Comparative study of widefield swept-source optical coherence tomography angiography in eyes with concomitant age-related macular degeneration and diabetic retinopathy

Matthew Finn; Grace Baldwin; Itika Garg; Hannah E Wescott; Thomas Koch; Filippos Vingopoulos; Rebecca Zeng; Hanna Choi; Diane Sayah; Deeba Husain; Nimesh A Patel; Leo A Kim; Joan W Miller; David M Wu; Demetrios G Vavvas; John B Miller

doi:10.1136/bjo-2023-323792

Comparative study of widefield swept-source optical coherence tomography angiography in eyes with concomitant age-related macular degeneration and diabetic retinopathy

Br J Ophthalmol. 2023 Oct 16:bjo-2023-323792. doi: 10.1136/bjo-2023-323792. Online ahead of print.

Authors

Matthew Finn^{1

2}, Grace Baldwin^{1

2}, Itika Garg^{1

2}, Hannah E Wescott^{1

2}, Thomas Koch^{1

2}, Filippos Vingopoulos^{1

2}, Rebecca Zeng^{1

2}, Hanna Choi^{1

2}, Diane Sayah^{1

2}, Deeba Husain², Nimesh A Patel², Leo A Kim², Joan W Miller², David M Wu², Demetrios G Vavvas², John B Miller^{3

2}

Affiliations

¹ Harvard Retinal Imaging Lab, Harvard Medical School, Boston, Massachusetts, USA.
² Retina, Massachusetts Eye and Ear, Boston, Massachusetts, USA.
³ Harvard Retinal Imaging Lab, Harvard Medical School, Boston, Massachusetts, USA john_miller@meei.harvard.edu.

PMID: 37844999
DOI: 10.1136/bjo-2023-323792

Abstract

Background/aims: We sought to evaluate widefield swept-source optical coherence tomography angiography (WF SS-OCTA) among eyes with concomitant age-related macular degeneration (AMD) and diabetes mellitus or diabetic retinopathy (DM/DR).

Methods: This cross-sectional, comparative study consisted of three study groups: eyes with (1) AMD and DM/DR, (2) AMD alone and (3) DM/DR alone. WF SS-OCTA (3×3, 6×6 and 12×12 mm) images were captured. Vascular metrics included foveal avascular zone (FAZ), vessel density (VD) and vessel skeletonised density (VSD). Mixed-effects multivariable regression models adjusted for age were performed by cohort and subgroup based on AMD and DR stages.

Results: Our cohort included 287 eyes from 186 patients with an average age of 64±14.0 years old. Results revealed significantly reduced vascular metrics in concomitant AMD and DM/DR eyes (N=68) compared with AMD-only eyes (N=71) on all angiograms but not compared with DM/DR-only eyes (N=148). For example, when compared with AMD-only eyes, AMD and DM/DR eyes had significantly reduced VD (β=-0.03, p=0.016) and VSD (β=-1.09, p=0.022) on 12×12 mm angiograms, increased FAZ perimeter (β=0.51, p=0.025) and FAZ area (β=0.11, p=0.015) on 6×6 mm angiogram, and reductions in all VD and VSD metrics on 3×3 and 6×6 mm angiograms. However, only 3×3 mm angiogram FAZ metrics were significantly different when comparing DM/DR eyes with concomitant AMD and DM/DR eyes.

Conclusion: WF SS-OCTA revealed significant reductions in retinal microvasculature metrics in AMD and DM/DR eyes compared with AMD-only eyes but not compared with DM/DR-only eyes.

Keywords: Imaging; Retina.