• OCT Predictors of DR Progression and DME

    By Lynda Seminara
    Selected By: Stephen D. McLeod, MD

    Journal Highlights

    Ophthalmology, December 2019

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    Sun et al. assessed the relationship between metrics of optical coherence tomography angiography (OCTA) and the progression of diabetic retinopa­thy (DR) and development of diabetic macular edema (DME) in patients with diabetes. They identified key predictors of DR progression and DME development, thus support­ing the predictive value of OCTA.

    This prospective study included 129 patients (205 eyes) with diabetes who were monitored for at least two years. OCTA images of the superficial and deep capillary plexuses were generated by digital software. After a qual­ity check, automated measurements were obtained of the foveal avascular zone (FAZ) area, FAZ circularity, vessel density, and fractal dimension of the superficial and deep capillary plexuses. Main outcomes were progression of DR and development of DME.

    During follow-up (median, 27.14 months), DR progressed in 28 (13.7%) of the 205 eyes. Of the 194 eyes without DME at baseline, 17 (8.8%) developed the condition during the study. After adjustment for established risk factors (DR severity, HbA1c levels, age, diabetes duration, and mean arterial blood pressure), significant predictors of DR progression were larger FAZ area, lower vessel density, and lower fractal dimen­sion of the deep capillary plexus. With regard to DME development, lower vessel density of the superficial capil­lary plexus proved to be the significant prognostic factor.

    In summary, better predictions of DR progression and DME can be attained by combining OCTA metrics with traditional risk factors, said the au­thors. Additional studies are needed to determine whether such metrics could identify subgroups of patients with DR who might benefit from more intensive workups or proactive treatment.

    The original article can be found here.