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Wide-field en face swept-source optical coherence tomography angiography using extended field imaging in diabetic retinopathy
  1. Takao Hirano1,2,
  2. Shinji Kakihara2,
  3. Yuichi Toriyama2,
  4. Muneeswar Gupta Nittala1,
  5. Toshinori Murata2,
  6. Srinivas Sadda1,3
  1. 1 Doheny Image Reading Center, Doheny Eye Institute, Los Angeles, California, USA
  2. 2 Deparment of Ophthalmology, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
  3. 3 Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
  1. Correspondence to Dr Srinivas Sadda, Doheny Image Reading Center, Doheny Eye Institute, Los Angeles, California 90033, USA; ssadda{at}


Aims To examine the feasibility of wide-field en face swept-source optical coherence tomography angiography (SS-OCTA) with extended field imaging (EFI) for evaluation of the retinal vasculature in diabetic retinopathy (DR).

Methods This study included 37 eyes of 27 patients (age, 65±10 years; male patients, 18; female patients, 9) with DR. All patients underwent comprehensive ophthalmological examination, including OCTA and fluorescein angiography (FA). The imaging methods were compared for visible field of view, presence and extent of non-perfused areas (NPAs), presence and number of new blood vessels (NVs), vessel density (VD) and patient comfort level measured by Visual Analogue Scale.

Results SS-OCTA with EFI allowed capture of larger areas (by 1.80±0.18 times on average) of the fundus than SS-OCTA without EFI. Compared with FA, the sensitivities of SS-OCTA with EFI for detection of NPAs and NVs were 96% and 79%, respectively, with specificities of 100% and 96%, respectively. There was no significant difference in extent of NPAs (61.2±45.8 vs 61.5±55.0 disc areas, P=0.99) or number of NVs (1.5±3.3 vs 0.9±1.8, P=0.68) between FA and SS-OCTA with EFI. VD showed significantly lower values in EFI SS-OCTA than in those acquired without EFI (31.6%±4.3%  vs 34.2%±4.3%, P<0.001). Wide-field OCTA with EFI was significantly more comfortable for patients than FA (P<0.001).

Conclusions SS-OCTA with EFI allows acquisition of wide-field en face images of the retinal vasculature in patients with DR, with greater patient comfort than FA.

  • retina
  • imaging

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  • Contributors TH, TM and SS: study conception, design, analysis, interpretation of data, drafting and revising, final approval. SK, YT and MGN: data acquisition, drafting and revising, final approval.

  • Funding SS is a consultant for and receives research support from Optosand Carl Zeiss Meditec, and serves as a consultant for Centervue, and has access to research instruments provided by Heidelberg Engineering, Topcon Medical Systems, Optos, Carl Zeiss Meditec, Nidek, and Centervue.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval Ethics committee of the Shinshu University School of Medicine (approval number 2044).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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