Wenying Fan1,2,3, Akihito Uji2,3, Charles C Wykoff4,5, David M Brown4,5, Jano van Hemert6, Khalil Ghasemi Falavarjani2,3, Kang Wang2,3, SriniVas R Sadda2,3, Michael Ip7,8. 1. Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology and Visual Sciences Key Laboratory, Capital Medical University, Beijing, China. 2. Doheny Image Reading Center, Doheny Eye Institute, Los Angeles, CA, USA. 3. Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA. 4. Retina Consultants of Houston, Houston, TX, USA. 5. Blanton Eye Institute, Houston Methodist Hospital & Weill Cornell Medical College, Houston, TX, USA. 6. Optos PLC, Dunfermline, UK. 7. Doheny Image Reading Center, Doheny Eye Institute, Los Angeles, CA, USA. ipmike333@gmail.com. 8. Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA. ipmike333@gmail.com.
Abstract
PURPOSE: To determine the relationship between baseline retinal non-perfusion area (NPA) and retinal vascular bed area (RVBA) on ultra-wide field fluorescein angiography (UWF FA) and long-term response to intravitreal ranibizumab therapy in diabetic macular oedema (DMO). METHODS: A post-hoc, 2-year observational case series. Baseline UWF FA images (Optos 200Tx) of 40 eyes from 29 patients with diabetes mellitus and treatment naïve DMO in the DAVE (NCT01552408) study were montaged and stereographically projected at the Doheny Image Reading Center to adjust for peripheral distortion. The retinal vasculature was automatically extracted to calculate RVBA. NPA was manually delineated by two masked certified graders. RVBA and NPA were computed in mm2 automatically by adjusting for peripheral distortion and then correlated with the severity of DMO. RESULTS: While global NPA at baseline was not correlated to retinal thickness measurements, baseline NPA in the superior retina was associated with the macular volume (MV) improvement (P = 0.022). Multivariate analysis revealed a smaller RVBA at baseline was correlated with a better MV outcome at two-year follow-up after adjusting for confounding factors (P = 0.049). CONCLUSION: Eyes with smaller baseline RVBA appear to have a better long-term anatomic outcome of DMO.
PURPOSE: To determine the relationship between baseline retinal non-perfusion area (NPA) and retinal vascular bed area (RVBA) on ultra-wide field fluorescein angiography (UWF FA) and long-term response to intravitreal ranibizumab therapy in diabetic macular oedema (DMO). METHODS: A post-hoc, 2-year observational case series. Baseline UWF FA images (Optos 200Tx) of 40 eyes from 29 patients with diabetes mellitus and treatment naïve DMO in the DAVE (NCT01552408) study were montaged and stereographically projected at the Doheny Image Reading Center to adjust for peripheral distortion. The retinal vasculature was automatically extracted to calculate RVBA. NPA was manually delineated by two masked certified graders. RVBA and NPA were computed in mm2 automatically by adjusting for peripheral distortion and then correlated with the severity of DMO. RESULTS: While global NPA at baseline was not correlated to retinal thickness measurements, baseline NPA in the superior retina was associated with the macular volume (MV) improvement (P = 0.022). Multivariate analysis revealed a smaller RVBA at baseline was correlated with a better MV outcome at two-year follow-up after adjusting for confounding factors (P = 0.049). CONCLUSION: Eyes with smaller baseline RVBA appear to have a better long-term anatomic outcome of DMO.
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