Utilizing Widefield SS-OCTA to evaluate diabetic retinopathy severity

John B. Miller, MD, discusses widefield swept-source OCTA and its use in monitoring biomarkers in diabetic retinopathy.

On October 10, 2021, John B. Miller, MD, presented his talk entitled, “Evaluation of Nonperfusion Area and Other Vascular Metrics by Widefield SS-OCTA as Biomarkers of Diabetic Retinopathy Severity,” at the ASRS 39th Annual Scientific Meeting.

Dr. Miller practices at Massachusetts Eye and Ear Infirmary, Retina Service. He is also an assistant professor of ophthalmology at Harvard Medical School.

Video transcript

Yeah, so I'm John Miller. I work at Mass. Eye and Ear and I run the Harvard Retinal Imaging Lab focusing on novel imaging devices and diabetic retinopathy specifically.

So we've done a lot of work with widefield swept-source OCT-A, which is still an investigational device that offers wider field of view and enhanced resolution. We focused on clinical applications and that can benefit our patients in routine clinical practice. So specifically in diabetic retinopathy, we've shown that you can predict complications like vitreous hemorrhage and neovascular glaucoma, based on specific parameters shown by the widefield swept-source OCT-A. More specifically, this technology is different from what we use routinely in clinic with spectral domain because it can give us a wider field of view to give us metrics on non-perfusion area and specific features of the neovascularization.

Today's talk is specifically on how can we classify diabetic retinopathy with OCT-A? Traditionally, we've always used fundus photographs and exam findings to identify diabetic retinopathy lesions and classify patient disease. But this has some subjectivity and is also time-intensive in some cases, and doesn't have the same quantified metrics that the OCT-A technology can provide.

So we showed that non-perfusion area was better than all other metrics at identifying diabetic retinopathy severity stage. And I think that this could be an important technology for our clinical practice as the device becomes more widely used. Specifically, we, I mean, we all use a lot of anti-VEGF injections, and there are difficult clinical decisions as to when to stop or when to initiate treatment. And having an actual metric like the non-perfusion area to follow over time, or the relative ischemia of the retina, may be a guide for our clinical care to help initiate or cease treatment for these patients with diabetic retinopathy.

Specifically, you can avoid doing a fluorescein angiography, which is an invasive test, it often requires a nurse; there are some severe allergic reactions. It is rare, but it can cause severe anaphylaxis, and it's just difficult to do at every clinical visit whereas we all are very used to getting an OCT at every clinic visit. So this could be an add-on to those routine OCTs.

The American Society of Retina Specialists (ASRS) hosted its 39th Annual Scientific Meeting from October 8-12, 2021, at the JW Marriott San Antonio Hill Country Resort and Spa in San Antonio, Texas.

According to ASRS, its 2021 scientific program offered attendees innovations in retina science, clinical practice, and surgery with 148 papers, 165 posters, 46 papers on demand, and 69 films, as well as a wide range of networking opportunities and the chance to exchange ideas and perspectives with peers.

Related Content: Additional ASRS 2021 Content | Conference Coverage | Ophthalmology