Optical Coherence Tomography (OCT) and OCT Angiography (OCTA) Biomarkers for Diabetic Retinopathy in Type 2 Diabetes Mellitus: A Scoping Review
DOI:
https://doi.org/10.31584/jhsmr.20241102Keywords:
foveal avascular zone, ganglion cell layer, OCT angiography (OCTA), optical coherence tomography (OCT), vessel densityAbstract
Objective: This scoping review aims to identify the biomarkers of optical coherence tomography (OCT) and OCT angiography (OCTA) for the assessment of diabetic retinopathy (DR) in type 2 diabetes mellitus (T2DM) patients.
Material and Methods: A search was conducted on multiple databases, including Scopus, ScienceDirect, WOS, and PubMed, spanning from 2015 to 2023. The criteria were selected based on the PRISMA guidelines. The search focuses on the macular OCT and OCTA biomarkers.
Results: The search identified 114 studies, and 20 were included in the final review. OCT findings demonstrated a reduction in the thickness of retinal layers, mainly the ganglion cell layer (GCL) and inner plexiform layer (IPL), correlating inversely with the diabetes duration. OCTA enables precise assessment of retinal vascular changes, such as the foveal avascular zone (FAZ) area and vessel density (VD), indicating DR severity. Increased FAZ area was observed in proliferative DR (PDR), and decreased VD impacted visual acuity. Other parameters (FAZ shape, circularity index, paracentral interpapillary area, fractal dimension, vessel length density, and perfusion density) are also altered in diabetic eyes. OCTA of the choriocapillaris studies reveals increased flow voids in PDR patients.
Conclusion: The scoping review underscores the potential application of OCT and OCTA in deciphering DR pathophysiology and highlights novel biomarkers for its detection and diagnosis. Nevertheless, longitudinal studies are warranted to validate its clinical utility. This review emphasizes the importance of advancing OCT/OCTA technology to enhance DR assessment, and ultimately improve patient care.
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