Purpose: To compare the visualization of microaneurysms (MAs) in patients with diabetic retinopathy (DR) using optical coherence tomography angiography (OCTA) with that using fluorescein angiography (FA).
Study design: Prospective, clinical, and experimental.
Methods: This study was a prospective evaluation of imaging technology. Thirty-seven eyes of 33 patients with DR were scanned using an OCTA instrument. The 83 MAs that were confirmed on OCT B-scan and OCT en face images were evaluated using OCTA, and these findings were compared with those evaluated using FA.
Results: Of the 83 MAs confirmed on OCT B-scan images, 73 (88%) were clearly visualized on the OCTA en face images as nodular or comma-shaped structures, while the remaining 12% did not present with a typical MA or vascular structure on the OCTA en face images at the relevant positions. Seventy-four of the 83 MAs (87%) confirmed on the OCT B-scan images presented as punctate hyperfluorescent spots on the FA images. On the FA images, 8 of 9 (88%) MAs absent on the OCTA en face images presented as hyperfluorescent spots. Visualization of the MAs on the OCTA en face images did not correlate with the OCT B-scan images of the MA lumens (open, closed, or heterogeneous).
Conclusions: For diabetic maculopathy, OCTA en face images do not present with comprehensive MAs images, indicating that some MAs might be overlooked with OCTA en face images.
Keywords: Angiography; Diabetic macular edema; Microaneurysms; Optical coherence tomography.