Expanded Field Swept-source Optical Coherence Tomography Angiography in the Assessment of Proliferative Diabetic Retinopathy and Associated Complications: A Review.

Abstract

Retinal imaging plays a critical role in the detection and management of proliferative diabetic retinopathy (PDR). Commonly used imaging modalities in the retina clinic include ultra-widefield fundus photography, ultra-widefield fluorescein angiography (FA), and optical coherence tomography (OCT). OCT angiography (OCTA) provides a noninvasive method to assess the retinal microvasculature and detect vascular alterations, including retinal neovascularization (NV). More recently, the emergence of expanded field swept-source OCTA (SS-OCTA) has offered faster en-face and cross-sectional imaging of the retina with a broader field of view. Prior reviews have highlighted the role of SS-OCTA in assessing associated lesions of PDR, including NV, microaneurysms, foveal avascular zone, intraretinal microvascular abnormalities, and capillary non-perfusion. In this review, we explore the clinical applications of expanded field SS-OCTA in characterizing NV morphology, comparing NV detection to FA, and offering potential imaging biomarkers associated with vision-threatening complications of PDR, including vitreous hemorrhage, neovascular glaucoma, and tractional retinal detachment.