Application of optical coherence tomography angiography in the assessment of diabetic macular edema staging and laser photocoagulation efficacy

• Published in: Photodiagnosis and photodynamic therapy 2024-04, Vol.46, p.104055-104055, Article 104055
• Main Authors: Fu, Wei-Na, Du, Yan, Gong, Zhi-Yong
• Format: Article
• Language: English
• Subjects: Aged; Diabetic macular edema; Diabetic Retinopathy - diagnostic imaging; Diabetic Retinopathy - surgery; Diabetic Retinopathy - therapy; Female; Fluorescein Angiography - methods; Humans; Laser Coagulation - methods; Laser photocoagulation; Macular Edema - diagnostic imaging; Male; Middle Aged; OCT; Optical coherence tomography flow imaging; Sensitivity and Specificity; Staging; Tomography, Optical Coherence - methods; Visual Acuity
• ISSN: 1572-1000; 1873-1597
• DOI: 10.1016/j.pdpdt.2024.104055

•OCTA has high sensitivity and specificity in the diagnosis and staging of DME, and can reflect the microvascular and visual changes in the central macular recess of patients before and after laser photocoagulation therapy, which can quantitatively guide the follow-up treatment of DME.•OCTA uses the split spectrum amplitude decorrelation flow imaging technology to quantify blood flow density and the retinal vascular system, clearly showing the structure of the blood vessels in each layer of the retina .•Laser photocoagulation is a common treatment for CSME, which stimulates the migration and proliferation of retinal pigment epithelial cells, reshapes the blood-retina barrier function, and regulates retinal blood supply.•Laser photocoagulation can coagulate lesions through the thermal effect of the laser, destroy highly oxygen-consuming outer retinal layers, block leaking capillaries, reduce neovascularization, and the scars formed by laser spots can accelerate the diffusion of oxygen into the retina, thereby eliminating macular edema. This study aimed to analyze the effect of optical coherence tomography angiography (OCTA) on diabetic macular edema (DME) staging and assess the efficacy of laser photocoagulation. Eighty-six patients (141 eyes) with suspected DME who visited our hospital from August 2019 to March 2022 were selected and underwent fundus angiography and OCTA. The two examination methods were compared in terms of their efficacy in macular edema staging. Subsequently, the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of OCTA in diagnosing DME were assessed using fundus angiography as the gold standard. In patients with clinically significant macular edema (CSME) treated with laser photocoagulation, the central concave non-perfused zone (FAZ), vascular density (VD), central macular retinal thickness (CRT), whole retinal blood flow density (FD-300), superficial capillary plexus (SCP), and deep capillary plexus (DCP) were measured using the OCTA 3 mm × 3 mm mode before treatment, at 3 months after treatment, and at 6 months after treatment. SCP, deep capillary plexus (DCP), blood flow density (VD), best corrected visual acuity (BCVA), and central retinal thickness (CRT) were recorded before treatment, 3 months after treatment, and 6 months after treatment. The correlation between BCVA and pre-treatment OCTA parameters at 6 months after treatment was analyzed using Pearson's correlation. Fundus angiogra