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Title: Optical Coherence Tomography Angiography Metrics Monitor Severity Progression of Diabetic Retinopathy-3-Year Longitudinal Study
Authors: Marques, Inês P. 
Kubach, Sophie
Santos, Torcato 
Mendes, Luís 
Madeira, Maria H. 
de Sisternes, Luis
Tavares, Diana 
Santos, Ana Rita 
Lewis, Warren
Lobo, Conceição 
Durbin, Mary K.
Cunha-Vaz, José 
Keywords: OCTA; diabetes; retinopathy; severity; ischemia
Issue Date: 25-May-2021
Publisher: MDPI
Project: AIBILI and by COMPETE Portugal2020 and by Fundo de Inovação, Tecnologia e Economia Circular (FITEC)—Programa Interface (FITEC/CIT/2018/2) 
Serial title, monograph or event: Journal of Clinical Medicine
Volume: 10
Issue: 11
Abstract: To examine retinal vessel closure metrics and neurodegenerative changes occurring in the initial stages of nonproliferative diabetic retinopathy (NPDR) and severity progression in a three-year period. Methods: Three-year prospective longitudinal observational cohort of individuals with type 2 diabetes (T2D), one eye per person, using spectral domain-optical coherence tomography (SD-OCT) and OCT-Angiography (OCTA). Eyes were examined four times with one-year intervals. OCTA vessel density maps of the retina were used to quantify vessel closure. Thickness of the ganglion cell + inner plexiform layer (GCL + IPL) was examined to identify retinal neurodegenerative changes. Diabetic retinopathy ETDRS classification was performed using the seven-field ETDRS protocol. Results: A total of 78 eyes/patients, aged 52 to 80 years, with T2D and ETDRS grades from 10 to 47 were followed for 3 years with annual examinations. A progressive increase in retinal vessel closure was observed. Vessel density (VD) showed higher decreases with retinopathy worsening demonstrated by step-changes in ETDRS severity scale (p < 0.001). No clear correlation was observed between neurodegenerative changes and retinopathy progression. Conclusions: Retinal vessel closure in NPDR correlates with DR severity progression. Our findings provide supporting evidence that OCTA metrics of vessel closure may be used as a surrogate for DR severity progression.
ISSN: 2077-0383
DOI: 10.3390/jcm10112296
Rights: openAccess
Appears in Collections:I&D IBILI - Artigos em Revistas Internacionais
I&D ICBR - Artigos em Revistas Internacionais
FMUC Medicina - Artigos em Revistas Internacionais

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