Impact of Optical Coherence Tomography Angiography Scan Protocols on Quantitative Microvascular Biomarkers in Diabetic Retinopathy.

@article{song2026impact,
  title = {{Impact of Optical Coherence Tomography Angiography Scan Protocols on Quantitative Microvascular Biomarkers in Diabetic Retinopathy.}},
  author = {Wenjun Song and Ryan Zi Lin Tan and Ayush Jayakrishnan and Hnin Hnin Oo and Lingyi Zhuang and Wei Hing Seah and Yusra Asad and Jun Ting Yeo and Sowkath Ali and Tai Yong Loh and Juling Sia and Pavan Paniharam and Ser Koon Goh and Peiqi Lo and Colin Ming Hui Goh and Jia Jia Mah and Yue Qiu and Rupesh Agrawal and Nicola Yi'an Gan and Yali Jia and Philip J Rosenfeld and Sandy Wenting Zhou},
  journal = {Translational vision science \& technology},
  year = {2026},
  month = oct,
  doi = {10.1167/tvst.15.10.18},
  url = {https://europepmc.org/article/MED/42878570},
  note = {CC BY-NC-ND},
}

TY  - JOUR
TI  - Impact of Optical Coherence Tomography Angiography Scan Protocols on Quantitative Microvascular Biomarkers in Diabetic Retinopathy.
AU  - Wenjun Song
AU  - Ryan Zi Lin Tan
AU  - Ayush Jayakrishnan
AU  - Hnin Hnin Oo
AU  - Lingyi Zhuang
AU  - Wei Hing Seah
AU  - Yusra Asad
AU  - Jun Ting Yeo
AU  - Sowkath Ali
AU  - Tai Yong Loh
AU  - Juling Sia
AU  - Pavan Paniharam
AU  - Ser Koon Goh
AU  - Peiqi Lo
AU  - Colin Ming Hui Goh
AU  - Jia Jia Mah
AU  - Yue Qiu
AU  - Rupesh Agrawal
AU  - Nicola Yi'an Gan
AU  - Yali Jia
AU  - Philip J Rosenfeld
AU  - Sandy Wenting Zhou
PY  - 2026
DA  - 2026/10/01
JO  - Translational vision science & technology
DO  - 10.1167/tvst.15.10.18
UR  - https://europepmc.org/article/MED/42878570
AB  - Purpose  The purpose of this study was to evaluate the influence of optical coherence tomography angiography (OCTA) scan protocols on quantitative measurements of diabetic retinopathy (DR) biomarkers and their diagnostic performance for DR staging.Methods  In this cross-sectional study, 110 eyes from 74 treatment-naïve patients with DR underwent OCTA imaging using 6 × 6 mm, 12 × 12 mm, and 29 × 24 mm scan protocols. OCTA biomarkers, including nonperfusion index (NPI), intraretinal microvascular abnormalities (IRMAs) counts, and neovascularization (NV) counts, were analyzed. Receiver operating characteristic (ROC) analysis evaluated performance for discriminating proliferative DR (PDR) from nonproliferative DR (NPDR), and advanced-stage DR (severe NPDR and PDR) from early-stage DR (mild-moderate NPDR).Results  NPI and IRMA counts increased with wider scan protocols across DR severities, with higher NV detection in PDR on wider scans. NPI showed higher performance with 29 × 24 mm scans in discriminating PDR from NPDR (0.86; 95% confidence interval [CI] = 0.79-0.93) and advanced from early DR (0.92; 95% CI = 0.88-0.97) compared with smaller scan protocols. In 6 × 6 mm scans, the combined NPI and IRMA counts outperformed NPI for discriminating advanced from early DR (0.87; 95% CI = 0.81-0.94 vs. 0.81; 95% CI = 0.72-0.89) and PDR from NPDR (0.82; 95% CI = 0.74-0.91 vs. 0.73; 95% CI = 0.62-0.83).Conclusions  Wider scan protocols captured greater burden of nonperfusion and microvascular abnormalities. NPI serves as a robust standalone biomarker across protocols. When imaging is limited to smaller fields, combining NPI and IRMA counts improves staging performance.Translational relevance  OCTA scan protocol selection influences quantitative assessment of DR biomarkers and may guide imaging strategies for clinical staging.
SN  - 2164-2591
ER  -