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  • Study reveals OCT angiography biomarkers tied to diabetic retinopathy progression

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    Review of: Macular and Peripapillary Optical Coherence Tomography Angiography Metrics Predict Progression in Diabetic Retinopathy: A Sub-analysis of TIME-2b Study Data

    Greig E, Brigell M, Cao F, et al. American Journal of Ophthalmology, November 2020

    This study assessed OCT angiography-derived vessel metrics of the macula and optic nerve head (ONH) that may predict progression of diabetic retinopathy.

    Study design

    Researchers performed a secondary analysis of data collected in the TIME-2b study. This study included 73 patients with moderate to severe diabetic retinopathy who were randomized to receive an investigational subcutaneous medication or sham. A subset of these patients had OCT angiography of the macula and optic nerve head. Images were analyzed for foveal avascular zone area and perimeter, nonperfusion area, vessel density and presence of intraretinal microvascular abnormalities (IRMA). The authors defined progression of disease as an increase of 2 or more steps in diabetic retinopathy severity score or development of diabetic edema.

    Outcomes

    During the 12-month follow-up, 15 patients (20.5%) had disease progression. Larger foveal avascular zone area, presence of IRMA, and reduced superotemporal and inferotemporal peripapillary vascular density were tied to increased odds of progression.

    Limitations

    The number of patients was small and, interestingly, diabetic macular edema was based on clinician grading but was not confirmed on OCT. These patients had moderate to severe nonproliferative diabetic retinopathy and fairly well-controlled diabetes prior to enrollment. In addition, several different OCT angiography devices were used at different centers which may have led to variability in measurements.

    Clinical significance

    This study suggests that certain OCT angiography findings in patients with moderate to severe nonproliferative diabetic retinopathy may be useful predictors of disease progression.