Advances in Optical Coherence Tomography for the Early Detection and Management of Diabetic Retinopathy

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@article{1722175,
      author = {Muhammad Qasim},
      title = {Advances in Optical Coherence Tomography for the Early Detection and Management of Diabetic Retinopathy},
      journal = {Iconic Research And Engineering Journals},
      year = {2026},
      volume = {10},
      number = {2},
      pages = {539-550},
      issn = {2456-8880},
      url = {https://www.irejournals.com/formatedpaper/1722175.pdf},
      abstract = {Diabetic retinopathy is now recognized as a neurovascular disorder characterized by neuronal dysfunction, capillary injury, inflammation, and barrier failure that precede the detection of sight-threatening disease by conventional ophthalmoscopy. Optical coherence tomography (OCT) has progressed beyond central retinal thickness measurement to serve as a multimodal platform for structural, angiographic, and computational phenotyping. This review thoroughly examines advances from 2020 to 2025 in spectral-domain OCT, swept-source OCT, OCT angiography (OCTA), wide-field acquisition, quantitative biomarker extraction, and artificial intelligence to enable early detection and longitudinal management of diabetic retinopathy. A structured narrative search of PubMed-indexed literature was carried out using combinations of diabetic retinopathy, diabetic macular edema, optical coherence tomography, OCT angiography, swept-source, biomarkers, nonperfusion, and deep learning. Human studies, systematic reviews, and clinically relevant validation studies were prioritized. Current evidence demonstrates that deep capillary plexus vessel loss, geometric perfusion deficits, foveal avascular zone remodeling, retinal thinning, disorganization of retinal inner layers, hyperreflective foci, ellipsoid-zone disruption, and vitreomacular interface abnormalities provide complementary diagnostic information. Wide-field swept-source OCTA enhances visualization of peripheral nonperfusion and neovascular complexes, while three-dimensional analysis and artificial intelligence lessen reliance on manually selected en face slabs. However, device-specific algorithms, segmentation errors, motion and projection artifacts, media opacity, and inconsistent outcome definitions limit cross-platform interchangeability. The most robust clinical approach is an integrated OCT framework that synthesizes structural wholeness, fluid phenotype, perfusion distribution, and temporal change. Standardized acquisition protocols, transparent algorithms, external validation, and prospectively defined outcome-linked thresholds are necessary before OCT-derived metrics can independently guide screening intervals or treatment decisions.},
      keywords = {Diabetic Retinopathy, Optical Coherence Tomography, OCT Angiography, Swept-Source OCT, Diabetic Macular Edema, Biomarkers, Artificial Intelligence},
      month = {August},
      doi = {https://doi.org/10.64388/IREV10I2-1722175}
  }