EXPANDED FIELD OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY BIOMARKERS ASSOCIATED WITH THE DEVELOPMENT OF TRACTIONAL RETINAL DETACHMENT IN PROLIFERATIVE DIABETIC RETINOPATHY.

Abstract

To investigate associations among expanded field swept-source optical coherence tomography angiography biomarkers and the development of tractional retinal detachment (TRD) in patients with proliferative diabetic retinopathy (PDR). Patients with PDR without TRD at baseline were imaged with swept-source optical coherence tomography angiography. Quantitative and qualitative OCTA metrics were independently evaluated by two trained graders. A logistic regression model was used to identify OCTA biomarkers associated with TRD development. Forty-nine PDR eyes from 38 participants were included. Seven of 49 eyes (14%) developed TRD over a median of 576 (range 35-805) days. Biomarkers associated with TRD were large retinal nonperfusion area (odds ratio [OR], 7.84; 95% confidence interval [CI], 2.61-16.3; P = 0.04), presence of neovascularization (NV) with total area > 4 disc diameters (OR, 2.30; 95% [CI], 1.09-4.51; P = 0.04), and presence of tabletop NV (OR, 2.64; 95% [CI], 1.42-4.86; P = 0.02), defined as NV displaced anteriorly by vitreous traction but tethered to the retina by vascular membranes. Presence of large retinal nonperfusion area, extensive NV, and NV with features of anterior displacement by vitreous traction were associated with increased risk of TRD occurrence. Swept-source optical coherence tomography angiography may be useful for predicting diabetic TRD development.