Comparison of widefield swept-source optical coherence tomography angiography and ultra-widefield fluorescein angiography in the detection of non-perfusion areas in diabetic retinopathy

PurposeTo compare the detection of non-perfusion areas (NPAs) in diabetic retinopathy (DR) using 24×20 mm widefield swept-source optical coherence tomography angiography (SS-OCTA) and ultra-widefield fluorescein angiography (UWFA), and to explore NPA distribution patterns.MethodsThis retrospective s...

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Main Authors: Chuyun Guo, Ning Xiao, Fang Li, Yue Han, Li Chen, Hongzhuang Chen, Yadan Shen, Xinru Ning, Ruolan Ling, Xi Wang, Lin Zhang, You Wang, Jie Zhong, Jie Li
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-04-01
Series:Frontiers in Endocrinology
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Online Access:https://www.frontiersin.org/articles/10.3389/fendo.2025.1521837/full
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author Chuyun Guo
Ning Xiao
Fang Li
Yue Han
Li Chen
Hongzhuang Chen
Yadan Shen
Xinru Ning
Ruolan Ling
Xi Wang
Lin Zhang
Lin Zhang
You Wang
Jie Zhong
Jie Li
author_facet Chuyun Guo
Ning Xiao
Fang Li
Yue Han
Li Chen
Hongzhuang Chen
Yadan Shen
Xinru Ning
Ruolan Ling
Xi Wang
Lin Zhang
Lin Zhang
You Wang
Jie Zhong
Jie Li
author_sort Chuyun Guo
collection DOAJ
description PurposeTo compare the detection of non-perfusion areas (NPAs) in diabetic retinopathy (DR) using 24×20 mm widefield swept-source optical coherence tomography angiography (SS-OCTA) and ultra-widefield fluorescein angiography (UWFA), and to explore NPA distribution patterns.MethodsThis retrospective study included 64 eyes from 48 DR patients who underwent 24×20 mm SS-OCTA and UWFA examinations. NPAs were manually annotated, and the detection rates and distribution patterns across retinal quadrants were analyzed and compared between the two imaging modalities.ResultsCompared to UWFA, the 24×20 mm SS-OCTA scan range missed 53.40% of total NPAs. The detection rates within the SS-OCTA scan range varied across quadrants: 50.58% (superior temporal), 55.33% (inferior temporal), 43.99% (superior nasal), and 43.45% (inferior nasal). NPAs were most prevalent in the inferior nasal region (40.16% of total NPAs). The ischemic index (ISI) derived independently from NPAs identified by the two imaging modalities showed a very strong positive correlation.ConclusionsWithin the scan range of 24×20 mm SS-OCTA, over 50% of total NPAs were missed compared to UWFA. However, OCTA can accurately reveal the degree of retinal ischemia within its field of view. NPA is unevenly distributed in the retina, with the predominant area being the inferior nasal region. This study suggests that this area should be prioritized for assessment in DR management.
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spelling doaj-art-28cfd1b57cbb4666b2be36d2bf29caf62025-08-20T02:25:59ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922025-04-011610.3389/fendo.2025.15218371521837Comparison of widefield swept-source optical coherence tomography angiography and ultra-widefield fluorescein angiography in the detection of non-perfusion areas in diabetic retinopathyChuyun Guo0Ning Xiao1Fang Li2Yue Han3Li Chen4Hongzhuang Chen5Yadan Shen6Xinru Ning7Ruolan Ling8Xi Wang9Lin Zhang10Lin Zhang11You Wang12Jie Zhong13Jie Li14Department of Ophthalmology, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, ChinaDepartment of Health Management Center & Institute of Health Management, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, ChinaHealth Management Medical Center, Chengdu First People’s Hospital, Chengdu, ChinaDepartment of Ophthalmology, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, ChinaDepartment of Ophthalmology, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, ChinaDepartment of Ophthalmology, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, ChinaDepartment of Ophthalmology, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, ChinaDepartment of Ophthalmology, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, ChinaDepartment of Ophthalmology, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, ChinaDepartment of Ophthalmology, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, ChinaDepartment of Ophthalmology, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, ChinaSichuan Provincial Key Laboratory for Human Disease Gene Study and Department of Laboratory Medicine, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, ChinaDepartment of Ophthalmology, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, ChinaDepartment of Ophthalmology, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, ChinaDepartment of Ophthalmology, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, ChinaPurposeTo compare the detection of non-perfusion areas (NPAs) in diabetic retinopathy (DR) using 24×20 mm widefield swept-source optical coherence tomography angiography (SS-OCTA) and ultra-widefield fluorescein angiography (UWFA), and to explore NPA distribution patterns.MethodsThis retrospective study included 64 eyes from 48 DR patients who underwent 24×20 mm SS-OCTA and UWFA examinations. NPAs were manually annotated, and the detection rates and distribution patterns across retinal quadrants were analyzed and compared between the two imaging modalities.ResultsCompared to UWFA, the 24×20 mm SS-OCTA scan range missed 53.40% of total NPAs. The detection rates within the SS-OCTA scan range varied across quadrants: 50.58% (superior temporal), 55.33% (inferior temporal), 43.99% (superior nasal), and 43.45% (inferior nasal). NPAs were most prevalent in the inferior nasal region (40.16% of total NPAs). The ischemic index (ISI) derived independently from NPAs identified by the two imaging modalities showed a very strong positive correlation.ConclusionsWithin the scan range of 24×20 mm SS-OCTA, over 50% of total NPAs were missed compared to UWFA. However, OCTA can accurately reveal the degree of retinal ischemia within its field of view. NPA is unevenly distributed in the retina, with the predominant area being the inferior nasal region. This study suggests that this area should be prioritized for assessment in DR management.https://www.frontiersin.org/articles/10.3389/fendo.2025.1521837/fulldiabetic retinopathynon-perfusion areasswept-source widefield optical coherence tomography angiographyultra-widefield fluorescein angiographyischemic index
spellingShingle Chuyun Guo
Ning Xiao
Fang Li
Yue Han
Li Chen
Hongzhuang Chen
Yadan Shen
Xinru Ning
Ruolan Ling
Xi Wang
Lin Zhang
Lin Zhang
You Wang
Jie Zhong
Jie Li
Comparison of widefield swept-source optical coherence tomography angiography and ultra-widefield fluorescein angiography in the detection of non-perfusion areas in diabetic retinopathy
Frontiers in Endocrinology
diabetic retinopathy
non-perfusion areas
swept-source widefield optical coherence tomography angiography
ultra-widefield fluorescein angiography
ischemic index
title Comparison of widefield swept-source optical coherence tomography angiography and ultra-widefield fluorescein angiography in the detection of non-perfusion areas in diabetic retinopathy
title_full Comparison of widefield swept-source optical coherence tomography angiography and ultra-widefield fluorescein angiography in the detection of non-perfusion areas in diabetic retinopathy
title_fullStr Comparison of widefield swept-source optical coherence tomography angiography and ultra-widefield fluorescein angiography in the detection of non-perfusion areas in diabetic retinopathy
title_full_unstemmed Comparison of widefield swept-source optical coherence tomography angiography and ultra-widefield fluorescein angiography in the detection of non-perfusion areas in diabetic retinopathy
title_short Comparison of widefield swept-source optical coherence tomography angiography and ultra-widefield fluorescein angiography in the detection of non-perfusion areas in diabetic retinopathy
title_sort comparison of widefield swept source optical coherence tomography angiography and ultra widefield fluorescein angiography in the detection of non perfusion areas in diabetic retinopathy
topic diabetic retinopathy
non-perfusion areas
swept-source widefield optical coherence tomography angiography
ultra-widefield fluorescein angiography
ischemic index
url https://www.frontiersin.org/articles/10.3389/fendo.2025.1521837/full
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