Title : Classification of neovascularization using wide-field OCT-A in PDR
Abstract:
Purpose: To classify neovascularization in treatment naïve patients of PDR based on wide-field Optical Coherence Tomography – Angiography (OCT-A)
Methods: All patients with PDR underwent detailed ocular examination including optical coherence tomography angiography (ZEISS AngioplexTM) using 14 x 14mm scan (50? field of view). Vitreo-retinal interface (VRI) segmentation was done to study the topography of NVE.
Results: On clinical examination all patients with NVE with no distinct feature suggestive of elevation/raised NVE were included. Vitreo-retinal interface was assessed using the auto-segmentation feature of the machine. Other features such as capillary drop-out areas (CDO) and increased intercapillary distance (ICD) were assessed in all patients.
Conclusion: OCTA provides succinct segmentation and thus allows us to objectively visualize subtle topographical changes of the NVE. Due to restricted field of view OCTA was far from being comparable to fluorescein angiography or clinical examination1 but VRI segmentation has allowed us to visualize elevated NVE and propose prognosticating them objectively
Clinical Implication: The topography of the NV may help prognosticate DR. These raised fronds are more likely to cause vitreous haemorrhage in patients with PDR even with small amount of vitreous traction on these fragile elevated fronds. Use of montage OCTA allows us to objectively visualize these elevated NV and eventually identify patients with PDR likely to have VH following interventions like PRP and anti-vascular endothelial growth factor injections (anti-VEGF).
