To quantitatively and morphologically document enlarged neovascularization elsewhere (NVE) using widefield swept-source (SS) optical coherence tomography angiography (OCTA) with vitreoretinal interface (VRI) slab images.
Retrospective observational imaging study.
The study included 46 NVEs in 25 eyes of 21 consecutive patients who presented with severe proliferative diabetic retinopathy with NVEs between March 2018 and June 2020 at Osaka University Hospital.
All patients underwent ophthalmologic examinations, including ultra-widefield fluorescein angiography (UWF-FA) imaging and widefield SS-OCTA scans.
We evaluated the area and the vascular density (VD) of NVEs detected on five 12×12 mm2 or two 15×9 mm2 SS-OCTA panoramic VRI slab images taken at the first and final visits.
At baseline, the mean area of the NVEs on OCTA was 1.85 ±2.81 mm2, and the vascular density of the NVEs was 73.9 ± 14.6%. At the final visit, the mean area of the NVEs on OCTA was 2.14 ± 3.14 mm2, and the mean vascular density of the NVEs was 65.3 ± 17.1%. The average NVE size change (mm2/month) was significantly associated with the ischemic index (P=0.009). NVE growth could be classified into two patterns: round-shaped (61.8%) and ramified (38.2%). The round-shaped group tended to have a larger ischemic index at baseline than the ramified group (p=0.0375).
We quantified the size and density of NVEs over time. The NVE size increase was significantly associated with the severity of ischemic changes. Furthermore, the ramified growth pattern was significantly correlated with the ischemic index. These findings suggest that the morphology of NVE is associated with more severe ischemia.

Copyright © 2021. Published by Elsevier Inc.