The role of OCTA in detecting retinal ischemia for patients with resolved DME

Researcher compared foveal vascular anatomy in patients with and without disorganization of retinal inner layers (DRIL) using OCT angiography (OCTA).

Study design

The analysis comprised 24 eyes with resolved diabetic macular edema. Using OCT B scans, investigators confirmed the presence of DRIL in 9 eyes; 15 control eyes did not have DRIL. The foveal avascular zone area on OCTA was compared between patients with and without DRIL.

Outcomes

Area of ischemia on OCTA scans corresponded to DRIL area. The size of the foveal avascular zone (FAZ) in the superficial and deep plexus and the full retina were significantly larger in the DRIL group when compared with the non-DRIL group. A larger FAZ in full retinal segmentation and the superficial plexus were positively correlated with lower visual acuity.

Limitations

The relatively small sample of patients and retrospective cross-sectional design of this study are 2 limitations of this study, which might obscure finding appropriate correlations and limit our interpretation regarding the disease course and corresponding OCTA changes.

Clinical significance

These findings suggest OCTA can be used to visualize retinal ischemia in patients with or without DRIL. Corresponding impaired blood flow with DRIL suggests that retinal ischemia and loss of normal vasculature contributes to DRIL.