Diabetic retinopathy, damage to the small blood vessels of the retina, usually causes no symptoms until it is advanced. Standard screening relies on a dilated exam or retinal photographs, which find the disease once visible changes such as tiny bulges or bleeding have appeared. A newer scan, OCT angiography (OCTA), maps blood flow in the retina without any dye injection. A review reported by Ophthalmology Times asked whether OCTA can spot trouble earlier.
What the review included
Loukia A. Politi and colleagues at Aristotle University of Thessaloniki in Greece reviewed 21 studies covering 3,348 eyes: 1,014 healthy eyes and 2,115 eyes of people with diabetes who had no retinopathy or only early retinopathy. The studies were too different to combine statistically, so the authors summarized them. The review was published in the European Journal of Ophthalmology.
What they found
- Reduced vessel density was the most consistent early sign, seen in 13 of 15 studies, and it tended to worsen as disease advanced.
- Enlargement of the small vessel-free zone at the center of the retina was reported in 9 of 17 studies, with inconsistent links to progression.
- Only three studies measured diagnostic accuracy, with sensitivity from 66.7% to 93.6% and specificity from 70.9% to 91.7%.
Why it is not ready for routine screening
The authors concluded the evidence is not yet sufficient for everyday clinical use. Different machines, scan sizes, and software produced different measurements, and there are no agreed normal ranges. Most studies looked at one point in time, so it is not clear whether early OCTA changes predict who will go on to vision-threatening disease.
What this means for people with diabetes
- The proven approach remains regular dilated exams or retinal photography on the schedule your eye doctor recommends.
- A normal-looking retina is good news, but it is not a reason to skip next year’s exam.
- Controlling blood sugar, blood pressure, and cholesterol lowers the risk of retinopathy getting worse.
If retinopathy is found, care is provided by retina specialists. For more plain-language reading on eye health, see oakparklasik.com.
Source: OCTA detects early diabetic retinopathy, but not yet screening-ready (Ophthalmology Times, 08/28/2026). This article is an educational summary written by Khanna Vision Institute and is not a substitute for medical advice.