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      Optical Coherence Tomography Angiography of Foveal Neovascularization in Diabetic Retinopathy

      case-report

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          Abstract

          Purpose: To report a case of foveal neovascularization in a patient with proliferative diabetic retinopathy as seen on optical coherence tomography angiography (OCT-A). Methods: Multimodal imaging was used for diagnostic investigation. Patient: A 61-year-old male with a 16-year history of insulin-dependent diabetes mellitus was referred to our medical retina department for examination and management. Meticulous fundus examination and multimodal imaging revealed proliferative diabetic retinopathy lesions, including neovascularization located in the foveal area. Results: OCT-A allowed us to detect the neovascular lesion, confirm that it originated from perifoveal capillaries, estimate its retinal depth, and evaluate the vessel blood flow in multiple layers. Conclusion: To the best of our knowledge this is the first report of OCT-A imaging of foveal neovascularization in diabetic retinopathy. OCT-A is a very useful examination for the diagnostic investigation of patients with diabetic retinopathy.

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          Most cited references5

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          Alteration of choroidal circulation in the foveal region in patients with type 2 diabetes.

          R Sugawara, F Mori, T Hikichi … (2004)
          To investigate changes in choroidal blood flow (CBF) in the foveal region in patients with type 2 diabetes. Laser Doppler flowmetry was used to determine the CBF in the foveal region in 70 patients with type 2 diabetes and 36 age and sex matched healthy subjects (control group). The patients were classified into three groups: 33 patients (33 eyes) with no diabetic retinopathy (NDR), 20 patients (20 eyes) with non-proliferative diabetic retinopathy and no macular oedema (NPDR/MO-), and 17 patients (17 eyes) with NPDR and MO (NPDR/MO+). Optical coherence tomography was also used to measure the foveal thickness. The group averaged CBF values were 13.5 (4.9), 9.4 (2.5), 10.8 (4.8), and 5.6 (2.0) (arbitrary units) in the control, NDR, NPDR/MO-, and NPDR/MO+ groups, respectively. The group averaged CBF values in the NDR group decreased (30.2%; p<0.01) compared with the control group. The average CBF value in the NPDR/MO+ group was also significantly lower (48.2%; p<0.01) compared with that in the NPDR/MO- group. The CBF in the foveal region significantly decreases in patients with diabetes, especially those with macular oedema.
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            Foveal neovascularization in diabetic retinopathy.

            B Joondeph, H Joondeph, T Flood (1987)
            Retinal neovascularization in diabetes mellitus almost always occurs at the optic disc and/or near the major nasal and temporal vascular arcades, sparing the foveal area. We examined seven eyes of seven patients with long-standing insulin-dependent diabetes mellitus who had unilateral foveal retinal neovascularization. The neovascularization originated from the perifoveal capillaries and demonstrated typical leakage on fluorescein angiography.
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              Foveal neovascularisation in diabetic retinopathy: case report and review of literature.

              Jyothsna Rajagopal, Anuradha Kamath, G Kamath … (2010)
              To report a rare case of unilateral foveal neovascularisation in an asymptomatic patient with 15-year history of insulin-dependent diabetes mellitus and bilateral proliferative diabetic retinopathy and diabetic macular edema. Fundus fluorescein angiography and optical coherence tomography scan confirmed the presence of foveal neovascularisation. There was complete regression of the foveal neovascularisation after pan retinal laser photocoagulation. We review the literature on foveal neovascularisation in diabetic retinopathy and propose a possible pathogenic mechanism for development of foveal neovascularisation in diabetic retinopathy and the reason for the response to pan retinal laser photocoagulation.
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                Author and article information

                Journal
                Journal ID (publisher-id): COP
                Journal ID (pmc): COP
                Journal ID (doi): 10.1159/issn.1663-2699
                Title: Case Reports in Ophthalmology
                Publisher: S. Karger AG
                ISSN (Electronic): 1663-2699
                Publication date Subscription-year: 2018
                Publication date Collection: January – April 2018
                Publication date (Electronic): 29 January 2018
                Volume: 9
                Issue: 1
                Pages: 93-97
                Affiliations
                1st Department of Ophthalmology, University of Athens, Georgios Gennimatas General Hospital, Athens, Greece
                Author notes
                *Konstantinos Andreanos, 22str. Digeni E.O.K.A., Nea Penteli, TR–15236 Athens (Greece), E-Mail coandre80@icloud.com
                Article
                Publisher ID: 485831 Pmcid ID: PMC5892317 Other ID: Case Rep Ophthalmol 2018;9:87–91
                DOI: 10.1159/000485831
                PMC ID: PMC5892317
                PubMed ID: 29643787
                SO-VID: 727f8d37-99b5-4560-824a-2ee3f60d26a0
                Copyright © © 2018 The Author(s). Published by S. Karger AG, Basel
                License:

                This article is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC). Usage and distribution for commercial purposes requires written permission. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                History
                Date received : 10 July 2017
                Date accepted : 29 November 2017
                Page count
                Figures: 3, Pages: 5
                Categories
                Subject: Case Report

                ScienceOpen disciplines: Vision sciences,Ophthalmology & Optometry,Pathology
                Keywords: Foveal neovascularization,Diabetic retinopathy,Optical coherence tomography angiography
                Data availability:
                ScienceOpen disciplines: Vision sciences, Ophthalmology & Optometry, Pathology
                Keywords: Foveal neovascularization, Diabetic retinopathy, Optical coherence tomography angiography

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