Dawn A Sim1, Pearse A Keane2, Ranjan Rajendram2, Michael Karampelas3, Senthil Selvam4, Michael B Powner4, Marcus Fruttiger4, Adnan Tufail2, Catherine A Egan3. 1. National Institute for Health Research, Moorfields Biomedical Research Centre, Moorfields Eye Hospital, London, United Kingdom; University College London, Institute of Ophthalmology, London, United Kingdom. Electronic address: dawnasim@gmail.com. 2. National Institute for Health Research, Moorfields Biomedical Research Centre, Moorfields Eye Hospital, London, United Kingdom; University College London, Institute of Ophthalmology, London, United Kingdom. 3. National Institute for Health Research, Moorfields Biomedical Research Centre, Moorfields Eye Hospital, London, United Kingdom. 4. University College London, Institute of Ophthalmology, London, United Kingdom.
Abstract
PURPOSE: To investigate the association between peripheral and central ischemia in diabetic retinopathy. DESIGN: Retrospective, cross-sectional. METHODS: Consecutive ultra-widefield fluorescein angiography images were collected from patients with diabetes over a 12-month period. Parameters quantified include the foveal avascular zone (FAZ) area, peripheral ischemic index, peripheral leakage index, and central retinal thickness measurements, as well as visual acuity. The peripheral ischemia or leakage index was calculated as the area of capillary nonperfusion or leakage, expressed as a percentage of the total retinal area. RESULTS: Forty-seven eyes of 47 patients were included. A moderate correlation was observed between the peripheral ischemia index and FAZ area (r = 0.49, P = .0001). A moderate correlation was also observed between the peripheral leakage index and FAZ area, but only in eyes that were laser naïve (r = 0.44, P = .02). A thinner retina was observed in eyes with macular ischemia (217 ± 81.8 μm vs 272 ± 36.0 μm) (P = .02), but not peripheral ischemia (258 ± 76.3 μm vs 276 ± 68.0 μm) (P = .24). The relationships between different patterns of peripheral and central macular pathology and visual acuity were evaluated in a step-wise multivariable regression model, and the variables that remained independently associated were age (r = 0.33, P = .03), FAZ area (r = 0.45, P = .02), and central retinal thickness (r = 0.38, P = .01), (R(2)-adjusted = 0.36). CONCLUSIONS: Ultra-widefield fluorescein angiography provides an insight into the relationships between diabetic vascular complications in the retinal periphery and central macula. Although we observed relationships between ischemia and vascular leakage in the macula and periphery, it was only macular ischemia and retinal thinning that was independently associated with a reduced visual function.
PURPOSE: To investigate the association between peripheral and central ischemia in diabetic retinopathy. DESIGN: Retrospective, cross-sectional. METHODS: Consecutive ultra-widefield fluorescein angiography images were collected from patients with diabetes over a 12-month period. Parameters quantified include the foveal avascular zone (FAZ) area, peripheral ischemic index, peripheral leakage index, and central retinal thickness measurements, as well as visual acuity. The peripheral ischemia or leakage index was calculated as the area of capillary nonperfusion or leakage, expressed as a percentage of the total retinal area. RESULTS: Forty-seven eyes of 47 patients were included. A moderate correlation was observed between the peripheral ischemia index and FAZ area (r = 0.49, P = .0001). A moderate correlation was also observed between the peripheral leakage index and FAZ area, but only in eyes that were laser naïve (r = 0.44, P = .02). A thinner retina was observed in eyes with macular ischemia (217 ± 81.8 μm vs 272 ± 36.0 μm) (P = .02), but not peripheral ischemia (258 ± 76.3 μm vs 276 ± 68.0 μm) (P = .24). The relationships between different patterns of peripheral and central macular pathology and visual acuity were evaluated in a step-wise multivariable regression model, and the variables that remained independently associated were age (r = 0.33, P = .03), FAZ area (r = 0.45, P = .02), and central retinal thickness (r = 0.38, P = .01), (R(2)-adjusted = 0.36). CONCLUSIONS: Ultra-widefield fluorescein angiography provides an insight into the relationships between diabetic vascular complications in the retinal periphery and central macula. Although we observed relationships between ischemia and vascular leakage in the macula and periphery, it was only macular ischemia and retinal thinning that was independently associated with a reduced visual function.
Authors: Alice C Jiang; Sunil K Srivastava; Ming Hu; Natalia Figueiredo; Amy Babiuch; Joseph D Boss; Jamie L Reese; Justis P Ehlers Journal: Ophthalmol Retina Date: 2019-08-28
Authors: Malvika Arya; Ramy Rashad; Osama Sorour; Eric M Moult; James G Fujimoto; Nadia K Waheed Journal: Expert Rev Med Devices Date: 2018-11-22 Impact factor: 3.166
Authors: Paolo S Silva; Dennis M Marcus; Danni Liu; Lloyd Paul Aiello; Andrew Antoszyk; Michael Elman; Scott Friedman; Adam R Glassman; Joseph M Googe; Lee Merrill Jampol; Daniel F Martin; Michele Melia; Carin M Preston; Charles C Wykoff; Jennifer K Sun Journal: JAMA Ophthalmol Date: 2022-10-01 Impact factor: 8.253
Authors: Tyson N Kim; Michael T Aaberg; Patrick Li; Jose R Davila; Malavika Bhaskaranand; Sandeep Bhat; Chaithanya Ramachandra; Kaushal Solanki; Frankie Myers; Clay Reber; Rohan Jalalizadeh; Todd P Margolis; Daniel Fletcher; Yannis M Paulus Journal: Eye (Lond) Date: 2020-04-27 Impact factor: 3.775