging (A-scan/B-scan, 928/807). We compared and examined the number of NV sites identified using conventional methods (merging the findings from biomicroscopy/color fundus photography, FA) and the number of NV sites identified using vitreoretinal interface and superficial retinal slabs of wide-field SS-OCTA images, including the position of NVs (nasal upper, nasal lower, temporal upper, temporal lower, or disc).
Results
We identified 168 NVs (32/40/45/35/16, in the abovementioned order) using the conventional method. Fovea-centered 23 × 20-mm OCTA images revealed 162 (96%) NVs (27/39/45/35/16). This method tended to miss nasal NV. In contrast, disc-centered 23 × 20-mm OCTA images identified nearly all NVs, detecting 166 (99%) NVs (32/40/44/34/16) in total. All NVs could be visualized using two wide-field OCTA images: fovea- and disc-centered.
Conclusion
Wide-field (23 × 20 mm) SS-OCTA—especially disc-centered—using Xephilio OCT-S1 identified nearly all NVs in eyes with PDR, with a single acquisition, thereby demonstrating its potential clinical application.
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Data availability
Data are available upon request.
References
Duh EJ, Yang HS, Haller JA, De Juan E, Humayun MS, Gehlbach P, Melia M, Pieramici D, Harlan JB, Campochiaro PA, Zack DJ (2004) Vitreous levels of pigment epithelium-derived factor and vascular endothelial growth factor: implications for ocular angiogenesis. Am J Ophthalmol 137:668–674. https://doi.org/10.1016/j.ajo.2003.11.015
Hirano T, Toriyama Y, Iesato Y, Imai A, Murata T (2018) Changes in plasma vascular endothelial growth factor level after intravitreal injection of bevacizumab, aflibercept, or ranibizumab for diabetic macular edema. Retina 38:1801–1808. https://doi.org/10.1097/IAE.0000000000002004
Feman SS, Leonard-Martin TC, Semchyshyn TM (1998) The topographic distribution of the first sites of diabetic retinal neovascularization. Am J Ophthalmol 125:704–706. https://doi.org/10.1016/s0002-9394(98)00013-0
Fan W, Nittala MG, Velaga SB, Hirano T, Wykoff CC, Ip M, Lampen SIR, van Hemert J, Fleming A, Verhoek M, Sadda SR (2019) Distribution of nonperfusion and neovascularization on ultrawide-field fluorescein angiography in proliferative diabetic retinopathy (RECOVERY Study): report 1. Am J Ophthalmol 206:154–160. https://doi.org/10.1016/j.ajo.2019.04.023
Gass JD (1968) A fluorescein angiographic study of macular dysfunction secondary to retinal vascular disease. VI. X-ray irradiation, carotid artery occlusion, collagen vascular disease, and vitritis. Arch Ophthalmol 80:606–617. https://doi.org/10.1001/archopht.1968.00980050608006
Kwiterovich KA, Maguire MG, Murphy RP, Schachat AP, Bressler NM, Bressler SB, Fine SL (1991) Frequency of adverse systemic reactions after fluorescein angiography Results of a prospective study. Ophthalmol 98:1139–1142. https://doi.org/10.1016/s0161-6420(91)32165-1
Ishibazawa A, Nagaoka T, Yokota H, Takahashi A, Omae T, Song YS, Takahashi T, Yoshida A (2016) Characteristics of retinal neovascularization in proliferative diabetic retinopathy imaged by optical coherence tomography angiography. Invest Ophthalmol Vis Sci 57:6247–6255. https://doi.org/10.1167/iovs.16-20210
Hirano T, Kitahara J, Toriyama Y, Kasamatsu H, Murata T, Sadda S (2019) Quantifying vascular density and morphology using different swept-source optical coherence tomography angiographic scan patterns in diabetic retinopathy. Br J Ophthalmol 103:216–221. https://doi.org/10.1136/bjophthalmol-2018-311942
Vaz-Pereira S, Morais-Sarmento T, Engelbert M (2021) Update on optical coherence tomography and optical coherence tomography angiography imaging in proliferative diabetic retinopathy. Diagnostics (Basel) 11(10):1869. https://doi.org/10.3390/diagnostics11101869
Sawada O, Ichiyama Y, Obata S, Ito Y, Kakinoki M, Sawada T, Saishin Y, Ohji M (2018) Comparison between wide-angle OCT angiography and ultra-wide-field fluorescein angiography for detecting non-perfusion areas and retinal neovascularization in eyes with diabetic retinopathy. Graefes Arch Clin Exp Ophthalmol 256:1275–1280. https://doi.org/10.1007/s00417-018-3992-y
Pichi F, Smith SD, Abboud EB, Neri P, Woodstock E, Hay S, Levine E, Baumal CR (2020) Wide-field optical coherence tomography angiography for the detection of proliferative diabetic retinopathy. Graefes Arch Clin Exp Ophthalmol 258(9):1901–1909. https://doi.org/10.1007/s00417-020-04773-x
Hirano T, Hoshiyama K, Hirabayashi K, Wakabayashi M, Toriyama Y, Tokimitsu M, Murata T (2020) Vitreoretinal interface slab in OCT angiography for detecting diabetic retinal neovascularization. Ophthalmol Retina 4:588–594. https://doi.org/10.1016/j.oret.2020.01.004
Borrelli E, Toto L, Viggiano P, Evangelista F, Palmieri M, Mastropasqua R (2020) Widefield topographical analysis of the retinal perfusion and neuroretinal thickness in healthy eyes: a pilot study. Eye (Lond) 34(12):2264–2270. https://doi.org/10.1038/s41433-020-0804-5
Russell JF, Flynn HW Jr, Sridhar J, Townsend JH, Shi Y, Fan KC, Scott NL, Hinkle JW, Lyu C, Gregori G, Russell SR, Rosenfeld PJ (2019) Distribution of diabetic neovascularization on ultra-widefield fluorescein angiography and on simulated widefield OCT angiography. Am J Ophthalmol 207:110–120. https://doi.org/10.1016/j.ajo.2019.05.031
Chiku Y, Hirano T, Takahashi Y, Tuchiya A, Nakamura M, Murata T (2021) Evaluating posterior vitreous detachment by widefield 23-mm swept-source optical coherence tomography imaging in healthy subjects. Sci Rep 11:19754. https://doi.org/10.1038/s41598-021-99372-z
Wilkinson CP, Ferris FL 3rd, Klein RE, Lee PP, Agardh CD, Davis M, Dills D, Kampik A, Pararajasegaram R, Verdaguer JT, Global Diabetic Retinopathy Project Group (2003) Proposed international clinical diabetic retinopathy and diabetic macular edema disease severity scales. Ophthalmol 110:1677–1682. https://doi.org/10.1016/S0161-6420(03)00475-5
Lange C, Feltgen N, Junker B, Schulze-Bonsel K, Bach M (2009) Resolving the clinical acuity categories “hand motion” and “counting fingers” using the Freiburg Visual Acuity Test (FrACT). Graefes Arch Clin Exp Ophthalmol 247(1):137–142. https://doi.org/10.1007/s00417-008-0926-0
Kawai K, Uji A, Murakami T, Kadomoto S, Oritani Y, Dodo Y, Muraoka Y, Akagi T, Miyata M, Tsujikawa A (2021) Image evaluation of artificial intelligence-supported optical coherence tomography angiography imaging using oct-A1 device in diabetic retinopathy. Retina 41:1730–1738. https://doi.org/10.1097/IAE.0000000000003101
Kadomoto S, Uji A, Muraoka Y, Tsujikawa A (2020) High-contrast scleroconjunctival microvasculature via deep learning denoising. Indian J Ophthalmol 68:2251. https://doi.org/10.4103/ijo.IJO_1079_20
Ishibazawa A, Nagaoka T, Takahashi A, Omae T, Tani T, Sogawa K, Yokota H, Yoshida A (2015) Optical coherence tomography angiography in diabetic retinopathy: a prospective pilot study. Am J Ophthalmol 160:35-44.e1. https://doi.org/10.1016/j.ajo.2015.04.021
Hirano T, Kakihara S, Toriyama Y, Nittala MG, Murata T (2018) Sadda S (2018) Wide-field en face swept-source optical coherence tomography angiography using extended field imaging in diabetic retinopathy. Br J Ophthalmol 102:1199–1203. https://doi.org/10.1136/bjophthalmol-2017-311358
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Conceptualization and data acquisition were done by Ken Hoshiyma, Yoshiaki Takahashi, and Takao Hirano. Data analysis and original draft preparation were performed by Takao Hirano and Toshinori Murata. All the authors contributed to the review and editing. All the authors read and approved the final manuscript.
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This study was approved by the ethics committee of the Shinshu University School of Medicine (approval number: 4908) and adhered to the tenets set forth in the Declaration of Helsinki.
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Meeting presentation: the content of this paper was presented at the 7th international symposium held by the Asia Pacific Retinal Imaging Society on Aug 20, 2020.
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Hirano, T., Hoshiyama, K., Takahashi, Y. et al. Wide-field swept-source OCT angiography (23 × 20 mm) for detecting retinal neovascularization in eyes with proliferative diabetic retinopathy. Graefes Arch Clin Exp Ophthalmol 261, 339–344 (2023). https://doi.org/10.1007/s00417-022-05878-1
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DOI: https://doi.org/10.1007/s00417-022-05878-1