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Association of OCT and OCT angiography measures with the development and worsening of diabetic retinopathy in type 2 diabetes

Eye volume 37, pages 3781–3786 (2023)Cite this article

Subjects

Abstract

Objective

To assess if optical coherence tomography (OCT) and OCT angiography (OCTA) measures are associated with the development and worsening of diabetic retinopathy (DR) over four years.

Methods

280 participants with type 2 diabetes underwent ultra-wide field fundus photography, OCT and OCTA. OCT-derived macular thickness measures, retinal nerve fibre layer and ganglion cell-inner plexiform layer thickness and OCTA-derived foveal avascular zone area, perimeter, circularity, vessel density (VD) and macular perfusion (MP) were examined in relation to the development and worsening of DR over four years.

Results

After four years, 206 eyes of 219 participants were eligible for analysis. 27 of the 161 eyes (16.7%) with no DR at baseline developed new DR, which was associated with a higher baseline HbA1c and longer diabetes duration. Of the 45 eyes with non-proliferative DR (NPDR) at baseline, 17 (37.7%) showed DR progression. Baseline VD (12.90 vs. 14.90 mm/mm2, p = 0.032) and MP (31.79% vs. 36.96%, p = 0.043) were significantly lower in progressors compared to non-progressors. Progression of DR was inversely related to VD ((hazard ratio [HR] = 0.825) and to MP (HR = 0.936). The area under the receiver operating characteristic curves for VD was AUC = 0.643, with 77.4% sensitivity and 41.8% specificity for a cut-off of 15.85 mm/mm2 and for MP it was AUC = 0.635, with 77.4% sensitivity and 25.5% specificity for a cut-off of 40.8%.

Conclusions

OCTA metrics have utility in predicting progression rather than the development of DR in individuals with type 2 diabetes.

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Data availability

Data are available from the first author upon reasonable request.

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Funding

This work was supported by the DBT/Wellcome Trust India Alliance Fellowship [grant number IA/CPHE/16/1/502670] awarded to Sangeetha Srinivasan.

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Authors and Affiliations

  1. Vision Research Foundation, Chennai, India

    Sangeetha Srinivasan

  2. NIHR Moorfields Biomedical Research Centre, London, UK

    Sobha Sivaprasad

  3. Dr. Mohan’s Diabetes Specialties Centre and Madras Diabetes Research Foundation, Chennai, India

    Ramachandran Rajalakshmi & Ranjit Mohan Anjana

  4. Weill Cornell Medicine-Qatar, Education City, Doha, Qatar & Central Manchester University Hospitals Foundation Trust, Manchester, UK

    Rayaz A. Malik

  5. National Centre for Disease Informatics and Research (NCDIR) & Indian Council of Medical Research (ICMR), Bangalore, India

    Vaitheeswaran Kulothungan

  6. Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, India

    Rajiv Raman & Muna Bhende

Authors
  1. Sangeetha Srinivasan
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  2. Sobha Sivaprasad
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  3. Ramachandran Rajalakshmi
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  4. Ranjit Mohan Anjana
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  5. Rayaz A. Malik
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  6. Vaitheeswaran Kulothungan
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  7. Rajiv Raman
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  8. Muna Bhende
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Contributions

SS, RRN, MPB involved in conceptualization of the study; SS involved in data analysis; SS, MPB involved in the drafting of the manuscript; SS, SSD, RR, RMA, RAM, VK, RRN, MPB involved in interpretation of results and in critical review of the manuscript.

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Correspondence to Muna Bhende.

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Srinivasan, S., Sivaprasad, S., Rajalakshmi, R. et al. Association of OCT and OCT angiography measures with the development and worsening of diabetic retinopathy in type 2 diabetes. Eye 37, 3781–3786 (2023). https://doi.org/10.1038/s41433-023-02605-w

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