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Optical Coherence Tomography Angiography (OCTA) as a New Diagnostic Tool in Ocular and Systemic Diseases—2nd Edition

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A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Optical Diagnostics".

Deadline for manuscript submissions: closed (31 October 2023) | Viewed by 11583

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Dr. Daniela Bacherini

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Department of Neurosciences, Psychology, Drug Research and Child Health Eye Clinic, University of Florence, AOU Careggi, 50139 Florence, Italy
Interests: retinal imaging; medical retina; OCT; OCT angiography
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Prof. Dr. Stanislao Rizzo

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1. Ophthalmology Unit, Catholic University of the Sacred Heart, Fondazione Policlinico Universitario A. Gemelli, 00168 Rome, Italy
2. Consiglio Nazionale delle Ricerche (CNR), 56124 Pisa, Italy
Interests: surgical retina
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Prof. Dr. Fabrizio Giansanti

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Department of Neurosciences, Psychology, Drug Research, and Child Health, Eye Clinic, University of Florence, AOU Careggi, 50139 Florence, Italy
Interests: surgical retina; medical retina
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

On behalf of the Diagnostics Editorial Team, I am delighted to present a Special Issue on the topic of Optical Coherence Tomography Angiography (OCTA) as a new diagnostic tool in clinical disease.

Currently we are assisting in an evolution and revolution of retinal diagnostic imaging. Optical Coherence Tomography Angiography (OCTA) is increasingly becoming a popular tool for retinal imaging in many retinal diseases, where it provides new and useful insights. It allows a rapid, non-invasive, and detailed evaluation of the retinal and choroidal vascular networks allowing the evaluation of the retina-choroidal flow layer by layer, with a separated evaluation of the different retinochoroidal plexi that may be involved individually or separately in various pathological diseases. OCTA can provide a qualitative and quantitative assessment of the retinal and choroidal microvascularization. There is growing interest in the potential role of OCTA in providing early diagnostic or prognostic biomarkers. This is why an increased interest in this new retinal imaging tool is also emerging in the field of systemic non-ocular pathologies.

This Special Issue aims to evaluate the use of OCTA as a new diagnostic tool in ocular and systemic pathologies in order to evaluate the possibility of obtaining new potential diagnostic biomarkers and to create a multidisciplinary integration between clinical medicine and the field of retinal imaging.

After all, the retina is a window on our central nervous system and vascularization; it would be interesting if we could also let our non-ophthalmologist colleagues look into this window.

The accepted papers will describe new applications in these areas. This Special Issue accepts high-quality articles containing original research results and case reports, as well as review articles.

Dr. Daniela Bacherini
Prof. Dr. Stanislao Rizzo
Prof. Dr. Fabrizio Giansanti
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

Optical Coherence Tomography Angiography
non-invasive retinal imaging
biomarkers

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Published Papers (10 papers)

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12 pages, 1091 KiB

Open AccessArticle

Quantitative Analysis of Retinal Perfusion in Patients with Frontotemporal Dementia Using Optical Coherence Tomography Angiography

by Eliane Luisa Esser, Larissa Lahme, Sebastian Dierse, Raphael Diener, Nicole Eter, Heinz Wiendl, Thomas Duning, Matthias Pawlowski, Julia Krämer and Maged Alnawaiseh

Diagnostics 2024, 14(2), 211; https://doi.org/10.3390/diagnostics14020211 - 18 Jan 2024

Viewed by 715

Abstract

Background: Optical coherence tomography angiography (OCT-A) provides detailed visualization of the perfusion of the vascular network of the eye. While in other forms of dementia, such as Alzheimer’s disease and mild cognitive impairment, reduced retinal perfusion was frequently reported, data of patients with frontotemporal dementia (FTD) are lacking. Objective: Retinal and optic nerve head perfusion was evaluated in patients with FTD with OCT-A. Quantitative OCT-A metrics were analyzed and correlated with clinical markers and vascular cerebral lesions in FTD patients. Methods: OCT-A was performed in 18 eyes of 18 patients with FTD and 18 eyes of 18 healthy participants using RTVue XR Avanti with AngioVue. In addition, patients underwent a detailed ophthalmological, neurological, and neuropsychological examination, cerebral magnetic resonance imaging (MRI), and lumbar puncture. Results: The flow density in the optic nerve head (ONH) and in the superficial capillary plexus (SCP) of the macula of patients was significantly lower compared to that of healthy controls (p < 0.001). Similarly, the VD in the deep capillary plexus (DCP) of the macula of patients was significantly lower compared to that of healthy controls (p < 0.001). There was no significant correlation between the flow density data, white matter lesions in brain MRI, cognitive deficits, and cerebrospinal fluid markers of dementia. Conclusions: Patients with FTD showed a reduced flow density in the ONH, and in the superficial and deep retinal capillary plexus of the macula, when compared with that of healthy controls. Quantitative analyses of retinal perfusion using OCT-A may therefore help in the diagnosis and monitoring of FTD. Larger and longitudinal studies are necessary to evaluate if OCT-A is a suitable biomarker for patients with FTD. Full article

(This article belongs to the Special Issue Optical Coherence Tomography Angiography (OCTA) as a New Diagnostic Tool in Ocular and Systemic Diseases—2nd Edition)

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10 pages, 1258 KiB

Open AccessArticle

Evaluation of Macular and Optic Disc Radial Peripapillary Vessel Density Using Optical Coherence Tomography Angiography in Gout Patients

by Özgür Eroğul, Adem Ertürk, Mustafa Doğan, Kudret Kurt and Murat Kaşıkcı

Diagnostics 2023, 13(24), 3651; https://doi.org/10.3390/diagnostics13243651 - 12 Dec 2023

Viewed by 750

Abstract

In this cross-sectional study, optical coherence tomography angiography (OCT-A) findings were compared in patients with gout (n = 30) and healthy participants (n = 32). The superficial and deep vessel density variables measured using OCT-A were compared between the groups. The superficial foveal and perifoveal vessel densities of the patient group were lower than those of the healthy participants (p = 0.014 and p = 0.045, respectively). However, all superficial and parafoveal vessel densities were similar in both groups (p = 0.469 and p = 0.284, respectively). The deep capillary plexus density measurements of the whole-zone, foveal, parafoveal, and perifoveal vessel densities using OCT-A revealed no significant differences between the groups (p = 0.251, p = 0.074, p = 0.177, and p = 0.881, respectively). A higher serum uric acid (SUA) level was found to be independently associated with a decreased superficial capillary plexus density and an increased choriocapillary flow deficit in the study population. Men were less sensitive to high SUA levels than women. These findings suggest that an elevated uric acid concentration may play a role in the development and progression of cardiovascular disease through changes in the microvasculature, as shown by the OCT-A parameters. Full article

(This article belongs to the Special Issue Optical Coherence Tomography Angiography (OCTA) as a New Diagnostic Tool in Ocular and Systemic Diseases—2nd Edition)

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10 pages, 983 KiB

Open AccessArticle

Assessment of Retinal Vessel Tortuosity Index in Patients with Fabry Disease Using Optical Coherence Tomography Angiography (OCTA)

by Kevin Hangartner, Anahita Bajka, Maximilian R. J. Wiest, Sophia Sidhu, Mario D. Toro, Peter M. Maloca and Sandrine A. Zweifel

Diagnostics 2023, 13(15), 2496; https://doi.org/10.3390/diagnostics13152496 - 27 Jul 2023

Viewed by 871

Abstract

Vessel tortuosity (VT) is a parameter used to assess retinal involvement in patients affected by systemic diseases such as Fabry disease (FD). In this study, we assessed a retinal VT index (VTI) using optical coherence tomography angiography (OCTA) in a group of patients with FD (FD cohort) compared to a healthy control group (HC cohort). This is a single-center, retrospective study analysis of all consecutive patients with genetically tested and confirmed FD who underwent regular ophthalmological visits from December 2017 to January 2020 at the Department of Ophthalmology at the University Hospital of Zurich, Switzerland. VTI was calculated for each OCTA image and the results were compared between FD and HC cohort. A total of 56 participants, 32 (male:female ratio 12:20) in the FD cohort and 24 (male:female ratio 13:11) in the HC cohort. Classic onset was determined in 18 patients. Overall, mean VTI (±SD) was 0.21 (±0.07). Male patients with classic-onset FD had a significantly higher mean VTI (0.33, SD ± 0.35) compared to all other subgroups (p-value < 0.05). Further investigations of retinal VTI in patients with FD could be helpful to use OCTA as a noninvasive screening and follow-up modality to assess disease progression in affected patients. Full article

(This article belongs to the Special Issue Optical Coherence Tomography Angiography (OCTA) as a New Diagnostic Tool in Ocular and Systemic Diseases—2nd Edition)

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14 pages, 3532 KiB

Open AccessArticle

Analysis of Optical Coherence Tomography (OCT) and Optical Coherence Tomography Angiography (OCTA) Parameters in Young Adults after SARS-CoV-2 Infection (COVID-19) Compared with Healthy Young Controls

by Anahita Bajka, Daniel Rudolf Muth, Maximilian Robert Justus Wiest, Sadiq Said, Magdalena Rejdak, Sophia Sidhu, Nastasia Foa, Frank Blaser, Daniel Barthelmes, Mario Damiano Toro, Eric H. Souied, Jeremy Werner Deuel, Patricia Schlagenhauf and Sandrine Anne Zweifel

Diagnostics 2023, 13(7), 1283; https://doi.org/10.3390/diagnostics13071283 - 28 Mar 2023

Cited by 1 | Viewed by 1733

Abstract

Purpose: To compare retinal changes in young adults with previous SARS-CoV-2 infection with healthy young controls using optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA). Methods: This prospective single-center study was conducted at the University Hospital of Zurich, Zurich, Switzerland. Participants were imaged from May to November 2021 using the SOLIX device (Visionix International SAS, Pont-de-l’Arche, France). We performed 12 mm × 12 mm, 6.4 mm × 6.4 mm, 6 mm × 6 mm and 3 mm × 3 mm OCT and OCTA scans, as well as fundus photography of each participant’s eyes. Results: In total, 466 participants were imaged. Of these, 233 were healthy controls with negative RT-PCR tests for SARS-CoV-2, 168 were young adults who had a SARS-CoV-2 infection at least 180 days previously, 19 were participants who had a SARS-CoV-2 infection < 180 days previously, and 46 were participants with asymptomatic SARS-CoV-2 infection (i.e., serologically positive but with no symptoms). Compared with healthy controls, statistically significant differences were found for OCTA recordings of the optic disc for the whole image (WI) and WI capillary vessel density, with both being higher in the SARS-CoV-2 group. Conclusion: Statistically significant results were only observed for selected variables, and in parts, only unilaterally, with relatively large p values (p = 0.02–0.03). Thus, we did not interpret these as clinically significant, leading to the conclusion that young and otherwise healthy individuals (mainly men) seem to recover from mild COVID-19 infections with no ophthalmological residues. Full article

(This article belongs to the Special Issue Optical Coherence Tomography Angiography (OCTA) as a New Diagnostic Tool in Ocular and Systemic Diseases—2nd Edition)

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11 pages, 777 KiB

Open AccessArticle

Relationship of Vessel Density to Vessel Length Density in Patients with Treated Fabry Disease

by Maximilian Robert Justus Wiest, Mario Damiano Toro, Albina Nowak, Anahita Bajka, Katrin Fasler, Mayss Al-Sheikh, Timothy Hamann and Sandrine Anne Zweifel

Diagnostics 2023, 13(7), 1227; https://doi.org/10.3390/diagnostics13071227 - 24 Mar 2023

Cited by 1 | Viewed by 948

Abstract

Background: Fabry disease (FD) is a potentially lethal lysosomal disorder with systemic vascular changes. Previous studies demonstrated retinal vascular involvement using optical coherence tomography angiography (OCTA) in affected patients; Aim: To analyze and quantify the retinal vasculature measuring vessel density (VD), vessel length density (VLD), and the ratio of VD to VLD (VD/VLD) in superficial capillary plexuses (SCP) and deep capillary plexuses (DCP) using OCTA in patients with FD and to show whether they differ from healthy controls (HC); Patients and methods: Single-center, retrospective, consecutive cohort study of patients with genetically proven FD. Patients underwent an ophthalmological examination including OCTA. VD, VLD, foveal avascular zone (FAZ), and the VD/VLD were compared to an HC group using a linear mixed model; Results: A statistically significant difference in the VLD and VD/VLD of DCP was observed between the two groups (p < 0.001). Using ROC curves with AUC and Youden’s Index, a cut-off value for differentiating both groups using VD/VLD in DCP FD with high specificity and high sensitivity was established; Conclusions: FD and HC groups seem to be separable using the VD/VLD ratio in DCP. This new biomarker might differentiate changes in the retinal microvasculature that are not detectable by VD or VLD alone. Full article

(This article belongs to the Special Issue Optical Coherence Tomography Angiography (OCTA) as a New Diagnostic Tool in Ocular and Systemic Diseases—2nd Edition)

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11 pages, 24675 KiB

Open AccessArticle

Microvascular Changes after Scleral Buckling for Rhegmatogenous Retinal Detachment: An Optical Coherence Tomography Angiography Study

by Matteo Fallico, Antonio Longo, Teresio Avitabile, Pietro Alosi, Marco Grillo, Niccolò Castellino, Vincenza Bonfiglio, Michele Reibaldi, Francesco Pignatelli and Andrea Russo

Diagnostics 2022, 12(12), 3015; https://doi.org/10.3390/diagnostics12123015 - 01 Dec 2022

Cited by 1 | Viewed by 956

Abstract

This retrospective study aimed to investigate macular microvascular alterations after successful scleral buckling (SB) for rhegmatogenous retinal detachment (RRD). Nineteen eyes with macula-on RRD and 18 eyes with macula-off RRD were included. In all cases, an encircling band was placed. Optical coherence tomography angiography (OCTA) was performed at baseline and postoperatively. Changes in the foveal avascular zone (FAZ) area and vessel density (VD) of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) were the primary outcomes. Correlations between OCTA findings and clinical variables were considered secondary outcomes. In both the macula-on and macula-off groups, the FAZ area was comparable with controls. In the macula-on group, VD in the whole SCP was lower compared with controls at both baseline (p < 0.001) and 6 months (p = 0.03), but showed a significant increase after surgery (p = 0.004). In the macula-off group, postoperative VD in both whole SCP and whole DCP was lower compared with controls (p < 0.001). In the macula-on group, there was an inverse correlation between axial length increase and SCP VD change (r = −0.508; p = 0.03). These findings demonstrated microvascular alterations after SB for RRD. However, VD impairment seems to be mitigated after surgery. A greater increase in postoperative axial length was associated with a poorer VD outcome. Full article

(This article belongs to the Special Issue Optical Coherence Tomography Angiography (OCTA) as a New Diagnostic Tool in Ocular and Systemic Diseases—2nd Edition)

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9 pages, 6419 KiB

Open AccessArticle

Scanning Laser Ophthalmoscopy Retromode Imaging Compared to Fundus Autofluorescence in Detecting Outer Retinal Features in Central Serous Chorioretinopathy

by Fabrizio Giansanti, Stefano Mercuri, Federica Serino, Tomaso Caporossi, Alfonso Savastano, Clara Rizzo, Francesco Faraldi, Stanislao Rizzo and Daniela Bacherini

Diagnostics 2022, 12(11), 2638; https://doi.org/10.3390/diagnostics12112638 - 31 Oct 2022

Cited by 9 | Viewed by 1294

Abstract

Central serous chorioretinopathy (CSCR) is a retinal disease characterized by a heterogeneous clinical phenotype, depending on the influence of different factors in its pathogenesis, including the presence of subretinal fluid (SRF), trophism of the retinal pigmented epithelium (RPE) and choroidal hyper-permeability. Our study has the purpose of assessing the ability of scanning laser ophthalmoscopy (SLO) retromode imaging, compared to fundus autofluorescence (FAF), to identify outer retinal features in a cohort of patients with a diagnosis of CSCR. A total of 27 eyes of 21 patients were enrolled in our study. All patients underwent full ophthalmological examination, including fundus retinography, fundus fluorescein angiography, optical coherence tomography (OCT), FAF and SLO retromode imaging. For each patient, the following features were evaluated: SRF, the presence of pigmented epithelium detachment (PED), RPE dystrophy, and RPE atrophy. RPE dystrophy was further characterized according to the appearance in FAF of iso-, hyper- and hypo-autofluorescent dystrophy. The ability to identify each feature was evaluated for FAF and SLO retromode alone, compared to a multimodal imaging approach. FAF identified SRF in 11/14 eyes (78%), PED in 14/19 (74%), RPE dystrophy with iso-autofluorescence in 0/13 (0%), hyper-autofluorescence in 18/19 (95%), hypo-autofluorescence in 20/20 (100%), and RPE atrophy in 7/7 (100%). SLO retromode imaging identified SRF in 13/14 eyes (93%), PED in 15/19 (79%), RPE dystrophy with iso-autofluorescence in 13/13 (100%), hyper-autofluorescence in 13/19 (68%), hypo-autofluorescent in 18/20 (90%), and RPE atrophy in 4/7 (57%). SLO retromode imaging is able to detect retinal and RPE changes in CSCR patients with a higher sensitivity than FAF, while it is not able to identify the depth of lesions or supply qualitative information about RPE cells’ health status, meaning that it is less specific. SLO retromode imaging may have a promising role in the assessment of patients with CSCR, but always combined with other imaging modalities such as OCT and FAF. Full article

(This article belongs to the Special Issue Optical Coherence Tomography Angiography (OCTA) as a New Diagnostic Tool in Ocular and Systemic Diseases—2nd Edition)

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9 pages, 3074 KiB

Open AccessArticle

Optical Coherence Tomography Angiography for the Evaluation of Retinal and Choroidal Vasculature in Retinitis Pigmentosa: A Monocentric Experience

by Fabrizio Giansanti, Giulio Vicini, Andrea Sodi, Cristina Nicolosi, Lavinia Bellari, Gianni Virgili, Stanislao Rizzo and Daniela Bacherini

Diagnostics 2022, 12(5), 1020; https://doi.org/10.3390/diagnostics12051020 - 19 Apr 2022

Cited by 2 | Viewed by 1516

Abstract

Purpose: We investigated the chorioretinal microvascular changes in patients with retinitis pigmentosa (RP) by optical coherence tomography angiography (OCTA). Methods: Twenty-six patients (52 eyes) affected by RP were compared with 19 healthy controls (38 eyes). OCTA 3 mm × 3 mm macular scans were performed in all subjects. We evaluated the vessel density (VD) of the superficial capillary plexus (VD SCP), deep capillary plexus (VD DCP), choriocapillaris (VD CC), and choroid (VD choroid). We also evaluated the foveal avascular zone (FAZ) area, and the correlation between clinical and OCTA parameters. We also measured central retinal thickness (CRT) and subfoveal choroidal thickness (CT). Results: RP patients compared to healthy controls showed significantly lower VD SCP values (27.56% ± 15.37 vs. 49.39% ± 1.55; p-value < 0.0001), lower VD DCP values (38.43% ± 15.23 vs. 3.34% ± 0.26; p-value < 0.0001), lower VD CC values (46.02% ± 1.293 vs. 50.63% ± 0.4274; p-value = 0.0040), and lower VD choroid values (38.48% ± 15.23 vs. 3.34% ± 0.26; p-value < 0.0001). Even the FAZ area was significantly lower in RP patients (0.45 mm² ± 0.35 vs. 0.26 mm² ± 0.13; p-value < 0.0001). The FAZ area was larger with increasing age, both in control (r = 0.42; p = 0.012) and RP group (r = 0.46; p-value = 0.009). In RP patients, there was a statistically significant correlation between best-corrected visual acuity and VD SCP (r = 0.24, p-value = 0.04) and VD DCP (r = 0.52; p-value = 0.0004) and between subfoveal choroidal thickness and VD SCP (r = 0.43, p-value < 0.001) and VD DCP (r = 0.35, p-value < 0.001). Conclusions: In our study, OCTA reported relevant vascular alterations in RP patients in comparison with the healthy controls, in agreement with the published literature. These abnormalities were associated with choroidal atrophy and related to visual acuity loss. OCTA provided clinically significant information and may represent a reliable tool for the management of RP patients. Full article

(This article belongs to the Special Issue Optical Coherence Tomography Angiography (OCTA) as a New Diagnostic Tool in Ocular and Systemic Diseases—2nd Edition)

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Review

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24 pages, 16654 KiB

Open AccessReview

Optical Coherence Tomography Angiography as a Diagnostic Tool for Diabetic Retinopathy

by Naomi Wijesingha, Wei-Shan Tsai, Ayse Merve Keskin, Christopher Holmes, Dimitrios Kazantzis, Swati Chandak, Heena Kubravi and Sobha Sivaprasad

Diagnostics 2024, 14(3), 326; https://doi.org/10.3390/diagnostics14030326 - 02 Feb 2024

Viewed by 971

Abstract

Diabetic retinopathy (DR) is the most common microvascular complication of diabetes mellitus, leading to visual impairment if left untreated. This review discusses the use of optical coherence tomography angiography (OCTA) as a diagnostic tool for the early detection and management of DR. OCTA is a fast, non-invasive, non-contact test that enables the detailed visualisation of the macular microvasculature in different plexuses. OCTA offers several advantages over fundus fluorescein angiography (FFA), notably offering quantitative data. OCTA is not without limitations, including the requirement for careful interpretation of artefacts and the limited region of interest that can be captured currently. We explore how OCTA has been instrumental in detecting early microvascular changes that precede clinical signs of DR. We also discuss the application of OCTA in the diagnosis and management of various stages of DR, including non-proliferative diabetic retinopathy (NPDR), proliferative diabetic retinopathy (PDR), diabetic macular oedema (DMO), diabetic macular ischaemia (DMI), and pre-diabetes. Finally, we discuss the future role of OCTA and how it may be used to enhance the clinical outcomes of DR. Full article

(This article belongs to the Special Issue Optical Coherence Tomography Angiography (OCTA) as a New Diagnostic Tool in Ocular and Systemic Diseases—2nd Edition)

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Other

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8 pages, 2255 KiB

Open AccessCase Report

Retinal Microvascular Alterations in a Patient with Type 1 Diabetes Mellitus, Hemoglobin D Hemoglobinopathy, and High Myopia—Case Report and Review of the Literature

by Alexandra Oltea Dan, Andrei Theodor Bălășoiu, Ileana Puiu, Andreea Cornelia Tănasie, Anca Elena Târtea and Veronica Sfredel

Diagnostics 2023, 13(18), 2934; https://doi.org/10.3390/diagnostics13182934 - 13 Sep 2023

Cited by 1 | Viewed by 765

Abstract

Type 1 diabetes mellitus (type 1 DM) is one of the most prevalent endocrinological diseases among children and young adults, with a growing incidence rate reaching up to 2.9 new cases per year per 100,000 persons below 15 years of age. We report a rare case of a 20-year-old female patient with type 1 DM, hemoglobin D (HbD) heterozygote variant and high myopia of −10.00 spheric diopters, and describe the retinal microvascular alterations visible on OCT angiography (angio-OCT). The patient also presented with a severe stature deficit (less than three standard deviations) and delayed puberty, which could not be explained only by suboptimal glycemic control and indicated possible hypopituitarism. HbA1c level evaluated with the high-performance liquid chromatography (HPLC) method was 6.5%, a falsely low value due to HbD hemoglobinopathy. On ophthalmic evaluation, the angio-OCT scan showed the following retinal microvascular alterations in the right eye (RE): the FAZ (Foveal Avascular Zone) area was 0.39 mm², the FAZ perimeter was 2.88 mm, and the circularity index was 0.58. The following alterations were shown in the left eye (LE): the FAZ area was 0.34 mm², the FAZ perimeter was 3.21 mm, and the circularity index was 0.41. Clinicians should consider high-performance retinal screening methods such as angio-OCT evaluation for young type 1 DM patients, especially for those with associated pathologies like high myopia and hemoglobinopathies. Moreover, multiple evaluation methods of HbA1c values are mandatory as hemoglobinopathies can interfere with the accuracy of HbA1c assay methods. Full article

(This article belongs to the Special Issue Optical Coherence Tomography Angiography (OCTA) as a New Diagnostic Tool in Ocular and Systemic Diseases—2nd Edition)

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