142
D. Cabrera DeBuc et al.
of the early methods can be found in [84]. What follows is by no means an indepth review of diseases, methods and technological advancements in the diagnosis
of the retinal diseases outlined; rather, it is intended to provide a short review of
our research findings about OCT diagnostic capabilities for various retinal disorders
using quantitative analyses.
6.3.1 Diabetic Retinopathy
Diabetic retinopathy (DR) is a leading cause of adult vision loss world-wide that
offers a significant diagnostic challenge. DR has sporadic visual or ophthalmic warnings until visual loss develops [85]. It is now obvious that satisfactory screening
protocols can identify diabetic retinopathy at an earlier stage, when preventive steps
can be taken in time. Therefore, the effective management and prevention of eye
complications in diabetes requires the development of novel functional and structural techniques, therapeutic strategies as well as methods for immediate quantitative
results, and interpretation of clinical data. The current diabetic eye healthcare strategies only aim at a model of care for treating DR based on diagnosis rather than an
opportunity for preventative eye care and health promotion. Ophthalmoscopy, fundus photography, and fluorescein angiography are the standard tools to diagnose DR
and DME [86, 87]. However, a wide range of possible solutions, such as advanced
imaging devices like OCTs, eyewear innovations, groundbreaking eye care treatment,
functional tests, vision training, and mobile applications are demonstrating new ways
to promote better eye health and improve the general well-being of individuals with
diabetes.
Particularly, in DR assessments, OCT has been used to measure volume and total
thickness of the retina along with structural changes of the various cellular layers of
the retina with the aid of segmentation algorithms [84, 88]. In addition to reveal the
presence of exudate, photoreceptor atrophy, and haemorrhage; OCT facilitates the
visualization of fluid regions. The role of OCT in the assessment and management of
diabetic eye complications has become significant in understanding the vitreoretinal
relationships and the internal architecture of the retina in diabetes [88–93]. OCT has
improved DR and mostly DME management by enabling the direct evaluation of
retinal thickness and the quantitative follow-up of retinal thickness changes that may
greatly influence therapeutic decisions.
Several studies support the concept that early DR includes a neurodegenerative
component [90–104]. In 2009, thinning of the total retina in T1D patients with mild
non-proliferative diabetic retinopathy (MDR) relative to normal controls was found
to be a result of selective thinning of intraretinal layers [105]. This study team also
published results that demonstrated loss of visual function in the macula and related
thinning of the GCL in the pericentral area of the macula of diabetic individuals [21,
94].
Another study comparing eyes with MDR to diabetic eyes with no DR, found
a reduced RNFL thickness in the pericentral and peripheral macular regions, and
D. Cabrera DeBuc et al.
of the early methods can be found in [84]. What follows is by no means an indepth review of diseases, methods and technological advancements in the diagnosis
of the retinal diseases outlined; rather, it is intended to provide a short review of
our research findings about OCT diagnostic capabilities for various retinal disorders
using quantitative analyses.
6.3.1 Diabetic Retinopathy
Diabetic retinopathy (DR) is a leading cause of adult vision loss world-wide that
offers a significant diagnostic challenge. DR has sporadic visual or ophthalmic warnings until visual loss develops [85]. It is now obvious that satisfactory screening
protocols can identify diabetic retinopathy at an earlier stage, when preventive steps
can be taken in time. Therefore, the effective management and prevention of eye
complications in diabetes requires the development of novel functional and structural techniques, therapeutic strategies as well as methods for immediate quantitative
results, and interpretation of clinical data. The current diabetic eye healthcare strategies only aim at a model of care for treating DR based on diagnosis rather than an
opportunity for preventative eye care and health promotion. Ophthalmoscopy, fundus photography, and fluorescein angiography are the standard tools to diagnose DR
and DME [86, 87]. However, a wide range of possible solutions, such as advanced
imaging devices like OCTs, eyewear innovations, groundbreaking eye care treatment,
functional tests, vision training, and mobile applications are demonstrating new ways
to promote better eye health and improve the general well-being of individuals with
diabetes.
Particularly, in DR assessments, OCT has been used to measure volume and total
thickness of the retina along with structural changes of the various cellular layers of
the retina with the aid of segmentation algorithms [84, 88]. In addition to reveal the
presence of exudate, photoreceptor atrophy, and haemorrhage; OCT facilitates the
visualization of fluid regions. The role of OCT in the assessment and management of
diabetic eye complications has become significant in understanding the vitreoretinal
relationships and the internal architecture of the retina in diabetes [88–93]. OCT has
improved DR and mostly DME management by enabling the direct evaluation of
retinal thickness and the quantitative follow-up of retinal thickness changes that may
greatly influence therapeutic decisions.
Several studies support the concept that early DR includes a neurodegenerative
component [90–104]. In 2009, thinning of the total retina in T1D patients with mild
non-proliferative diabetic retinopathy (MDR) relative to normal controls was found
to be a result of selective thinning of intraretinal layers [105]. This study team also
published results that demonstrated loss of visual function in the macula and related
thinning of the GCL in the pericentral area of the macula of diabetic individuals [21,
94].
Another study comparing eyes with MDR to diabetic eyes with no DR, found
a reduced RNFL thickness in the pericentral and peripheral macular regions, and