Multimodal retinal imaging in the diagnosis of intraretinal microvascular abnormality

ABSTRACT

Introduction: Retinal imaging in diabetic retinopathy has experienced significant advances since the days of the Early Treatment for Diabetic Retinopathy Studies. Differentiating intraretinal microvascular abnormalities (IRMA) from neovascular complexes remain a challenging part of disease staging but may become easier in this age of multimodal imaging.

Areas covered: This review presents an overview of the available imaging modalities, their current applications and limitations as well as future developments in the pipeline. The implication of new imaging technology on the traditional definition of IRMAs and how this may translate into potential treatment outcomes for the patient will be discussed. This review is based on a literature search of all English language articles published on PubMed.

Expert commentary: The characterisation of IRMA has evolved with the development of OCT to identify morphological differences. Wide field imaging may also identify IRMA outside of standard field of view of conventional imaging. The use of advanced imaging techniques is likely to play a greater role in both disease staging and management of diabetic retinopathy in the future.

KEYWORDS:

• Diabetic retinopathy grading
• diabetic retinopathy
• retinal imaging
• retinal neovascularization
• intraretinal microvascular abnormalities
• stereoscopic photography
• optical coherence tomography
• optical coherence tomography angiography
• fluorescein leakage
• internal limiting membrane

Declaration of interest

A Tufail has participated on advisory boards for Heidelberg Engineering and Optovue. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Additional information

Funding

This research has received a proportion of its funding from the Department of Health’s NIHR Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital and UCL Institute of Ophthalmology. The views expressed in the publication are those of the authors and not necessarily those of the Department of Health.