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Optical Coherence Tomography Angiography in Diabetes

  • Microvascular Complications—Retinopathy (JK Sun and PS Silva, Section Editors)
  • Published:
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Abstract

Diabetic retinopathy is a progressive microvascular disease that leads to increased vessel permeability, retinal ischemia, and retinal neovascularization. Optical coherence tomography angiography (OCTA) is a novel angiography technique that has the capability to advance our understanding of diabetic eye disease by providing high-resolution images of retinal and choroidal microvasculature blood flow and structure. Using OCTA, the vascular changes of diabetic retinopathy including microaneurysms, retinal non-perfusion, intraretinal microvascular abnormalities, and neovascularization can be clearly visualized. OCTA offers several advantages over fluorescein angiography (FA) in that it is faster, safer, and non-invasive, allows better visualization of retinal vessels in both the superficial and deep capillary layers, and can provide quantitative measurements of areas of non-perfusion of the macula and nerve. OCTA capillary perfusion density maps and average perfusion density values provide an easy way to grade progressive vascular change. Despite these advantages, imaging with OCTA can only provide a limited view of the peripheral retina and is unable to demonstrate leakage, staining, or pooling. OCTA requires patients to maintain good fixation to obtain high-resolution images which can be a challenge for those with severe macular disease. In patients who cannot safely undergo FA, OCTA may serve as an alternative form of angiography that can be safely and more frequently performed for the management of diabetic retinopathy.

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Authors and Affiliations

  1. The New York Eye & Ear Infirmary of Mount Sinai, 310 E 14th Street, New York, NY, 10003, USA

    Jessica Lee & Richard Rosen

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  1. Jessica Lee
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  2. Richard Rosen
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Correspondence to Richard Rosen.

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Conflict of Interest

Richard Rosen reports personal fees from Optovue, Nano Retina, Clarity, Regeneron, Allergan, and OCATA Therapeutics; grants from Genentech; and non-financial support from OD-OS. In addition, Dr. Rosen has a pending patent for Optovue AngioAnalytics.

Jessica Lee declares that she has no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Microvascular Complications—Retinopathy

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Lee, J., Rosen, R. Optical Coherence Tomography Angiography in Diabetes. Curr Diab Rep 16, 123 (2016). https://doi.org/10.1007/s11892-016-0811-x

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  • DOI: https://doi.org/10.1007/s11892-016-0811-x

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