Nadia Waheed, MD, MPH: OCT Angiography Predicts DR Progression


A new study from AAO 2020 is the first to show a significant association between peripapillary vessel density loss and progression of diabetic retinopathy.

A study presented at the American Academy of Ophthalmology (AAO) 2020 Virtual Conference showed that optical coherence tomography (OCT) angiography metrics at baseline have the potential to predict risk of diabetic retinopathy progression at year 1.

The investigators performed color fundus photography as well as 3x3 and 6x6 macular scans, which were analyzed by a reading center.

They defined disease progression as either a ≥2-step increase in DRSS score or the development of diabetic macular edema (DME).

Thus, they enrolled a total of 167 individuals, 77 of which were affiliated with sites that had OCT angiography machines available. Within that subgroup, 73 patients had long-term progression data over the course of 1 year.

Enrolled patients were ≥18 years, had moderate-to severe diabetic retinopathy (ETDRS 43-53), had no center involved (DME), and had best correct visual acuity (BCVA) ≥ 70.

According to their multivariate logistic regression analysis, diabetic retinopathy progression was associated with enlarged foveal avascular zone (FAZ) area (4.75; OR, 115.6; P = .019), the presence of intraretinal microvascular abnormalities (IrMA) (3.00; OR, 20.09; P = .008), and decreased temporal peripapillary vessel density (superior and inferior).

In an interview with HCPLive®, study investigator Nadia Waheed, MD, MPH, Retina Specialist and Associate Professor, Tufts University School of Medicine, suggested that these associations were not particulary surprising.

“Intuitively, we’ve always known that,” she said. “We do fluorescein angiography to give us an idea of how the patient is doing and how the patient’s vasculature is doing. And this is kind of just a direct correlate to that.”

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