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In this study the authors present a prospective cross-sectional comparative study of typical findings of diabetic retinopathy to analyse the agreement between the image modalities of optical coherence tomography angiography (OCTA) and fluorescein angiography (FA). Fifty-three eyes of 42 patients with a mean age of 61 years were included in the study. Thirty-six of 53 eyes revealed non-proliferative diabetic retinopathy; 17/53 eyes had proliferative diabetic retinopathy. Macular images were taken between FFA and OCTA. The recorded count of microaneurysms (MAs) and the size of the foveal avascular zone (FAZ) were compared. The mean size of the FAZ was 0.39 in FA and 0.42 in OCTA. The mean count of MAs was 14 in FA and 13 in OCTA. The intraclass correlation for FA was 0.72, with a 95% confidence interval of 0.58-0.83. The intraclass correlation for OCTA was 0.82, with a 95% confidence interval of 0.72-0.89. The assessability was favourable to OCTA in 38-41/53 eyes regarding the FAZ and favourable to FA in 45-49/53 eyes regarding MAs. The readers favoured OCTA for the assessment of the FAZ and FA for the assessment of MAs. The data suggested that OCTA might be a better tool in the assessment of the FAZ compared to FA. However, there is need for improvement when it comes to clearly showing MAs. Complementary use of FA and OCTA ensures the best diagnostic approach in patients with diabetic retinopathy. Limitations: No differentiation between superficial and deep retinal vasculature was made because this is not possible on FA. Also, no differentiation was made between stages of proliferative and non-proliferative diabetic retinopathy.

Comparison between findings in optical coherence tomography angiography and in fluorescein angiography in patients with diabetic retinopathy.
Enders C, Baeuerle F, Lang GE, et al.
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Sofia Rokerya

MBBS MRCOphth FRCSI, King's College University Hospital, UK.

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