Visualization of microaneurysms using optical coherence tomography angiography: comparison of OCTA en face, OCT B-scan, OCT en face, FA, and IA images

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). Prospective, clinical, and experimental. 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. 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). 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.