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Comparative study of widefield swept-source optical coherence tomography angiography in eyes with concomitant age-related macular degeneration and diabetic retinopathy
  1. Matthew Finn1,2,
  2. Grace Baldwin1,2,
  3. Itika Garg1,2,
  4. Hannah E Wescott1,2,
  5. Thomas Koch1,2,
  6. Filippos Vingopoulos1,2,
  7. Rebecca Zeng1,2,
  8. Hanna Choi1,2,
  9. Diane Sayah1,2,
  10. Deeba Husain2,
  11. Nimesh A Patel2,
  12. Leo A Kim2,
  13. Joan W Miller2,
  14. David M Wu2,
  15. Demetrios G Vavvas2,
  16. John B Miller1,2
  1. 1 Harvard Retinal Imaging Lab, Harvard Medical School, Boston, Massachusetts, USA
  2. 2 Retina, Massachusetts Eye and Ear, Boston, Massachusetts, USA
  1. Correspondence to Dr John B Miller, Harvard Retinal Imaging Lab, Boston, MA 02114, USA; john_miller{at}meei.harvard.edu

Abstract

Background/aims We sought to evaluate widefield swept-source optical coherence tomography angiography (WF SS-OCTA) among eyes with concomitant age-related macular degeneration (AMD) and diabetes mellitus or diabetic retinopathy (DM/DR).

Methods This cross-sectional, comparative study consisted of three study groups: eyes with (1) AMD and DM/DR, (2) AMD alone and (3) DM/DR alone. WF SS-OCTA (3×3, 6×6 and 12×12 mm) images were captured. Vascular metrics included foveal avascular zone (FAZ), vessel density (VD) and vessel skeletonised density (VSD). Mixed-effects multivariable regression models adjusted for age were performed by cohort and subgroup based on AMD and DR stages.

Results Our cohort included 287 eyes from 186 patients with an average age of 64±14.0 years old. Results revealed significantly reduced vascular metrics in concomitant AMD and DM/DR eyes (N=68) compared with AMD-only eyes (N=71) on all angiograms but not compared with DM/DR-only eyes (N=148). For example, when compared with AMD-only eyes, AMD and DM/DR eyes had significantly reduced VD (β=−0.03, p=0.016) and VSD (β=−1.09, p=0.022) on 12×12 mm angiograms, increased FAZ perimeter (β=0.51, p=0.025) and FAZ area (β=0.11, p=0.015) on 6×6 mm angiogram, and reductions in all VD and VSD metrics on 3×3 and 6×6 mm angiograms. However, only 3×3 mm angiogram FAZ metrics were significantly different when comparing DM/DR eyes with concomitant AMD and DM/DR eyes.

Conclusion WF SS-OCTA revealed significant reductions in retinal microvasculature metrics in AMD and DM/DR eyes compared with AMD-only eyes but not compared with DM/DR-only eyes.

  • Retina
  • Imaging

Data availability statement

All data relevant to the study are included in the article or uploaded as supplemental information.

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Data availability statement

All data relevant to the study are included in the article or uploaded as supplemental information.

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Footnotes

  • X @itikagarg

  • Presented at The work from this manuscript was submitted for presentation in part at the Association for Research in Vision and Ophthalmology (ARVO) Annual Meeting 2023 in New Orleans, Louisiana, USA.

  • Contributors Concept and design—MF, GB, IG, FV, DH, NAP, LK, JWM, DW, DV and JBM. Data collection—MF, GB, IG, HEW, TK, FV, RZ, HC and DS. Original manuscript draft—MF and GB. Critical revision of the manuscript—MF, GB, IG, TK, HEW, FV, RZ, HC, DS, DH, NAP, LK, JWM, DW, DV and JBM. Guarantors—JBM.

  • Funding Lions International Fund (grant 530125 and 530869).

  • Disclaimer The funding organisation had no role in design or conduct of this research.

  • Competing interests JBM is a consultant for Alcon, Allergan, Carl Zeiss, Sunovion, Topcon and Genentech. DV is a consultant for Valitor and Olix Pharmaceuticals; and has received financial support from National Eye Institute and by grants from the National Institute of Health (R01EY025362 and R21EY0203079), Research to Prevent Blindness, Loefflers Family Foundation, Yeatts Family Foundation and Alcon Research Institute. DW holds a patent through Massachusetts Eye and Ear. JWM is a consultant for Sunovion, KalVista Pharmaceuticals and ONL Therapeutics; holds a patent through and has received financial support from ONL, Drusolv Therapeutics, Valeant Pharmaceuticals/Massachusetts Eye and Ear; has received financial support from Lowy Medical Research Institute; holds a position of influence with Apitnyx; and holds personal financial interest in Ciendias Bio. LK has received research support from National Eye Institute and CureVac; and has a financial arrangement with Pykus Therapeutics. NAP is a consultant for Alimera Sciences, Alcon, Allergan and Genentech. DH is a consultant for Allergen, Genentech and Omeicos Therapeutics; and has received financial support from National Eye Institute, Lions VisionGift, Commonwealth Grant, Lions International, Syneos and the Macular Society. The following authors do not have any competing interests to disclose—MF, GB, IG, HEW, TK, FV, RZ, HC and DS.

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

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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